Compare the top private health insurance providers in Australia — see cover, features and typical rates side by side.
What is private health insurance in Australia?
Private health insurance sits alongside Australia's public Medicare system, giving you cover for treatment as a private patient. It comes in two main types: hospital cover, which pays toward private hospital treatment and lets you choose your doctor and avoid public waiting lists, and extras (or ancillary) cover, which helps with dental, optical, physiotherapy and other services Medicare does not fund. Many people take a combined policy that bundles both together.
How the Australian market works
Medicare provides universal public healthcare, so private cover is optional but actively encouraged through tax settings. Hospital policies are sold in standardised Basic, Bronze, Silver and Gold tiers, a system that makes comparison easier by defining the minimum clinical categories each tier must cover, such as pregnancy on Gold. Funds cannot refuse you or charge more because of pre-existing conditions under community rating, though waiting periods apply before you can claim for certain treatments.
Benefits of private cover
Choice and shorter waits — Hospital cover lets you choose your specialist and private hospital and avoid public elective-surgery queues, which can be long for non-urgent procedures.
Extras for everyday health — Extras cover offsets the cost of dental, optical, physio and similar services that Medicare does not fund at all.
Tax advantages — Appropriate hospital cover can exempt higher earners from the Medicare Levy Surcharge and attract an income-tested premium rebate.
How to choose a policy
Decide whether you need hospital cover, extras or both, then match the hospital tier to your life stage — for example, Gold-level cover is required for pregnancy and birth. Compare excess levels, which reduce premiums in exchange for a payment at admission, against the out-of-pocket cost at claim time. Check waiting periods, whether your preferred hospitals are agreement hospitals, and any gap-cover arrangements that limit what specialists can charge you.
Leading providers in Australia
The comparison features Medibank, Bupa Australia, HCF, nib, Australian Unity, CBHS Health Fund, Defence Health and Phoenix Health Fund. Medibank and Bupa are the two largest funds, HCF is a large not-for-profit and nib is a major listed insurer, while several restricted funds such as Defence Health and CBHS serve specific communities. Choice comes down to the tier, extras, excess and hospital agreements that best suit your needs and budget.
What it costs
Premiums vary by state, age, cover tier, excess and whether you take hospital, extras or combined cover, so no single price applies across the market. Two settings shift the net cost: the income-tested private health insurance rebate reduces your premium, while choosing a higher excess lowers it further. Buying hospital cover before age 31 helps you avoid the Lifetime Health Cover loading that increases premiums for later starters. Premiums also typically rise each year, usually from 1 April, so reviewing your policy annually and switching funds if better value emerges can keep costs in check without losing your waiting-period credits.
Protections and regulation
Private health insurers are regulated by APRA, and the Private Health Insurance Ombudsman handles complaints. Community rating means funds cannot discriminate on health status or age at entry. The Medicare Levy Surcharge, from 1% to 1.5%, applies to higher earners without adequate hospital cover — for 2025-26 the singles income threshold is A
01,000 and the family threshold A$202,000, above which the surcharge adds to the standard 2% Medicare Levy.
Common questions
Do I need it if I have Medicare? — Medicare covers public treatment, but private hospital cover offers choice and shorter waits and can save higher earners the Medicare Levy Surcharge.
What is Lifetime Health Cover loading? — If you first take hospital cover after age 31, a 2% loading applies for each year you delayed, up to a cap, so taking cover earlier keeps premiums lower.
Private Health Insurance in Australia — FAQ
How much does private health insurance cost in Australia?
Giraffy tracks 5 private health insurance products across Medibank,Bupa Australia,HCF,nib,Australian Unity insurers in Australia. Premiums depend heavily on age, health status, level of cover, and excess chosen. In Australia, private health insurance works alongside Medicare — it covers private hospital rooms and some gap payments. The Medicare Levy Surcharge applies to higher earners without private cover.
What does private health insurance typically cover?
Core cover usually includes: inpatient hospital treatment (surgery, overnight stays), specialist consultations, diagnostic tests, and sometimes cancer care. Many policies exclude mental health, dental, and optical as standard — these can be added as upgrades. Always check the specific policy schedule for exclusions.
What is excluded from most private health insurance policies?
Common exclusions include: pre-existing conditions (at least at first), chronic long-term conditions, cosmetic surgery, fertility treatment, organ transplants (often), and treatments abroad. Exclusions vary significantly between insurers — compare the policy wordings, not just the headline price.
What is an excess on a health insurance policy?
The excess (or deductible) is the amount you pay towards each claim before the insurer covers the rest. A higher excess lowers your monthly premium. Set your excess at an amount you could comfortably afford to pay in a year — this balances premium savings against out-of-pocket cost if you need to claim.
Can I get private health insurance with a pre-existing condition?
Yes, but most insurers will exclude your pre-existing condition from the policy, or apply a 'moratorium' — where the condition is excluded until you've been symptom-free for 2+ years. 'Full medical underwriting' lets you know at outset exactly what's excluded, giving more certainty than a moratorium.
Does private health insurance cover mental health treatment?
Mental health cover is increasingly included in standard policies, but terms vary significantly. Check whether inpatient psychiatric care, therapy sessions, and psychiatric medication are covered, and whether annual session limits apply. Some insurers offer digital mental health support as a standard perk.