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Health Insurance Comparison in Australia

Health Insurance Comparison in Australia

Health insurance comparison means checking premiums, inclusions, and excess levels across different funds before you commit. You need two things to start, your cover type and your postcode. costs nothing and carries no obligation, so you can see how your private health insuComparing rance stacks up today.

Why compare health insurance in Australia?

Written by Clint Robinson, GoSwitch CEO

Published 10 August 202613 mins read

Comparing tells you whether you are still paying a fair price for cover that still fits. Premiums rise each year while your health needs change, so a policy chosen years ago rarely matches your situation now.

Premiums rise on 1 April. Health funds lift their prices once a year, so what you pay goes up even when nothing about your policy changes.
Funds set their own premiums. Two funds can charge different amounts for cover that includes the same treatments, and that difference only shows up side by side.
The public healthcare system leaves gaps. Medicare covers treatment as a public patient, and private cover exists to close the gaps that matter most to you.
Your cover outlasts your needs. A policy chosen for a single person in their twenties rarely suits a growing family or someone nearing retirement.

Comparison services have to be paid somehow. GoSwitch earns a commission from the health fund when a customer joins, and that commission never changes the premium you pay. Our how we get paid page sets out the arrangement in full.

How to compare health insurance in Australia

Compare health insurance in four steps, starting with the type of cover you need. Work through them in order, because each decision narrows the next. Have your current details nearby if you already hold cover.

Choose your cover type. Decide between hospital cover, extras only cover, and combined cover before you start. The rest of the comparison runs in a few minutes once that is settled.
Enter your postcode and who is covered. Supply the postcode where you live and whether the policy covers one person, two adults, a family, or a single parent.
Compare inclusions and excess before price. Line up what each health insurance policy includes, what it leaves out, and what excess applies, then look at the premium last.
Read the Private Health Information Statement. Check the standardised statement every fund must supply, which sets out inclusions, exclusions, excesses, and waiting periods in the same format each time.

Comparing on premium alone is where most people come unstuck. Two policies priced within a few dollars of each other can differ sharply on excess and on which treatments they exclude. Reading both statements side by side is the only way to see it.

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Which hospital cover tier do you need?

The tier you need depends on which treatments you want covered, not on the tier name. Private hospital cover comes in four government-set tiers, and each must include a minimum list of clinical categories.

Tier	Minimum clinical categories	Covers treatments such as	Who it suits
Basic	3 categories, all able to be restricted	Rehabilitation, hospital psychiatric services, and palliative care	People who want the lowest level of cover available
Bronze	21 categories, 18 of them unrestricted	Joint reconstructions, gynaecology, hernia and appendix, and digestive system	Younger singles and couples with no known treatment needs
Silver	29 categories, 26 of them unrestricted	Everything in Bronze plus heart and vascular system, lung and chest, back, neck and spine, and dental surgery	People who want broad cover without paying for the top tier
Gold	All 38 categories, none restricted	Everything in Silver plus cataracts, joint replacements, pregnancy and birth, and weight loss surgery	Anyone planning elective surgery or wanting the widest cover

Source: Private Health Insurance Ombudsman, hospital treatment product tiers. Checked 28 July 2026.

Restricted means something specific. A restricted category covers you as a private patient in a public hospital only. A private hospital admission can still leave you with a large bill.

Tier names on their own tell you very little. What matters is the clinical category list behind them. Insurers can also add categories above the minimum and sell the result as Basic Plus, Bronze Plus, or Silver Plus.

You will see different category counts quoted elsewhere. Bronze is often described as 18 and Silver as 26. Those counts include only the unrestricted categories and leave out the three restricted ones every tier carries.

What extras cover pays for

Extras cover pays towards health services you receive outside hospital that Medicare does not fund. Insurers and regulators call it general treatment, and you may also see it called ancillary cover.

Service	What varies between funds
Dental check-ups	Whether a scale and clean is fully covered, and how many you can claim each year
Optical	The benefit paid on frames and lenses, and how often you can claim
Physio	The benefit per visit and the yearly cap on visits
Psychology	The number of sessions covered and the benefit per session
Podiatry	Whether routine care and orthotics are both included
Hearing aids	Whether devices are covered at all, and the maximum benefit
Orthodontics	The lifetime limit, which caps what you can ever claim

Hospital cover sits in four government-set tiers. Extras levels do not. Each fund decides what its own levels include, so two policies sold as top extras can pay very different amounts.

Nearly every extras service carries a limit. That can be a cap per service, a cap per year, or a lifetime limit you can never claim beyond.

Ambulance cover is a separate type again. Some funds bundle it into extras policies, others sell it alone, and Queensland and Tasmania cover their own residents through state schemes.

How much does health insurance cost in Australia?

Health insurance premiums rose by an average of 4.41 per cent on 1 April 2026. The Minister for Health and Ageing approved that figure in February. Your own increase may sit above or below it, because each fund sets its own change.

Six things decide what you pay, and our health insurance cost guide breaks each one down further.

What changes the price	How it works
Cover type	Hospital only, extras only, or combined cover
Hospital tier	A higher tier covers more clinical categories and costs more
Excess	A higher excess lowers what you pay each month
Who is covered	A single policy costs less than a couple, family, or single parent policy
Your state	Funds price the same policy differently across states and territories
Rebate and loading	Any government rebate reduces your premium and any loading increases it

Your premium is not the only cost. Medicare pays 75 per cent of the Medicare Benefits Schedule fee for hospital treatment and your fund pays at least 25 per cent.

If your doctor charges above that fee, the difference falls to you as out-of-pocket expenses. A gap cover arrangement between your fund and that doctor can reduce or remove it.

An average cannot tell you your own price. Our health insurance specialists can, on 1300 107 074, once they know your postcode and the cover you want.

Who qualifies for the government rebate?

You qualify for the private health insurance rebate if you hold a complying policy and your income sits under the Tier 3 threshold. The rebate covers hospital, general treatment, and ambulance policies.

Income thresholds from 1 July 2026

	Base tier	Tier 1	Tier 2	Tier 3
Singles	$105,000 or less	$105,001 to $123,000	$123,001 to $164,000	$164,001 or more
Families	$210,000 or less	$210,001 to $246,000	$246,001 to $328,000	$328,001 or more

Single parents and couples are tested against the family thresholds. Families add $1,500 to each threshold for every child after the first.

Rebate percentages, 1 July 2026 to 31 March 2027

Age	Base tier	Tier 1	Tier 2	Tier 3
Under 65	24.118%	16.079%	8.038%	0%
65 to 69	28.139%	20.098%	12.058%	0%
70 and over	32.158%	24.118%	16.079%	0%

Source: Private Health Insurance Ombudsman and Department of Health, Disability and Ageing. Checked 28 July 2026.

Claim the rebate one of two ways. Take it as a reduced premium from your insurer, or claim it as a tax offset when you lodge your return.

Nominating a premium reduction means estimating your tier in advance. Nominate too high and the difference comes back as a tax offset. Nominate too low and you carry a tax debt, though no penalty applies for estimating wrong.

Rebate percentages adjust again on 1 April 2027.

What the Medicare Levy Surcharge costs you

The Medicare Levy Surcharge costs between 1 and 1.5 per cent of your income. You pay it if you earn above the threshold and hold no private hospital cover. It sits on top of the 2 per cent Medicare levy most taxpayers already pay.

Income, singles	Income, families	Surcharge
$105,000 or less	$210,000 or less	0%
$105,001 to $123,000	$210,001 to $246,000	1%
$123,001 to $164,000	$246,001 to $328,000	1.25%
$164,001 or more	$328,001 or more	1.50%

Source: Australian Taxation Office, 2026-27 income year. Checked 28 July 2026.

Family thresholds rise by $1,500 for each dependent child after the first. Not every hospital policy exempts you. The excess must be $750 or less on a policy covering one person, or $1,500 or less on a policy covering more than one.

Extras cover does not exempt you at all. The ATO does not treat general treatment as private patient hospital cover, so an extras only policy leaves the MLS in place.

The MLS and the rebate use the same income tiers but pull in opposite directions. One is a tax you pay for going without cover. The other is money back on cover you hold.

The surcharge is worked out by the day. Holding appropriate cover for part of the year reduces the charge for the days you were covered.

Lifetime Health Cover loading and the 1 July deadline

Take out hospital cover before 1 July following your 31st birthday and you never pay Lifetime Health Cover loading. That date is your LHC base day. Miss it and you pay 2 per cent extra for each year you were over 30 when you take cover out.

The Ombudsman gives this example. Someone taking out hospital cover for the first time at 40 pays an 18 per cent loading. That is 2 per cent for each of the nine years past their base day.

The loading is capped at 70 per cent. However long you wait, it cannot climb higher than that.
Ten continuous years of cover removes it. Once you have held hospital cover and paid the loading for that period, it drops off permanently.
Cancelling later can bring it back. If you drop hospital cover after the loading ends, taking out a new policy can make you liable again.

Two things catch people out. Extras cover does not count towards Lifetime Health Cover, and on a couples policy the loading is the average of both adults.

The government rebate does not apply to the loading part of your premium.

Standard waiting periods across Australian health funds

The government caps hospital waiting periods, so no fund can make you wait longer than the limits below. Extras cover works differently, because insurers can apply any waiting period they choose.

Hospital treatment	Maximum wait
Pre-existing conditions	12 months
Pregnancy and birth-related services	12 months
Psychiatric care, rehabilitation, and palliative care	2 months, even for a pre-existing condition
All other hospital treatment	2 months

Source: Private Health Insurance Ombudsman and Department of Health and Aged Care. Checked 28 July 2026.

These are ceilings, not fixed terms. A fund can offer shorter waiting periods than the cap, and many waive them on extras to attract new members.

Extras waiting periods sit outside the rules entirely. Routine services tend to carry short waits and major ones carry longer waits, but the only reliable source is the policy document itself.

A pre-existing condition is any ailment with signs or symptoms in the six months before you took out cover or upgraded it. Your fund appoints the medical practitioner who makes that call.

A fund cannot refuse you cover or charge you more for a pre-existing condition. It can only apply the waiting period.

Accidents are the main exception. Treatment for an accident that happens after your policy starts usually carries no wait at all.

Health funds available through GoSwitch

GoSwitch compares policies from 14 health insurance providers. That is not every fund in the Australian market, so the list below sets out exactly who sits on the panel.

ahm
AIA
Australian Seniors
Australian Unity
Bupa
Frank
GMHBA
HCF
HCi
HIF
Hunter Health Insurance
nib
Real Insurance
RT Health

How those funds get presented to you is governed by a code. GoSwitch Services Pty Ltd and the ItsMy Group are both signatories to the Private Health Insurance Intermediaries Code of Conduct. It sets the standards intermediaries must meet when they compare and sell cover.

Change health funds in four steps

Waiting periods you have already served carry across when you switch health insurance to the same or a lower level of cover. Insurers cannot make you serve them twice, and that holds even when you change funds.

Choose the new policy. Match or lower your current level of cover to keep every waiting period you have already served.
Nominate a start date and leave the old policy alone. Your new fund cancels the old cover as part of the transfer, so there is no gap and no overlap.
Let the new fund request your transfer certificate. It moves from your old fund to your new one and confirms the waiting periods you have completed.
Check your refund and the cooling-off window. Your old fund refunds premiums paid beyond your switch date, and most funds allow 30 days to change your mind if you have not claimed.

Upgrading is the one exception. Anything newly covered, or covered at a higher level than before, still carries its own waiting period.

GoSwitch publishes its Trustpilot reviews openly, so you can read how switching health insurance went for other people before you start.

Check your cover against the market

Enter your postcode and see how your cover compares with what the market offers now. Behind the tool sits a team at our South Melbourne office on Park Street. Reach them on 1300 107 074 if you would rather talk it through than click through.

Compare first, then decide whether anything needs to change!

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FAQs

Does health insurance cover physiotherapy?

Yes, extras cover pays towards physio you receive outside hospital, subject to a benefit per visit and an annual cap set by each fund. Hospital cover contributes only when physio forms part of treatment you receive as an admitted patient, so compare both.

Does health insurance cover MRI scans?

Health insurance covers an MRI only when you have one as an admitted hospital patient, because legislation stops insurers paying for out-of-hospital imaging. Everything else runs through Medicare, so compare hospital cover rather than extras if diagnostic scans concern you.

What is the cheapest health insurance in Australia?

Basic tier hospital cover carrying a high excess is usually the cheapest option, though it covers only three clinical categories on a restricted basis. Compare Basic policies across all 14 funds to see what the lowest premium actually buys.

What is the best site to compare health insurance?

The government site privatehealth.gov.au lists every policy sold in Australia, including funds no comparison service covers, and is the only genuinely complete source. GoSwitch compares a panel of 14 funds and handles the paperwork when you switch, so many people check both.

What is the best health insurance company to go with?

The best health insurance company for you will depend on your individual needs and the specific health services you’re looking for. Some companies excel in hospital cover, while others offer better value for extras. GoSwitch makes it easy to compare different companies and their offerings so you can find the one that’s right for you.