Australia’s healthcare system, backed by Medicare, offers free or lower-cost medical services, but it’s not comprehensive, leading to lengthy waiting lists for common procedures due to the system’s inflexibility.
- 1. Health Insurance
- 2. Best Health Insurance Companies in Australia
- 3. Phoenix Health Fund – Australia
- 4. NIB – Australia
- 5. HBF – Australia
- 6. St Lukes – Australia
- 7. Bupa – Australia
- 8. Latrobe – Australia
- 9. GMHBA – Australia
- 10. HCF – Australia
- 11. AIA – Australia
- 12. AHM – Australia
- 13. FAQs – Health Insurance Australia
- 14. Conclusion – Health Insurance Australia
Many Australians opt for private health insurance to bypass waiting lists and pay less for services not covered by Medicare. Private Health Australia reports that 14.42 million Australians, or 55% of the population, have private health cover, with coverage growing by 2% last year.
APRA reports a significant increase in the private health sector’s net profit to $2.2 billion in 2023, with premiums rising by 3.3% and hospital coverage reaching 45.1%.
Health insurance premiums in Australia have risen, leading to increased monthly costs for hospital and extras cover. To find the best private health insurance provider, compare options on the Australian market and consult the government website or the Commonwealth Private Health Insurance Ombudsman’s report.
1. Health Insurance
A financial plan called health insurance aids people in controlling the price of their medical bills. By providing coverage for services that aren’t completely covered by public insurance, it supplements Medicare, the country’s public healthcare system. In addition to providing coverage for out-of-hospital services like dental and optical care, private health insurance usually covers hospital stays for inpatient treatments and surgery.
It gives people the freedom to select private healthcare providers, albeit there could be waiting periods before receiving some benefits. In order to make private health insurance more cheap, the Australian government gives rebates and subsidies. This encourages people to keep their coverage up to date for a variety of medical requirements beyond what the public system covers.
1.1 Need for Health Insurance
Health insurance in Australia is a crucial part of the healthcare system, supplementing the public system’s Medicare coverage. Private health insurance is available in two categories: hospital cover and extras cover. Hospital cover covers hospital stays, surgeries, and related treatments, while extras cover covers non-hospital services.
The government encourages private health insurance through initiatives like Lifetime Health Cover. The Australian government provides subsidies and rebates to make private health insurance more accessible, aiming to ensure comprehensive and tailored healthcare protection.
2. Best Health Insurance Companies in Australia
However, the list of open insurers that are now providing health insurance in Australia is shown below; anybody can purchase a policy from any of these providers.
- Phoenix
- NIB
- HBF
- St Lukes
- Bupa
- Latrobe
- GMHBA
- HCF
- AIA
- AHM
3. Phoenix Health Fund – Australia
3.1 Why we choose it – Phoenix Health Fund Australia
Phoenix Health Insurance is a very high-ranking provider despite having a 0.2% market share because to its high member retention rate for hospital-only coverage, the fact that 91.9% of its hospital services offer a no-gap policy, and the fact that 82.5% of its payments are returned to clients.
When it comes to wait periods, Phoenix’s hospital coverage includes a two-month waiting period for the majority of ailments and a 12-month waiting period for pre-existing conditions, pregnancy, and delivery. On the other hand, there is no waiting time for unintentional injuries, and ambulance coverage begins the following day. On the user evaluation website ProductReview, it received an astounding 4.9 stars out of over 300 ratings from customers.
3.2 Pros & Cons – Phoenix Health Fund Australia
| Pros | Cons |
| favorable client testimonials | No more savings |
| 91.9% of hospital expenses paid across the country | It is only possible to acquire two of its three additional cover plans in combination with hospital cover. |
| 0% of complaints that the Ombudsman looked into |
3.3 Company Overview – Phoenix Health Fund Australia
London, England-based Phoenix Group Holdings plc (previously Pearl Group plc) is an insurance services company. It is a component of the FTSE 100 Index and is listed on the London Stock Exchange.
They have been in business for more than 240 years, expanding gradually via a number of mergers and acquisitions.
They have most recently expanded our portfolio to include well-known companies including Standard Life, SunLife, and ReAssure.
Originally, they went door-to-door to sell life insurance contracts. Today, they manage the assets, savings, and pensions of almost 12 million clients throughout the UK and Europe.
3.4 Products & Services – Phoenix Health Fund Australia
In Australia, health insurance providers often provide a variety of goods and services, such as:
- Hospital Cover
- Bronze Hospital
- Bronze Plus Essentials Hospital
- Silver Everyday Hospital
- Silver Plus Family Hospital
- Silver Plus Advantage Hospital
- Extras Cover
- Value Extras 60
- Kick Start Extras 50
- Healthy Flex Extras 50
- Ambulance Cover
They also provide following coverages,
- Mental Health Cover
- Waiting Periods
- Customer Service
- Online Services
3.5 Contact Details – Phoenix Health Fund Australia
You can contact company through,
| Phone Number | 1800 028 817 |
| Mailing Address | PO Box 156, Newcastle NSW 2300 |
| [email protected] | |
| Official Website | https://phoenixhealthfund.com.au/ |
4. NIB – Australia
4.1 Why We Choose It – NIB Australia
With a 9.4% market share, NIB is among the top five health insurance companies in Australia. It refunds 73.5% of all member payments to its customers and has a two-month waiting period for most treatments under its additional cover and most conditions under its hospital cover. This is a major factor in why NIB did not score higher as it is lower than that of many other insurers.
Customers of NIB can still utilize their own chosen providers, in contrast to other health insurance companies that force them to visit designated “member providers” in order to receive care. Clients will also be happy to learn that, at 57.2%, NIB has one of the highest rates of supplementary coverage.
4.2 Pros & Cons – NIB Australia
| Pros | Cons |
| Clients are free to select the service providers they want. | Reduced proportion given back to members |
| Large percentage of no-gap services, particularly for extras | A few unfavorable reviews |
| Has live chat functionality for customer support |
4.3 Company Overview – NIB Australia
One of Australia’s health funds with the quickest growth was founded in 1952 and is called nib.
Nib Group provides health and medical insurance to over 1.6 million Australian and New Zealand residents. We also provide health insurance to around 200,000 international students and workers in Australia.
In addition, they are a top three Australian travel insurer and global distributor of travel insurance through our business, nib Travel, providing financial protection and assurance to travelers wherever they are in the world.
4.4 Product & Services – NIB Australia
NIB offers insurances for,
- Singles cover
- Couples cover
- Family cover
- Overseas student cover
- Overseas worker cover
4.5 Contact Details – NIB Australia
You can contact company through,
| Phone Number | +61 2 9692 4300 |
| Address | 22 Honeysuckle Drive, Newcastle NSW 2300 |
| [email protected] | |
| Official Website | https://www.nib.com.au/ |
5. HBF – Australia
5.1 Why We Choose It – HBF Australia
When it comes to hospital coverage in particular, HBF is the best option for private health insurance. According to the most recent Ombudsman report, it covers 92.8% of general medical services (excluding extras) and 94.4% of hospital expenses nationally, along with having a 92.3% member retention rate on hospital-only plans.
Regretfully, HBF has received a lot of negative ratings, and the Ombudsman looked into 17.8% of complaints in the most recent State of the Health Funds report. This year, that percentage dropped to 4.9%, indicating that HBF has obviously improved the way it handles complaints.
5.2 Pros & Cons – HBF Australia
| Pros | Cons |
| After a day, accidents are covered. | A few unfavorable reviews |
| 94.4% of hospital expenses paid across the country | Approximately 15% of policyholder payments are used for management costs. |
| After four months, new members receive six weeks free. |
5.3 Company Overview – HBF Australia
An Australian company that offers health insurance is HBF Health Limited. With a 7.82% national market share, it is the fifth-largest private health insurance company in Australia.Although the HBF has its headquarters in Western Australia, 18.6% of its members live in other states and territories.
HBF, established in 1941, is a leading provider of health insurance in Western Australia. It offers affordable health services for hospital, ancillary, urgent ambulance, and complementary therapies. HBF’s market share increased to 8% in 2021 after acquiring CUA Health Pty Ltd, Life Ready Physio, and Queensland Country Health Fund. The company also acquired Life Ready Physio in 2022 and Queensland Country Health Fund in 2023.
| Industry | Private health insurance |
| Founded | 1941 |
| Headquarters | Perth, Western Australia |
| Key people | Dr Lachlan Henderson (CEO) |
| Products | Health insurance |
5.4 Products & Services – HBF Australia
| Health cover | Extras cover | Hospital cover | Cover for… |
| Singles | Flex 50 | Basic Extras | Dental |
| Couples | Flex 60 | Basic Hospital Plus | Optical |
| Families | Complete 60 | Basic Hospital Plus Elevate | Physiotherapy |
| Single parents | Top 70 | Bronze Hospital Plus | Mental health |
| Overseas visitors | Silver Hospital | Nutrition and dietetics | |
| Ambulance | Silver Hospital Plus | Switching to HBF | |
| Gold Hospital Elevate |
5.4 Contact Details – HBF Australia
You can contact company through,
| Phone Number | 133 423 |
| Address | 570 Wellington Street Perth WA, 6000 |
| [email protected] | |
| Official Website | https://www.hbf.com.au/ |
6. St Lukes – Australia
6.1 Why We Choose It – St Lukes Australia
Although St Lukes’s market share of Australia’s health insurance pool is very small—0.6%—its products and services are comparable to those of some of the industry leaders. Longer waiting periods are applicable to specific conditions or services. The standard waiting period for hospital conditions and additional cover is two months.
While St. Lukes receives a lot of positive reviews on the independent consumer review site ProductReview, it is important to note that a number of recent reviews have noted a decline in standards. Of all the contributions St. Lukes receives from its members, 84% are returned to its customers via benefits.
6.2 Pros & Cons – St Lukes Australia
| Pros | Cons |
| Positive customer feedback | No client service after hours |
| Regular savings for brand-new subscribers | There are only physical customer service centers in Tasmania. |
| No complaints were looked upon by the Ombudsman. | A few unfavorable reviews |
6.3 Company Overview – St Lukes Australia
| Industry | Insurance |
| Headquarters | Launceston, TAS |
| Founded | 1952 |
| Specialties | Health insurance, Customer service, Gap free preventative dental, and Health management programs |
6.4 Products & Services – St Lukes Australia
Health insurance services includes,
- Hospital Cover
- Extras Cover
6.5 Contact Details – St Lukes Australia
You can contact company through,
| Phone Number | 1300 651 988 |
| Mailing Address | PO Box 915 Launceston 7250 Tasmania |
| [email protected] | |
| Official Website | https://stlukes.com.au/ |
7. Bupa – Australia
7.1 Why We Choose It – Bupa Australia
An Australian company that offers health insurance is HBF Health Limited. With a 7.82% national market share, it is the fifth-largest private health insurance company in Australia.Although the HBF has its headquarters in Western Australia, 18.6% of its members live in other states and territories.
7.2 Pros & Cons – Bupa Australia
| Pros | Cons |
| Recurring savings | Utilizing Members First Providers is necessary to increase benefit returns. |
| 90.9% of hospital-related services are covered. | A few unfavorable reviews |
| High prevalence of no-gap services on extras. | Physiotherapy and eyewear are excluded by certain extras insurance. |
7.3 Products & Services – Bupa Australia
Types of health insurance services offered by the company are,
| Combined | Hospital | Extras |
| Basic Plus Active Saver (BASIC PLUS) | Basic Accident Only Hospital $750 Excess | Extras Saver |
| Basic Plus Young Singles Saver | Basic Plus Starter Hospital $750 Excess | Freedom 50 |
| Bronze Plus Young Singles Choice | Bronze Plus Simple Hospital $750 Excess | Starter Extras |
| Silver Plus Essential Hospital $750 Excess | Freedom 60 | |
| Silver Plus Advanced Hospital $750 Excess | Super Extras | |
| Top Extras |
7.4 Contact Details – Bupa Australia
You can contact company through,
| Phone Number | +61 3 9487 6400 |
| Address | Bupa 33 Exhibition Street, Melbourne, VIC 3000 Australia |
| [email protected] | |
| Official Website | https://www.bupa.com.au/ |
8. Latrobe – Australia
8.1 Why We Choose It – Bupa Australia
With almost 80,000 clients nationwide, Latrobe is a not-for-profit private health insurance with a 0.7% market share. By letting clients pay for just what they require and now include emergency ambulance services in all of its hospital and extras policies, it gives members a great deal of options. With 91% of private hospital visits covered, its hospital coverage is very strong.
Latrobe pays a large percentage of member contributions (15%) on management expenses, and its member retention rate of 76.8% is lower than that of most of its rivals. The Ombudsman looked at 1.6% of complaints, which is more than double its market share.
8.2 Pros & Cons – Bupa Australia
| Pros | Cons |
| Discounts available when paying in advance | Different wait times for specific extras |
| Optical, physiotherapy and dental included in all extras policies | Restricted hours for customer service Lower retention rate compared to competition |
| Emergency ambulance cover included in all policies |
8.3 Products & Services – Bupa Australia
Coverage provided are,
- Healthy Start Hospital Package
- Bronze Hospital
- Bronze Plus Hospital
- Silver Hospital
- Silver Plus Hospital
- Extras cover
Extra cover coverages includes,
- Basic Extras
- Core Families Extras
- Core Essentials Extras
- Core Complete Extras
- Premier Families Extras
- Premier Singles and Couples
8.4 Contact Details – Bupa Australia
You can contact company thorugh,
| Phone Number | 1300 362 144 |
| Address | Latrobe Health Services Limited 32 Darlimurla Ave, Newborough VIC 3825 |
| [email protected] | |
| Official Website | https://www.latrobehealth.com.au/ |
9. GMHBA – Australia
9.1 Why We Choose It – GMHBA Australia
Customers hold GMHBA in high respect for its ability to provide excellent customer service, and they give it a pretty good rating on Product Review. Notably, members of GMHBA may access live chat as well as phone customer support from 8 a.m. to 6 p.m. with a callback option to prevent long wait times.
But just 48.2% of extras are covered by GMHBA, and only 89.7% of hospital stays—a little less than rivals.
9.2 Pros & Cons – GMHBA Australia
| Pros | Cons |
| Live chat function available for customer service queries | Hospital-only insurance have a worse member retention rate than their rivals. |
| Regular discounts | Just 48.2% of the excess is paid for. |
| Some good reviews |
9.3 Products & Services – GMHBA Australia
Company provides services for following categories,
- Singles
- Couples
- Single parent
- Family
- Pregnancy
- Under 30s discount
Other coverages includes, ‘
| Hospital Cover | Extras |
| Accident Only Hospital | Basic Extras Set Benefit |
| Basic Plus Starter Hospital | Basic Extras 55 % |
| Bronze Plus Hospital | Mid Extras Set Benefit |
| Bronze Plus Advantage Hospital | Mid Extras 65% |
| Silver Plus Hospital | Top Extras Set Benefit |
| Silver Plus Premium Hospital | Top Extras 75% |
9.4 Contact Details – GMHBA Australia
You can contact company through,
| Phone Number | 1300 382 144 |
| Address | Level 3/60 Moorabool St, Geelong VIC 3220, Australia |
| [email protected] | |
| Official Website | https://www.gmhba.com.au/ |
10. HCF – Australia
10.1 Why We Choose It – HCF Australia
HCF bills itself as the biggest not-for-profit health fund in Australia; as of this writing, it held a 12.4% market share. In addition to offering a high proportion of no-gap services (90.1% hospital coverage), it has a strong member retention rate and pays out 86.7% of its contributions to members in benefits.
However, even with these impressive figures, HCF still has shortcomings in a few important areas. The most significant of these is the number of complaints that the Ombudsman has looked into, which is 23.8%—nearly twice its market share. Furthermore, HCF has only gotten an average rating of 2.9 stars out of more than 600 reviews; a low ranking is sometimes attributed to inadequate customer service.
10.2 Pros & Cons – HCF Australia
| Pros | Cons |
| Very high percentage of member retention | The waiting time for all pre-existing conditions (hospital and extras) is 12 months. |
| An abundance of no-gap services | High percentage of complaints that the Ombudsman looked into in comparison to market share |
| Saturday customer service | A few unfavorable reviews |
10.3 Products & Services – HCF Australia
| Hospital Treatments | Extras Treatments |
| Eye excluding cataracts Gastrointestinal endoscopy Gynaecology Hernia and appendix Joint reconstructions Kidney and bladder Lung and chest Male reproductive system Miscarriage and termination of pregnancy Pain management Palliative care Medically necessary plastic surgery Podiatric surgery Skin Sleep studies Tonsils adenoids and grommets Blood Bone joint and muscle Brain and nervous system Breast surgery Cancer Dental surgery Diabetes management Digestive system Ear nose and throat | Extra treatments no |
10.4 Contact Details – HCF Australia
You can contact company through,
| Phone Number | 1800 560 855 |
| Mailing Address | GPO BOX 4242 Sydney, NSW 2001 |
| [email protected] | |
| Official Website | https://www.hcf.com.au/ |
11. AIA – Australia
11.1 Why We Choose It – AIA Australia
On Australia’s top customer review website, Product Review, AIA is ranked among the top health insurance companies. AIA has got an average rating of 4.8 stars out of over 700 reviews. It is most frequently praised for its excellent customer service and value.
Regrettably, though, AIA’s hospital coverage doesn’t have a very high member retention rate, and the Ombudsman looked into 2.5% of complaints, which is significantly more than its.3% market share.
11.2 Pros & Cons – AIA Australia
| Pros | Cons |
| 82.8% of benefits returned to members | Low incidence of hospital-only policyholder retention |
| Positive customer reviews | Restricted hours for customer service |
11.3 Products & Services – AIA Australia
They provide coverages for,
- Single
- Couple
- Family
- Single Parent
11.4 Contact Details – AIA Australia
You can contact company through,
| Phone Number | 1800 333 613 |
| Address | AIA AUSTRALIA PO BOX 6111 |
| [email protected]. | |
| Official Website | https://www.aia.com.au |
12. AHM – Australia
12.1 Why We Choose It – AHM Australia
The 2023 Finder Customer Satisfaction Award went to ahm. It received great marks for customer service, value for money, and application procedure out of 750+ clients that participated in the poll. Additionally, it offers some of the most affordable hospital coverage available.
12.2 Pros & Cons – AHM Australia
| Pros | Cons |
| Health insurer with the highest rating in the 2023 Customer Satisfaction Awards | Hospital fees are reimbursed to the tune of 90.6%. St Lukes (92.6%) and HBF (94.4%) are two of the better insurers. |
| Cheap hospital plans and no waiting periods on various supplementary policies. | There is no gap in 84.6% of medical treatments. Better insurers include Bupa (91.6%), Phoenix (92.2%), and NIB (91.8%). |
| According to the most recent Ombudsman report, Medibank, the owner of AHM, had a comparatively smaller number of complaints than any other health funds. | The least expensive gold level insurance on the market is not AHMS’s gold option. |
12.3 Products & Services – AHM Australia
Health insurance services offered by the company are,
- Health insurance
- Hospital
- Extras
- Hospital & extras
- No gap dental
- Tax & hospital cover
- Youth Discount
- Pregnancy
- Overseas students
12.4 Contact Details – AHM Australia
You can contact company are,
| Phone Number | 1800 081 875 |
| Address | Head office 77 Market Street Wollongong NSW 2500 Australia |
| [email protected] | |
| Official Website | https://ahm.com.au |
13. FAQs – Health Insurance Australia
Do I need private health insurance if I have Medicare?
Medicare provides coverage for a wide range of medical treatments, but private health insurance can provide further advantages including reduced waiting periods for elective surgery, freedom to select a physician, and coverage for services not included in Medicare (such dental, optical, and physiotherapy).
What is the difference between hospital cover and extras cover?
Benefits for hospital stays, procedures, and treatments are provided under hospital cover. Extras cover (also known as auxiliary or general treatment) pays for out-of-hospital treatments such as chiropractic, physiotherapy, dentistry, and optical.
Is ambulance cover included in private health insurance?
Not all private health insurance plans automatically include ambulance coverage. It might be covered by certain plans, but it could need to be purchased individually under others. See your insurance details or get in touch with your insurer if you have any questions.
14. Conclusion – Health Insurance Australia
In summary, health insurance in Australia is essential to completing the public health system that Medicare offers. People with private health insurance have more freedom in selecting their medical providers, experience shortened wait times for elective operations, and receive coverage for a variety of services not provided by Medicare. With many policies available, including hospital cover and supplemental cover, Australians may personalize their health insurance to fit their individual needs.
The goal of government programs like the Lifetime Health Cover loading and the Medicare Levy Surcharge is to promote enrollment in commercial health insurance. Even though health insurance has many advantages, people should carefully consider their options and compare them to make sure their particular needs for medical care are met. Frequent policy reviews and knowledge of government rebates help consumers make well-informed decisions about health insurance, which ultimately improves Australians’ general health and well-being.
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