How we compare health insurers

Example monthly premiums are in AUD and include the 24.118% Australian Government rebate, the maximum for adults under 65. They assume a single income of $105,000 or less, or a family income of $210,000 or less for couples and families, rising by $1,500 for each dependent child after the first. This rebate rate applies from 1 April 2026 to 31 March 2027. No Lifetime Health Cover loading, fund discounts or joining offers are applied. These are examples, not personalised quotes.

Price tables use the same household and state for every policy, and the selected hospital excess where a policy offers it. Where it does not, we show the nearest excess and label it. A range means more than one version of a policy matches the selected profile. Adding a hospital price and an extras price does not give a combined quote.

Source: Australian Government rebate table, checked 19 October 2026.

We show whether each hospital policy includes, restricts or excludes a treatment category, using the insurer's Private Health Information Statements. Included means benefits apply subject to the policy's conditions; gaps can remain. Restricted means limited benefits, which can leave significant private-hospital costs. Not included means the category is excluded. The shortlist shows only policies that fully include a treatment; it is a filter, not a recommendation or a confirmation of eligibility. Check waiting periods and treatment eligibility in the policy statement.

Extras tables show Single-policy examples. Each links to a policy statement for a particular state, so it does not establish the limits for every state or household, and the examples do not change with the price selectors. Benefit percentages are selected optical and physiotherapy examples, not a promise of the same rate for every service. A shared limit is one pool, not a separate limit for each service, so claims for one service can reduce what remains for another. Annual limits are maximum benefits, not money you automatically receive. Check the policy statement for other conditions, sublimits and waiting periods.

For each insurer we take a hospital policy and look for open, publicly available policies from other insurers in the same hospital tier. They must match on cataracts and joint replacements. These two categories help select relevant alternatives; they are not the whole list of benefits. We then compare all 38 hospital treatment categories, show the differences in the main table and keep matching categories in the full comparison. Information we could not confirm is not treated as an exclusion. Prices use the same household, state and rebate. The alternatives are selected examples, not a search of the whole market or a quality ranking.

Review sites reflect people who choose to post. Ombudsman figures reflect complaints that reach the Private Health Insurance Ombudsman and use a different population and process. A complaint share is not the percentage of members who complained, and a referral is not proof that a problem was resolved. Neither source predicts an individual's claims experience. When a brand's cover is issued by another company, complaint and industry figures describe that issuer, not the brand's customers alone.

Complaint, market-share, no-gap and extras figures come from the State of the Health Funds Report, which the Private Health Insurance Ombudsman publishes after the end of each financial year (1 July to 30 June). Complaint shares are the complaints the Ombudsman received, or investigated, about an insurer in that year, as a share of those about all insurers; the share of all complaints leaves out overseas visitor and overseas student cover. Market share is measured on 30 June. The no-gap figure is the share of medical services for which the patient pays no gap once the insurer's benefits, schemes and agreements are counted, averaged over the insurer's policies across Australia; the extras figure is the average share of extras charges the insurer covers across all its extras policies and services. Where an insurer's government profile on privatehealth.gov.au shows a different figure, the page uses the report's, because the report states its period. Below the yearly figures, the complaints card adds the latest quarter from the Ombudsman's newest Quarterly Update: the complaints it referred to the insurer to resolve and those it investigated, each as a share of those about all insurers. One quarter is not a trend.

App ratings are the average star rating, and the number of ratings or reviews the store shows, for an insurer's app on the Australian App Store and on Google Play, on the date shown. They rate the app, not the insurer's cover or claims. When a brand's members use another company's app, the page names that app and says so. We treat fewer than 100 ratings in a store as a small sample.

If you have an unresolved issue with an insurer, start with the insurer's own complaints process. If it remains unresolved, the Private Health Insurance Ombudsman explains how to seek help.

Each figure carries its own date. Policy information has a retrieval date and prices have an effective date. Offers, contact details, reviews, app ratings and complaint figures are checked separately, and checking one does not make the others more recent. Before joining, confirm your quote, eligibility and policy conditions with the insurer. This information is general, not personal insurance advice.

Our assessments of each insurer are based on published policy and price information and policy documents. They are not a whole-market ranking or a personal recommendation.