search calculate now

Explore Overview

Compare Overview

Calculate Cheapest Policy Search for a new policy based on your health cover needs and budget. We compare every insurer and every policy.

calculate new policy

Compare Existing Policy Compare your existing policy with similar policies to meet your current health cover needs and budget. Compare every insurer and every policy.

compare existing policy

Calculate Rebate Discount & Loading Check if your health insurance premium decreases or increases by calculating your Government Rebate, Age-based Discount and Lifetime Health Cover Loading.

About Us Overview

Our Brand Promises

How We Make Money

Your Contact Information

Guides Overview

Australian Health System (25 articles) Health Insurance Prices (20 articles) Private Health Insurance (33 articles) Private Health Insurers (15 articles) Medicare (28 articles) Medicare Benefits Schedule (MBS) (6 articles) Pharmaceutical Benefits Scheme (PBS) (8 articles) Public Hospitals (6 articles) Private Hospitals (7 articles) Medicare Levy (7 articles) Private Health Insurance Rebate (7 articles) Age-based Discount (5 articles) Lifetime Health Cover Loading (11 articles)

Hospital Cover (9 articles) Extras Cover (6 articles) Ambulance Cover (5 articles) Excluded Treatments

Insurers Overview

AAMI Health Insurance

AIA Health Insurance

Allianz Care Australia

APIA Health Insurance

Astute Simplicity Health

Australian Unity

Bupa Health Insurance

CBHS International Health

Doctors’ Health

Emergency Services Health

Health Partners

Hunter Health Insurance (by CDH Benefits Fund)

ING Health Insurance

Latrobe Health Services

Mildura Health Fund

Nurses & Midwives Health

Phoenix Health Fund

Priceline Health Insurance

Qantas Insurance

Queensland Country Health Fund

Real Health Insurance

Reserve Bank Health Society (RBHS)

Seniors Health Insurance

St Lukes Health

Suncorp Health Insurance

Teachers Health

Territory Health Fund

Transport Health

Westfund

Aussies paying steep Gaps for specialist care, data shows

Specialist fees for private hospital care in Australia have increased dramatically – in some cases, by as much as 9 times, new data shows. Figures from Private Healthcare Australia, the peak body for the health insurance industry, found that average out-of-pocket fees charged for treating private patients have surged by staggering amounts between 2018-19 and...

Govt warns insurers about premium increases

The Minister of Health has warned health insurers to focus on providing value to customers when they apply to increase their premiums over the next few weeks. Private health insurers are allowed to raise premiums once a year only, subject to government approval. Insurer applications for 2026 premium increases are due in November, with approved...

ACT residents paying high Gaps, as premiums set to rise

Some ACT residents are being hit with shock bills for public hospital treatment, new figures show. Following news this week that health insurance premiums for ACT residents may rise by at least $180 next year, an analysis of billing records has revealed the high Gaps being paid for Canberra hospital treatment. Data from Private Healthcare...

Hospital Cover claims jump 11.6% amid public hospital strain

With public hospitals under strain, health insurers are paying out greater sums for private patient treatment, new data shows. Quarterly health insurance statistics released by the Australian Prudential Regulation Authority, which regulates the industry, showed a significant increase in the amount paid for Hospital Cover claims in the June 2025 quarter. Health insurers paid $4.98...

Four times more Australians paying Medicare Levy Surcharge, data shows

New data from the Australian Tax Office shows that the number of people being charged the Medicare Levy Surcharge (MLS) has almost quadrupled over 6 years. Data found 768,537 Aussies paid the MLS in the 2022-23 financial year, up from 196,807 in 2017. An article in The Australian says the increase is due to rising...

Yoga, Pilates and other natural therapies return to Extras Cover

Australians treated with natural therapies may soon be able to claim rebates on Extras Cover. Following a review completed last year, the government has reinstated 7 of the 16 natural therapies that were removed from private health insurance cover in 2019. The health insurance industry is now developing framework to cover: Private Healthcare Australia, the...

Bupa paying millions in compensation for claims error

Bupa members who had Hospital Cover claims rejected between 1 May 2018 and 31 August 2023 may be entitled to compensation. The health insurer has announced it incorrectly rejected “mixed coverage” claims – claims for 2 or more treatments at a time – and certain other types of claims during this period. Bupa has apologised...

Teachers Health and TUH merge to form larger health insurer

Members of Teachers Health and TUH are about to become part of the sixth largest health insurer in Australia. The two not-for-profit insurers have announced they will merge next week on 1 July, forming a combined insurer that will cover 500,000 people, Teachers Health said. TUH said the merger will bring some small benefits to...

Our Contributors Overview

Stephen Treacey

CEO and Founder

Sophie Bartho

Chief Operating Officer

Vladimir Kundrat

Chief Technical Officer

Trudie McConnochie

Writer and Researcher

Writer and Researcher

Peter Kawecki

UX/UI Designer

Loren Jaffe

Brand and Graphic Designer

Customer Engagement Australia

Led by Chris Payne

Do you have a reference number? Resume your calculation.

Explore Overview

Guides Overview

Australian Health System (25 articles) Health Insurance Prices (20 articles) Private Health Insurance (33 articles) Private Health Insurers (15 articles) Medicare (28 articles) Medicare Benefits Schedule (MBS) (6 articles) Pharmaceutical Benefits Scheme (PBS) (8 articles) Public Hospitals (6 articles) Private Hospitals (7 articles) Medicare Levy (7 articles) Private Health Insurance Rebate (7 articles) Age-based Discount (5 articles) Lifetime Health Cover Loading (11 articles)

Hospital Cover (9 articles) Extras Cover (6 articles) Ambulance Cover (5 articles) Excluded Treatments

Insurers Overview

AAMI Health Insurance

AIA Health Insurance

Allianz Care Australia

APIA Health Insurance

Astute Simplicity Health

Australian Unity

Bupa Health Insurance

CBHS International Health

Doctors’ Health

Emergency Services Health

Health Partners

Hunter Health Insurance (by CDH Benefits Fund)

ING Health Insurance

Latrobe Health Services

Mildura Health Fund

Nurses & Midwives Health

Phoenix Health Fund

Priceline Health Insurance

Qantas Insurance

Queensland Country Health Fund

Real Health Insurance

Reserve Bank Health Society (RBHS)

Seniors Health Insurance

St Lukes Health

Suncorp Health Insurance

Teachers Health

Territory Health Fund

Transport Health

Westfund

Aussies paying steep Gaps for specialist care, data shows Govt warns insurers about premium increases ACT residents paying high Gaps, as premiums set to rise Hospital Cover claims jump 11.6% amid public hospital strain Four times more Australians paying Medicare Levy Surcharge, data shows Yoga, Pilates and other natural therapies return to Extras Cover Bupa paying millions in compensation for claims error Teachers Health and TUH merge to form larger health insurer

Compare Overview

Calculate Cheapest Policy Search for a new policy based on your health cover needs and budget. We compare every insurer and every policy.

calculate new policy

Compare Existing Policy Compare your existing policy with similar policies to meet your current health cover needs and budget. Compare every insurer and every policy.

compare existing policy

Calculate Rebate Discount & Loading Check if your health insurance premium decreases or increases by calculating your Government Rebate, Age-based Discount and Lifetime Health Cover Loading.

About Us Overview

Our Brand Promises

Our Contributors Overview

Stephen Treacey

Sophie Bartho

Vladimir Kundrat

Trudie McConnochie

Peter Kawecki

Loren Jaffe

Loren Jaffe Customer Engagement Australia

How We Make Money

Your Contact Information

Do you have a reference number?
Resume your calculation.

Compare Every Insurer

No Commercial Bias

Cheapest Policy Guaranteed

Free Open Access

Compare Every Insurer

No Commercial Bias

Home Explore Guides

Guide

Private Health Insurance

Reviewed and updated 12 August 2025

In this Guide, we provide an overview of private health insurance in Australia, as well as answer your most common questions.

This Guide explains:

how private health insurance works
how to work out whether you need private health insurance and the best type of cover for you
some key concepts underlying private health insurance:
how to manage your private health insurance and how to make a claim.

Private health insurance explained

What is private health insurance?

Is private health insurance community rated or risk rated?

How does private health insurance work?

Do I need private health insurance?

Why don’t private health insurers cover the entire cost of treatments?

Will I get treatment faster if I have private health insurance?

What happens if I don’t have private health insurance?

What are private health insurance incentives?

What are private health insurance surcharges?

How much tax will I save with private health insurance?

What is the best way to compare private health insurance policies?

Managing your private health insurance

How to choose private health insurance

What is a Private Health Information Statement (PHIS)?

What are private health insurance premiums?

What are private health insurance waiting periods?

Do waiting periods apply if I change health insurers?

What is an excess?

What is a co-payment?

What are out-of-pocket costs?

Do I have to pay out-of-pocket fees for treatments outside of hospital?

How can I avoid out-of-pocket costs?

How to make a private health insurance claim

What is informed financial consent?

What is a Medical Gap?

What is a Hospital Gap?

What is the Medical Gap Cover Scheme?

When does private health insurance reset?

What is a closed policy?

How do I know if I have a combined policy or separate policies?

What can I do if I have a problem with my private health insurance?

How do I change to a different private health insurer?

How do I cancel my private health insurance?

What is a Private Health Insurance Statement?

NEXT Private Health Insurers

PREVIOUS Health Insurance Prices

Compare Every
Insurer

Compare all Australian health insurers and every policy

No Commercial
Bias

Compare using independent and comprehensive information

Cheapest Policy
Guaranteed

Compare all Private Health Information Statements, cheapest to most expensive

Free Open
Access

Compare without entering your name, email or phone number

Related Content

advertisement

calculate your health insurance calculate now

Policies change monthly, stay informed

Insurers regularly update policies, introduce new policies and close policies. Our data is updated monthly.
We will only send information relevant to you. You can unsubscribe at any time. See our Privacy Policy.