2026 Health Report

The cost of healthcare in 2026: who's going without, what private health insurance is really being used for and where the loyalty tax is biting.

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Ceyda Erem

Updated

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The snapshot

How Australians are navigating healthcare costs, private health insurance and the value of their cover in 2026. Here are the headline numbers at a glance.

23%

of Australians have gone without medical treatment in the past 12 months because of cost, rising to 31% among Gen Z.

60%

of those who skipped care put off going to the dentist

25%

have visited a hospital ED because they couldn't get an affordable GP appointment

28%

have paid out-of-pocket for a service they expected their cover to pay

53%

of Australians currently hold some form of private health insurance

47%

of cover holders name avoiding public waitlists as their main reason

83%

of cover holders stick with the same insurer long-term

38%

of cover holders say they don't get value or they rarely make claims

18%

of cover holders never review their health cover at all

Source: Finder survey of 1,010 Australian adults, 2026. PHI figures based on 535 holders.

Almost a quarter are going without care

The cost of living has brutally hit household budgets in recent years, with many Australians forced to make tough calls over where funds go. Almost a quarter (23%) of Australian adults have skipped medical treatment in the past 12 months because of cost, with younger generations 'worse off' than their older counterparts.

Went without, by generation

Gen Z

31%

Gen X

26%

Gen Y

21%

Boomer

10%

The youngest cohort is more than three times as likely as the oldest to put off treatment they need.

Went without, by state

VIC

29%

QLD

23%

NSW

20%

SA

17%

WA

16%

A pattern that mirrors broader cost-of-living indicators in those states.

The gender gap

28%

of women went without

17%

of men went without

An 11-point spread that reflects both higher healthcare engagement among women and the cumulative impact of cost-of-living pressures on female-led households.

Dental is the first thing to go

They say prevention is better than cure, but not if you can't afford to get through the door. Preventative and routine checks were the first to go, including scans and skin checks, which can compound into bigger problems (and bigger bills) when finally addressed. Among those who delayed or avoided care, dental was the single biggest casualty, followed by GP visits and physiotherapy.

What care gets delayed first

Dental

60%

GP visits

43%

Physio

27%

Optometrist

21%

Specialist

19%

Mental health

14%

Scans & X-rays

14%

Skin checks

14%

💡 Finder Tip

Opt for extras that matter to you

A big mistake many Australians make when first taking out extras cover is overloading their policy with extras they'll never use. While this might seem like an easy way to get 'maximum value', the reality is that you're just overpaying on treatments you'll never use. Instead, take a look at the services you have or plan to use in the next 12 months, then start building a policy that truly aligns with your needs.

When the GP gets too dear, the ED fills up

The ED-instead-of-GP problem

25%

have visited a hospital ED because they couldn't get an affordable GP appointment.

A further 14% say they would do the same if a GP became too expensive, putting almost 4 in 10 (39%) within reach of an ED visit driven by GP affordability.

Unexpected out-of-pocket bills

28%

paid out-of-pocket for a service they expected their cover to pay - 18% via extras, 10% via hospital.

42%

Gen Z caught out

17%

Boomers caught out

💡 Finder Tip

Read your product disclosure statement - once

Most surprise bills come from a mismatch between what people assume their policy covers and what it actually covers. Things like waiting periods, item-number exclusions and annual sub-limits are all important policy features to double check. Before any planned procedure, call your insurer and ask three things: the MBS item number your surgeon is using, the gap and whether your level of cover includes the procedure at that hospital.

Source: Finder survey of 1,010 Australian adults, 2026.

Who's covered, and how

Private health insurance is a highly personal product across individuals and families. Just over half of Australians (53%, or 535 respondents) hold some form of private cover. The second half of this report looks at this cohort and how they hold and use their cover.

Single, joint or family?

Single

42%

Family

33%

Joint

26%

Boomers split almost evenly between single (52%) and joint (46%) - their kids have aged out. Gen Y and Gen Z now dominate family policies, at 43% and 42%.

Level of hospital cover

Basic / Bronze

34%

Silver

30%

Gold

24%

Extras only

7%

Not sure

5%

Basic and Bronze cover is over-represented; the 5% unsure of their tier likely aren't getting the best deal.

A quiet gender pattern. Men are notably more likely to hold Gold (27% vs 22%) or Silver (32% vs 26%) cover, while women are more likely to hold Basic (20% vs 16%) or to be unsure of their tier (8% vs 3%), a real pattern of women on lower-tier cover and less familiar with what they're paying for.

Source: Finder survey of 535 Australians with private health insurance, 2026.

Healthcare for some, tax relief for others

Most holders keep their private cover to get better healthcare and avoid public waitlists; others opt in from a more tactical standpoint. Here's what our respondents said.

47%

cite better healthcare & avoiding waitlists as their main reason

32%

say waitlists and reducing their tax bill matter equally

18%

cite tax as the primary reason, the smallest share

The generational flip. Among Boomers, three-quarters (74%) hold cover primarily for healthcare, and only 4% cite tax. Among Gen Y that reverses: only 36% cite healthcare, while 29% - the highest of any generation - say the Medicare Levy Surcharge is what keeps them in the system.

74%

Boomers: for healthcare

29%

Gen Y: for tax

💡 Finder Tip

Holding cover purely for tax? Do the maths

The Medicare Levy Surcharge kicks in at $105,001 for singles and $210,001 for families (2026–27), at 1%–1.5% of taxable income. For a single on $110,000, that's $1,100 in extra tax avoidable with the cheapest qualifying policy. But many cheap 'tax-dodge' policies carry $750 excesses and big exclusions, so it's worth double-checking the fine print before signing up.

Most holders are recent claimers

Almost half of policy holders (44%) have made a claim within the past quarter, with dental dominating as the top treatment claimed. Only 13% have never made a claim, suggesting most Australians with private cover are actively getting value from it.

When did you last claim?

Past month

24%

Past 3 months

20%

Past 6 months

22%

Over a year ago

21%

Never claimed

13%

Boomers are the most active: 37% claimed in the past month. Gen Z has the highest never-claimed rate (20%).

What people claim for

Dental

63%

Optical

50%

Other treatments

21%

Physiotherapy

19%

Mental health

14%

'Other treatments' is a catch-all spanning remedial massage, chiropractic and dietetics.

💡 Finder Tip

Use your annual extras limits before December

Most extras policies reset annual limits on 1 January, and limits don't roll over. If you've got $400 of dental cover left in November, that's $400 you've already paid for. In other words, book the clean, have the X-ray and get the new glasses before the calendar rolls. If your insurer doesn't send unused-limit reminders, set a calendar nudge for early November every year.

On value, holders are split down the middle

When asked whether they get the most value out of their cover, holders divide almost exactly in two, and women are far more likely to feel short-changed.

38%

No - they rarely make claims

38%

Yes - they regularly receive benefits

25%

Yes, but - they could claim more

Women are under-claiming. 45% of female holders say they rarely make claims, versus 33% of men. Conversely, 43% of men say they regularly receive benefits, versus just 30% of women, a 13-point gap suggesting women may be leaving entitlements unclaimed.

45%

Women: rarely claim

33%

Men: rarely claim

💡 Finder Tip

Get the family's claim activity into one view

Many under-claiming households just lack visibility. For instance, receipts get lost, kids' physio bills go unclaimed or a partner's optical claim never gets submitted. Most major insurers now let you authorise a partner or family member as a claimant on the app, so everyone's receipts route to one balance. If you're under-claiming because your policy doesn't cover what you actually use, that's a sign to review your cover.

83% pay the loyalty tax without questioning it

Premiums rise an average of 3–4% a year, yet most holders never shop around. This year alone saw the highest premium increase in more than a decade, at 4.41%. Switching to a comparable plan can typically save $200–$400 per policy, per year.

How often holders review cover

Once a year

40%

Every few years

23%

Every 6 months+

19%

Never review

18%

Boomers are the most disciplined (55% review yearly). Women are 14 points more likely than men to never review (26% vs 12%).

The loyalty tax

83%

stick with the same insurer long-term

While most Australians are putting their policies to work, 83% still hand their loyalty to the same insurer year after year, potentially missing out on a better deal. Only 17% regularly switch. South Australians are the most loyal (90% stick); Victorians the least (79%). Gen Y are the most likely to switch (20%), followed by Gen Z (18%).

💡 Finder Tip

Switching doesn't reset your waiting periods

The biggest myth about switching is that you'll lose your waiting periods. You don't. As long as you switch to an equivalent or lower-tier policy, your insurer is legally required to recognise the waiting periods you've already served. The best time to switch is right before 1 April, when premiums rise. This way, you can lock in the new policy and your old insurer refunds any pre-paid premium past your cancellation date.

The pressure on private cover is real

Across all Australians with private health cover, a meaningful share are cancelling, downgrading or switching. And the picture is sharper among women.

22%

have cancelled, plan to cancel, or plan to downgrade in the next 12 months

11%

are planning to switch to a different provider

A meaningful gender divide. 33% of women currently don't have cover (vs 24% of men), and only 31% are 'happy with my plan' (vs 46% of men). Together with the higher rate of women going without care due to cost (28% vs 17%), the data points to women absorbing more of the household's healthcare-cost pressure in 2026.

31%

Women happy with plan

46%

Men happy with plan

💡 Finder Tip

Downgrade before you cancel

If you're thinking of cancelling because of cost, look at downgrading first. Moving from Gold to Silver, or Silver to Bronze, can typically save 20–40% in premium while keeping most of what you actually use. If you cancel hospital cover and later re-join, you'll pay Lifetime Health Cover loading (2% extra per year of age over 30 you weren't covered) and serve waiting periods again. Downgrading avoids both.

References & methodology

References

This report draws on Finder's 2026 Health Survey for all primary statistics. Premium thresholds and tax figures reference the ATO Medicare Levy Surcharge income thresholds for the 2026–27 financial year, and the Department of Health's published guidance on the Lifetime Health Cover loading. Child Dental Benefits Schedule limits are current to the Services Australia website at time of publication.

Methodology

Finder conducted a nationally representative survey of 1,010 Australian adults in early 2026, verified for representativeness by Qualtrics. Where a question was asked only to holders of private health insurance, the smaller sample (n = 535) is noted alongside the relevant figure. Care-delay questions were asked only of those who had gone without treatment due to cost (n = 230); the claims question was answered by 526 holders.

Generation bands follow standard Australian definitions: Baby Boomers (1946–1964), Gen X (1965–1980), Gen Y / Millennials (1981–1996) and Gen Z (1997–2012). Percentages are rounded to the nearest whole number; totals may not sum to 100% due to rounding or multi-select questions.

Media & interviews

Taylor Blackburn

Head of Public Relations, Finder

aupr@finder.com

To arrange an interview or discuss the report's results in more detail, please get in touch.

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Finder Health Report 2026 · finder.com.au · © 2026 Finder

Source: Finder survey of 1,010 Australian adults, 2026.

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Written by

Senior writer

Ceyda Erem is Finder’s senior writer for insurance and has almost 10 years of experience writing about personal finance. Formerly a copywriter for several business and finance clients, Ceyda has written hundreds of articles, guides, blogs and more to ensure Australians stay in the loop about how to best manage their money. She has a Bachelor of Arts, Majoring in Writing from Macquarie University. See full bio

Ceyda's expertise
Ceyda has written 165 Finder guides across topics including:
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