Best Health Insurance Australia | 5 Top Picks for 2021 - Finder

Best health insurance: Our top picks for Australia

We compared 25+ funds to research the best health insurance.

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Finding the best health insurance

There's no single health insurance that's best for everyone as all our needs are different - and what's best for you might not be best for someone else.

Best Health Insurance: Finder top picks

Finder Pick: Most popular health fund – Medibank

Honestly, no health insurance policy is perfect. They all have pros and cons, and every person has completely different health needs.

To see which fund is the most popular in Australia, we looked at two core factors. Firstly, out of our own visitors during the period of March 2020 to March 2021, Medibank was the most visited Finder partner by users. Secondly, the Commonwealth Ombudsman State of the Health Funds Report, which reports on all Australian funds' national market share, revealed Medibank had the highest percentage of members.

Beyond the statistics, when it comes to the policies on offer, Medibank offers a wide range and also gives a high standard of care to out of hospital services compared to other funds in the market, offering free activities to keep people healthy, rewards points that can be exchanged for vouchers and also a comprehensive telephone support package.

Top pick for waiting periods – ahm lifestyle extras

Waiting periods for hospital treatments are the same no matter which fund or policy you choose.

To make our top pick, we looked at the extras policies of every non-restricted health fund in Australia to compare waiting periods for "extras only" options. We compared the waiting period set for common treatments such as general dental, physiotherapy and optical.

Our top pick is ahm's lifestyle extras because it lets you claim heaps of benefits from day one, including general dental, optical and physiotherapy. No other policy offered this option.

With other policies, you have to wait at least 2 or 6 months to claim these benefits, unless you buy a combined hospital and extras policy. Plus, it's affordable at roughly $12 a week.

Top pick for Medicare Levy Surcharge – Frank's Entry Hospital (Basic+)

To avoid the Medicare Levy Surcharge, which will cost you a minimum of $90 a month, all you have to do is get hospital cover with an excess of $750 or less.

Frank's Entry Hospital (Basic+) policy is the cheapest hospital cover available in 2021. It costs around $75 a month for a single policy based in NSW. So you'll actually save money by having a policy.

You won't get many benefits, but you will be covered for some of the basics such as tonsils, adenoids and grommets, gynaecology, joint reconstructions and dental surgery.

Top pick for extras coverage – St.Lukes

St.Lukes Health

When choosing an extras policy, there are a few factors to consider – limits, waiting periods and also how much you can claim back for each treatment.

You can't always find this information on the tin so to speak. But each year the Commonwealth Ombudsman publishes the latest statistics via the State of the Health Funds Report. We looked at the 2020 release and reviewed each fund by general treatment (extras). Charges covered 8 common treatments (including dental, physio and optical) to see which gave the highest percentage back to the customer's pocket. St.Lukes came out a clear winner.

We also checked the percentage of general treatment (extras) charges covered across every state. To make our top pick, we excluded restricted funds and corporate policies so we could highlight an option open for all. St.Lukes came out as the top fund across both categories.

Top pick for not for profit – HCF

We reviewed 11 not for profit health funds in Australia.

Our rating was based on the Finder value ranking algorithm which is used to give our Finder Awards. The algorithm weighs each policy based on criteria such as the excess/co-payment amount, number of associated (agreement) hospitals, treatments covered in public or private hospitals, waiting periods and annual benefit limits.

  • The policy must be available in NSW, VIC, WA, SA and QLD
  • Hospital policies will be assessed for a single person across five states (NSW, VIC, WA, SA and QLD) using Finder's health insurance engine algorithm
  • An insurer may only claim one place in the final winners' list in this category
    $500 excess

Out of the 11 not for profit funds that we reviewed, HCF was the only not for profit fund to have a policy in the top 5 across all three categories: best bronze, silver and gold. It was also the only not for profit finalist in the Best Gold and Best Bronze awards.

Use our free comparison tool to find the best health insurance for your needs

The tool below lets you compare health insurance policies side-by-side - just enter your details, choose the level of cover you'd like, then click search policies.

Once you have your quotes, you can then refine your search so it's tailored to your specific needs. Just tick the benefits (such as pregnancy or dental) that are most important to you, and we'll show you policies that match.

Who are the best health funds in Australia?

No health fund is perfect for everyone - some focus on specific regions, some are only open to particular groups, and some operate for a profit, while others don't.

However, there are a few important points to consider when choosing your health fund - including how partner networks operate, how excesses and waiting times are applied, and what out of pocket costs you should expect.

  • Partner networks: Health funds partner with various medical professionals and service providers, so you can choose who performs your knee replacement or which dentist does your root canal. However, if your preferred service provider isn't in your health fund's partner network, you might not be able to claim as much money back.
  • Excesses: You may have to pay an excess if you're admitted to hospital and opt for private treatment - but the amount will vary depending on your health fund and specific policy.
  • Wait times: Health funds often apply wait times on certain procedures - this means if you buy a policy today, you might not be able to make a claim for a certain treatment until months - or even years - later.
  • Out of pocket costs: Health insurance doesn't always cover all of the costs associated with an illness or injury - usually, you'll only be paid a percentage of the final bill, up to a certain limit.
  • Best for rural: If you live rurally or regionally, it's worth finding out how a health fund will make its benefits worthwhile to you. Some health funds are focussed on specific regions - like HBF, which services Western Australia.

Others, including HCF, offer travel and accommodation benefits while some, such as Bupa and Medibank, are rolling out online health services and live video conferencing with medical professionals.

Private hospital cover is available in four different tiers - basic, bronze, silver, and gold - which provide increasingly comprehensive cover as you ascend through the levels.

However, this doesn't mean that all gold policies will be the same - features still vary between different policies, so it's important to compare before you buy.

Best private hospital cover

For the 2020 Finder Awards, we compared 23 gold policies, 45 silver policies, and 25 bronze policies - according to our methodology, these are the funds that came out on top:

Best Gold health insurance

  • Winner: Bupa Gold Hospital $500 excess
  • Finalist: HCF Gold Hospital $500 excess
  • Finalist: Phoenix Health Fund Gold Complete $500 excess

Best Silver health insurance

  • Winner: Bupa Mid Hospital $500 Excess - Silver Plus
  • Finalist: CUA Standard Hospital Silver Plus $500 Excess
  • Finalist: NIB Silver Hospital $500 excess

Best Bronze health insurance

  • Winner: Health.com.au Base Hospital (Bronze +) $500 excess
  • Finalist: HBF Health Limited Bronze Hospital Plus $500 excess
  • Finalist: HCF Hospital Bronze Pus $500 Excess

Best private health insurance for families

You can choose health insurance which matches the needs of you and your family - whether you're just in the planning stage, you've already got children, or you're wrangling unruly teenagers. Make sure to look out for some key features which might be particularly useful:

  • Pre-pregnancy - If you're hoping to start a family in the near future, it may be worth investing in a gold-level policy, so you can get money back for fertility treatments as well as pre and post-natal care. Keep in mind if you want private hospital care for your baby, there may be a waiting period - usually at least 12 months - between when you took your policy out and when you can claim.
  • Children - Find child-friendly health insurance by looking for policies that offer cover for your kids at little or no extra cost. Some policies will waive the hospital excess if your child is admitted to hospital, while it's also worth checking for no-gap dental benefits.
  • Teenagers - Most health insurers will cover dependent children up to the age of 18, but if you think your kid would benefit from the support for a little longer, you can choose a health fund which lets you extend the age limit to for children up to age 25 - providing they're still a full-time student and remain unmarried.

Best for extras coverage

Extras cover is designed to help with the cost of non-hospital healthcare - so things like dental treatments, prescription glasses, and physiotherapy are usually included. Emergency ambulance transport can also fall under extras, along with psychology consultations.

There are some important factors to consider when choosing which extras cover is best for you.

  • Inclusions - Not all extras are created equal. You may find two policies which are similar in price but have different inclusions.

For example, nib's Core and Family Extras policy doesn't include psychology treatments but Medibank's Top Extras 55 policy will pay out $200 towards psychology treatments.

  • Waiting periods - Health insurers enforce waiting periods on certain treatments - but every provider applies waiting periods differently.

For example, ahm's Lifestyle Extras cover has no waiting period on optical or routine dental. However, CUA's Classic Extras cover - which costs a similar amount - comes with a six-month wait period for optical and a two-month wait for routine dental.

  • Limit amount - There'll also be a limit to the amount you can claim for each specific treatment - again, this will vary between different health insurance policies. Medibank's Growing Family 60 cover has a $300 limit for physiotherapy, while CUA's 60% Extras cover has a $500 limit.
  • Costs covered - Extras cover won't always pay the whole cost of a treatment - instead, it will cover a percentage of the final bill. The table below shows the average percentage of costs covered by different health funds.

The below table shows the average amount of costs covered by service:

Fund name (Open membership funds)Dental [1]Optical [1]PhysiotherapyPsychology
AIA Health51.80%54.50%58.10%55.70%
Australian Unity45.20%65.50%60.80%33.20%
BUPA56.00%56.50%47.00%41.20%
CBHS Corporate49.70%56.30%52.60%44.00%
CDH37.30%52.70%42.20%17.30%
CUA Health51.30%58.80%38.80%34.40%
GMHBA50.40%57.20%47.70%43.80%
HBF56.10%58.10%47.80%40.00%
HCF58.50%57.30%44.20%45.70%
HCI51.30%53.00%41.30%29.70%
health.com.au49.00%49.20%57.80%51.60%
Health Partners61.60%54.40%59.40%35.80%
HIF48.20%58.40%39.00%32.10%
Latrobe33.50%55.20%32.40%28.9%
MDHF61.30%63.00%40.60%26.80%
Medibank (includes ahm)53.50%68.90%46.50%32.20%
nib57.80%54.10%60.70%60.60%
onemedifund59.30%52.20%52.00%37.10%
Peoplecare48.60%60.30%39.20%37.60%
Phoenix56.70%66.10%43.60%40.10%
QCH51.70%60.10%43.70%42.60%
St Lukes64.50%75.70%50.10%45.50%
Transport Health55.00%57.50%43.60%27.60%
Westfund51.50%56.20%45.20%39.60%

[1] For some funds, the data does not take account of discounts at some providers or fund Dental / Optical centres.
Source: https://www.ombudsman.gov.au/publications/reports/state-of-the-health-funds/all-reports/docs/2020-state-of-the-health-funds-report

Best sign up deals for April 2021 from Finder Partners

Check the deals below before buying health insurance and you could save money on your premium - or get a reward for signing up.

ahm Deals ahm Deals
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Get up to $100 when signing up to both hospital + extras

$100 for couples and families and $50 for couples. Offer applies for new joiners.

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Coupon code ends

Medibank Health Insurance Deals Medibank Health Insurance Deals
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Get 6 weeks free. PLUS any 2 & 6 month waits on extras waived

Offer applies on eligible combined hospital & extras cover by 30 June. New members only. T&C's apply.

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Coupon code ends

CUA Health Deals CUA Health Deals
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Get up to $400 e-gift card + Skip 2 & 6 month waiting periods

Offer applies when joining hospital + extras cover by 30 April 2021. New members only. T&C's apply.

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Get deal
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Deal ends

PeopleCare Health Insurance Deals PeopleCare Health Insurance Deals
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Get $100 gift card + 10% off on extras premium (with combined cover)

Join hospital only or combined hospital & extras cover for new members. T&Cs apply.

Last verified

Get deal
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Qantas Health Insurance Deals Qantas Health Insurance Deals
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Get up to 130,000 Qantas Points

Earn up to 130,000 points on top policies, all policies earn Qantas Points. Offer applies for new joins only until May 24, 2021. T&Cs apply.

Last verified

Get deal
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Deal ends

AAMI Health Insurance Deals AAMI Health Insurance Deals
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Get $200 off when signing up to both hospital + extras

Offer applies for new joiners by 30 April 2021. T&Cs apply.

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Get deal
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Deal ends

HCF Health Insurance deals HCF Health Insurance deals
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HCF members can get loyalty rewards and discounts across Australian stores

Health fund members can claim 10% off Rebel gift cards, 4% off Woolworths e-gift cards & more.

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Get deal
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HBF Health Insurance HBF Health Insurance
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Get 4 weeks free

Get 4 weeks free after 60 days. Offer applies for hospital + extras combined policies.

Last verified

Get deal
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Deal ends

More ways to get value for money

  • Pay your premium in advance to avoid the administration fees associated with monthly payments.
  • Opting to pay annually via direct debit can get you a discount with some health funds.
  • Pay an excess or co-payment to lower your premium in exchange for paying a lump or daily sum if you go to hospital.
  • Join a restricted membership fund if you are eligible, as the premiums are usually lower and benefits to members higher.
  • Mix and match your hospital and extras cover, as two different funds may have the best* offers on each.
  • If insuring your family, check how long your children can stay covered under your policy.
  • To avoid paying a gap, make sure your preferred doctor and hospital both have agreements with your health fund.

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*Disclaimer: The products compared on this page are chosen from a range of offers available to us and are not representative of all the products available in the market. There is no perfect order or perfect ranking system for the products we list on our Site, so we provide you with the functionality to self-select, re-order and compare products. The initial display order is influenced by a range of factors including conversion rates, product costs and commercial arrangements, so please don't interpret the listing order as an endorsement or recommendation from us. We're happy to provide you with the tools you need to make better decisions, but we'd like you to make your own decisions and compare and assess products based on your own preferences, circumstances and needs.

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2 Responses

    Default Gravatar
    MichaelFebruary 15, 2017

    Which private health insurance companies offer the best reimbursement of the cost of hearing aids?

      Avatarfinder Customer Care
      ZubairFebruary 16, 2017Staff

      Hi Michael,

      Thank you for your question.

      The best insurance company for you would be the one that best meets your needs, preference, and budget.

      If you would like to review the cover limits of Australian funds for hearing aids please head over to our health insurance for hearing aids article.

      Open that link and you will find a list of health insurance brands that offer hearing aids cover. Check our comparison table to get an overview of their offer. Once you’re done comparing, you can then select the “Go to site” button to be redirected to your chosen provider’s official website.

      While looking for insurers, please make sure you read the terms and conditions of the policy to learn more and know if it is the right policy for you or not.

      I hope this helps. Should you have further questions, please don’t hesitate to reach us out again.

      Have a wonderful day!

      Cheers,
      Zubair

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