Health Insurance Companies – Who’s Right for You?

How do you choose between health funds? Full list of health insurance companies and reviews, along with tips and trick for comparing policies.

Comparing your health insurance options is more than looking at a policy, it's about reviewing health insurance companies too.

But how do you compare health insurance companies? What makes one health fund better than the next?

This guide takes a look at what separates good health insurance companies from the bad, what you should look for, as well as summarises of the policies and benefits offered by health insurance companies in Australia.

Don't want to compare health insurance companies yourself? Speak with an adviser today about comparing your options.

Compare your cover options online or with an adviser

Details Features
High 65 / 75 / 85% - $0/$250/$500 Excess
High 65 / 75 / 85% - $0/$250/$500 Excess
Combines High Hospital Cover with its highest level of extras cover.
  • Cover starting from $44.74 weekly
  • 12 month waiting period for pregnancy
  • 65% back on extras
  • Choice of $0, $250 and $500 excess
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Premier Package
Premier Package
Top tier combined hospital and extras policy that covers you for an extensive range of hospital and general treatment services.
  • All the benefits of HCI's Premier Hospital policy
  • All the benefits of HCI's Premier Extras policy
  • Cover for pregnancy and IVF treatment
  • Cover for general and major dental
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Deluxe flexi
Deluxe flexi
Deluxe flexi provides cover for a range of treatments including hip replacement, spinal fusion, dialysis and major eye surgery.
  • No excess for kids
  • All joint replacements
  • Major eye surgery
  • Rehabilitation
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GoldStar
GoldStar
Premium hospital cover with complete cover for hospital expenses. Save 4% when you pay for 12 months of your cover upfront.
  • All theatre fees covered
  • Unlimited maternity cover
  • Choose no excess or $200, $400, $500 per admission
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Smart Combination
Smart Combination
Smart combination provides a high level of cover for both hospital and extras.
  • Claim up to $2725 back on extras
  • Hip and knee replacements
  • General and major dental
  • Physio
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Prestige
Prestige
Highest level of combined cover offered by CBHS. Includes the same benefits as Comprehensive Hospital and Top Extras plus more. Restricted fund: Only current or former staff (and their families) of Commonwealth Bank Group and their subsidiaries which include Aussie, Bankwest, Colonial First State and more can join.
  • No excess or co-payments on hospital cover
  • Non-student dependent under 25 can be kept on policy
  • Access to Chronic Disease Management Programs
  • Widest range of extras including orthodontics
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Bronze Hospital (no pregnancy) and Bronze Extras Set Benefits
Bronze Hospital (no pregnancy) and Bronze Extras Set Benefits
High level of hospital cover and extras cover for a range of popular services including knee and should reconstructions.
  • Most comprehensive hospital options
  • Cover for general and major dental
  • Shared or single room in a private hospital
  • Intensive and coronary care
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Premium Hospital and Silver Extras Cover
Premium Hospital and Silver Extras Cover
Comprehensive hospital cover including pregnancy cover. Also included affordable mid-level extras cover for dental, optical and therapies.
  • Cover from $39.50 per week
  • Pregnancy and birth-related services cover
  • Heart surgery cover
  • 100% cash back on two dental check per year
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Top Hospital with Top Extras
Top Hospital with Top Extras
Get comprehensive hospital and extras cover and tailor your policy to your needs.
  • Pregnancy and birth services cover
  • Back surgery cover
  • $1000 general dental annual limit
  • $600 physiotherapy annual limit
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Young Couples Combined Cover
Young Couples Combined Cover
Mid-level hospital and basic level Extras package with an excess for young, healthy couples that are not quite ready to start a family.
  • Emergency ambulance cover
  • Cancer-related surgery cover
  • 70% back on extras
  • $300 dental annual limit per person
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What should I look for in a health insurer?

Health insurance companies come in all shapes and sizes, and finding the right one for you involves comparing insurers and their policies until you find the perfect fit. Things to look for in a health insurer include:

  • Whether they have agreements with hospitals and ancillary service providers in your area, so you will have low or no out-of-pocket expenses
  • Whether their cover includes a percentage of costs rather than a set benefit amount, as this will usually ensure you get more back
  • Whether they give you access as a member to health and lifestyle-related discounts
  • Whether they are a restricted membership fund, as this usually means lower premiums and higher benefits for members
  • Whether they have a good reputation, with few complaints and high retention rates
  • Whether they have a good industry rating and claims payment record
  • Whether they have lower management expenses as a percentage of premiums.

Benefit breakdown by health insurer

The following is a comparison of Australian health insurance providers, which summarises their policies and the benefits they offer.

ACA Health

ACA Health Benefits Fund is a not-for-profit health fund for employees of the Seventh-Day Adventist Church and their families.

  • Deluxe Hospital. Top-level hospital cover with no excess or co-payment.
  • Private Hospital. Mid-level cover combining a broad range of benefits with affordable premiums.
  • Basic Hospital. Essential cover for private treatment in a public hospital.
  • Complete Ancillary. Comprehensive extras cover for basics like optical and dental plus natural therapies, dietetics and more.
  • Ancillary Lite. Entry-level extras cover including optical, general dental and physio.

Benefits

  • $17 million in benefits paid each year
  • Optical discounts available to holders of ancillary cover
  • Member-owned health fund
  • Personal and professional service
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ahm

ahm is a part of Medibank Private Ltd and trades as ahm Health Insurance.

  • Budget. Entry-level cover for young singles and couples.
  • Basic. Covers essential services for young singles and couples.
  • Classic. Mid-range insurance without pregnancy cover.
  • Top (no obstetrics). Cover for the things you want to be covered for and not the things you don't, like obstetrics and assisted reproductive services.
  • Top. Comprehensive cover for most procedures and services.
  • Basic. Cover for basic everyday services like general dental, optical, chiro and physio.
  • Lifestyle. Cover for essential extras plus 17 alternative and complementary therapies.
  • Family. Extras cover for families, with more on dental.
  • Super. The highest level of cover, with most extras included.

Benefits

  • Single annual limit to be used on the extras you want
  • No waiting periods on most extras
  • Online and mobile claims and payments
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Australian Unity

Australian Unity is a health care, financial services and retirement living organisation that provides services to over half a million Australians.

Australian Unity policy options

  • Basic Starter. Get access to a range of extras and hospital cover for accidents.
  • Smart Start®. Get covered for hospital cover for a range of everyday procedures (even some specialised procedures) in addition to up to $1,300 back per person for simple extras.
  • Smart Essentials. With Smart Essentials you'll be able to claim back, per person, up to $2,150 on a range of popular extras. In addition to this you'll be able to get cover for heart related services and a range of everyday procedures.
  • Smart Combination. This top level option cover you for popular extras and allows you to claim back up to $2,725 per person. You'll also have cover for some specialised service, heart related services and a range of common procedures.

Benefits

  • General dental
  • Physio
  • Hospital care at home and in home rehab
  • Basic Hospital. Basic cover for accident and some procedures.
  • Basic+ Hospital. Cover for accidents and range of essential procedures.
  • Mid Hospital. Cover for accidents, heart related services and an range of procedures. Option to add pregnancy cover.
  • Gold Hospital. Cover for some specialised services, heart-related services, accidents, a comprehensive range of procedures.
  • Platinum Hospital. Highest level of cover for a range of benefits including pregnancy and fertility services.

Benefits

  • Surgical prostheses
  • Hospital care at home and in home rehab
  • Emergency ambulance
  • Basic Extras. If you only want entry level extras cover, this option will allow you to claim back up to $950 per person for a range of simple extras. Limits apply.
  • Bronze Extras. This policy allows you to claim back common extras treatments up to $1,200 per person.
  • Silver Extras. Want cover for a broad range extras? This policy will allow you to claim back up to $3,400 per person.
  • Gold Extras. This level covers you for a broad range of extras and will allow you to claim back up to $6,730 per person.
  • Platinum 80%. This top level cover option will allow you to claim up to $8,500 back on extras.

Benefits

  • General dental
  • Physiotherapy
  • Optical
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Budget Direct

Budget Direct Health Insurance is part of GMHBA Limited (Geelong Medical and Hospital Benefits Association).

Policies

  • Public Hospital. Shared room cover for a range of treatments as a private patient in a public hospital.
  • Mid Hospital. Cover for a shared room in a private hospital, without things you may not need (e.g. pregnancy-related services).
  • Top Hospital. Cover for a wide range of treatments as a private patient in both public and participating private hospitals.
  • Basic Extras. Basic cover for common services such as optical, general dental and alternative therapy treatments.
  • Top Extras. Cover for lots of services, with high limits.
  

Benefits

  • 10% discount if you’re already a Budget Direct customer
  • Choice of 55% or 85% back on extras (up to the annual limits)
  • 30-day money back guarantee
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Bupa

Formerly known as HBA, MBF and Mutual Community, Bupa has been around for more than 60 years.

Policies

  • Family Essentials. Cover for the whole family in private hospitals for accidents plus shared-room accommodation in public hospitals for you and your partner for all other procedures.
  • Budget Hospital. Basic hospital cover for the young and healthy.
  • Standard Hospital Cover. Covers most inpatient hospital treatments, with minimum benefits paid on some services not relevant to your stage of life.
  • Top Hospital. Comprehensive cover with the option to adjust your premium with different excess options, including nil excess.
  • Bronze Extras. Basic extras cover with access to some extra services to help you stay in good health.
  • Your Choice Extras. Choice of cover for four services to suit your needs.
  • Silver Extras. A wide range of services with good benefit levels and annual maximums.
  • Gold Extras. A wide range of services with high benefit levels and annual maximums.
  • Platinum Extras. A comprehensive range of services and high benefit levels.

Benefits

  • Extensive ancillary services network
  • Agreements with most private hospitals
  • Medical no gap or known gap scheme
  • Range of positive health programs
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CBHS

CBHS Health Fund is a restricted not-for-profit fund for current and former employees of the Commonwealth Bank of Australia Group and their eligible families.

Policies

  • Basic. Basic hospital cover for those who just want the essentials.
  • Limited. More comprehensive cover with some restricted benefits on services and treatments you are less likely to need (e.g. pregnancy).
  • Comprehensive. A high level of hospital cover for services and treatments.
  • Essential Extras. Basic extras cover for those who maintain a healthy lifestyle and only want the essentials.
  • Intermediate Extras. Mid-level cover providing benefits for popular general services and treatments for day-to-day health management.
  • Top Extras. attractive overall limits for those seeking security for an extensive range of services.

Benefits

  • Health management program for those with chronic illnesses
  • Best Doctors specialist network with some products
  • Choice Network of no-gap dental and optical providers
  • A range of health and wellness-related discounts
  • Hospital in the Home alternative to some hospital treatments
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Cessnock District Health Fund

Cessnock District Health Benefits Fund has been offering cost-effective private health cover for its members for more than 60 years.

  • Cessnock District Health Fund Top Hospital Only. High-level hospital cover with no excess payable.
  • Cessnock District Health Fund Top Hospital Only With $250 Excess. High-level cover but with a $250 excess payable when you are admitted to hospital.
  • Cessnock District Health Fund Top Hospital Only With $500 Excess. High-level cover but with a $500 excess payable when you are admitted to hospital.
  • Cessnock District Health Fund Basic Only. Entry-level hospital cover.
  • Cessnock District Health Fund Extras Only. Covers a wide range of general treatments, including everything from optical and dental to podiatry, acupuncture and natural therapies.
  • Cessnock District Health Fund Ambulance Only. This policy covers the cost of ambulance services Australia-wide.

Benefits

  • Cost-effective cover for singles and families
  • Affordable premiums
  • Friendly and professional service
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CUA

Credit Union Australia Limited (CUA) is a private health insurer registered under the Private Health Insurance Act and committed to the principles of the Private Health Insurance Code of Conduct.

Policies

  • 100% Private Hospital Cover. You pay nothing for a hospital admission, apart from $250, if you select the excess option.
  • 90% Private Hospital Cover. You pay 10% of a hospital admission capped at $500 per person per calendar year.
  • 75% Private Hospital Cover. You pay 25% of a hospital admission capped at $1,000 per person per calendar year.
  • 65% Private Hospital Cover. You pay 35% of a hospital admission capped at $1,000 per person per admission.
  • 100% Public Hospital Cover. Covers private treatment in a public hospital, with no excess or co-payment payable.
  • Silver Extras. Covers optical, dental, physio and remedial therapy, with lower capped amounts for services.
  • Gold Extras. Covers optical, dental, physio and remedial therapy, with higher capped amounts for services.

Benefits

  • No excess or co-payment for dependant kids’ hospital admission
  • First month free for new members
  • The freedom to choose your own healthcare provider
  • Online and mobile claiming
  • Discounts for home loan customers
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Defence Health

Defence Health offers its suite of private health cover options to more than 235,000 members with connections to the Australian Defence Force.

  • Defence Health Premier Hospital. Comprehensive hospital cover to provide complete peace of mind.
  • Defence Health Value Hospital. Mid-range cover that offers a wide range of benefits but excludes certain high-cost procedures.
  • Defence Health Essential Hospital. Entry-level cover for those who are young, fit and healthy.
  • Defence Health Premier Extras. Top-level cover for an extensive range of general treatments.
  • Defence Health Value Extras. Mid-level cover with lower benefit limits than a Premier Extras policy.
  • Defence Health Essential Extras. Basic cover for the most commonly-used extras treatments.

Benefits

  • Discounts available from optical network partners
  • 15% off at network dentists
  • Affordable cover
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Frank

Frank Private Health Insurance Australia is a not-for-profit health fund that is part of GMHBA (Geelong Medical and Hospital Benefits Association).

Policies

  • Basic Hospital. Essential hospital cover with the option to add cover in a private hospital for selected procedures.
  • Better Hospital. Good general coverage without the things you might not need, such as pregnancy cover.
  • Best Hospital. Comprehensive cover with the option to remove pregnancy or increase gap cover.
  • Some Extras. Basic extras cover for optical, dental and alternative therapy treatments.
  • Lots Extras. Cover for a wide range of services, with high benefits and annual limits.

Benefits

  • An all-online provider, so premiums are lower
  • Frank Hospital Rewards program to help cover out-of-pocket hospital expenses
  • Choose your own provider
  • Up to 80% back on extras
  • Access to member bonuses
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GMF

GMF Health is part of HealthGuard Health Benefits Fund Limited and is a not-for-profit member-based health fund.

Policies

  • Lite Hospital. Low cost shared-room hospital cover, where you only pay for the services you need.
  • Mid Hospital. Private-room cover for common hospital services including maternity cover.
  • Complete Hospital. Comprehensive private-room insurance covering most hospital services, including joint replacement, gastric banding and dialysis.
  • Lite Extras. Low cost covers for nine of the most common health services, including general dental, chiro and optical.
  • Mid Extras. Cover for more than 20 extras, including dental, physio and preventative services such as massage therapy.
  • Complete Extras. Comprehensive cover for all the essentials with a choice of 25 different services.

Benefits

  • Simple and transparent options
  • Choose your own health care provider
  • Straightforward claims process
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GMHBA

Geelong Medical and Hospital Benefits Association (GMHBA) is a regionally-based not-for-profit member-based health fund.

Policies

  • Bronze. Basic cover for treatment as a private patient in a public hospital.
  • Silver. Moderate cover for treatment in a private hospital, which includes a co-payment and excludes a range of services and treatments.
  • Gold. Comprehensive cover for a wide range of treatments in a participating private hospital.
  • Bronze. Cost-effective extras cover with limited services and smaller annual limits.
  • Silver. Moderate extras cover with medium level benefits and substantial annual limits.
  • Gold. A high level of cover on a wide range of services, with generous benefits and annual limits.

Benefits

  • Quick and easy online claims
  • Opportunity to accumulate Reward dollars through the Connect Rewards Plus program
  • A range of packages for those into sports and fitness
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GU Health

GU Health, also known as Grand United Corporate Health, is a specialist corporate health insurer that services more than 300 companies.

GU Health Cover

  • GU Health tailors a range of health cover options to meet the needs of different employers.

Benefits

  • Benefits available for an extensive range of inpatient services
  • Cover tailored to suit the needs of your company and employees
  • Discounts available at clothing, exercise and travel insurance partners
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HBF

HBF is a not-for-profit health fund and one of the five largest health funds in Australia. Based in Western Australia, it’s been looking after the cover needs of its members for more than 70 years.

  • HBF Top Hospital. High-level hospital cover for complete peace of mind.
  • HBF Healthy Saver Hospital. Affordable cover designed for growing families.
  • HBF Mid Hospital. Mid-level cover that combines a range of benefits with value for money.
  • HBF Young Saver Hospital. Low-cost, entry-level health cover.
  • HBF Premium Essentials. High-level cover for 39 extras services.
  • HBF Extra Essentials. Comprehensive cover for 20 essential extras services.
  • HBF Flexi Extras. Choose cover for 10 general treatments from the 19 available options.
  • HBF Essentials Standard. Cover for 18 popular general treatments.
  • HBF Easy 8. Cover for HBF’s eight most popular general treatment options.
  • HBF Essentials Saver. Basic extras cover that offers value for money.
  • HBF Dental Saver. Basic cover for general dental services.

Benefits

  • Owned by its members
  • Save 4% when you pay your premiums by direct debit
  • Free personal health app
  • Wide range of discounts on optical and dental services
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HCF

The Hospitals Contribution Fund of Australia Limited (HCF) is one of the Big Four health funds and is the largest not-for-profit health fund in Australia.

Policies

  • Basic Hospital. Designed for the healthy and budget conscious, with accident cover, emergency ambulance and more.
  • Mid Hospital. Covers some common procedures and includes accident cover, emergency ambulance, heart surgery and more.
  • Premium Hospital. Comprehensive cover including accident, emergency ambulance, heart surgery, hip & knee, psychiatric, pregnancy and more.
  • Bronze Extras. Basic cover for dental and selected therapies.
  • Bronze Plus Extras. Basic cover for dental, optical and selected therapies.
  • Silver Extras. Mid-level cover for a range of services and therapies.
  • Gold Extras. Cover for a wide range of services and therapies.
  • Platinum Extras. Top level cover for most therapies and services.

Benefits

  • No hospital excess for dependant children
  • Only one hospital excess amount per person per calendar year
  • 10% member discount on travel and pet insurance
  • Heart cover included in all hospital products except Basic Hospital
  • Free Victor Chang heart health checks with extras cover
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Health Care Insurance

Founded in 1938, Health Care Insurance (HCI) aims to offer quality cover and value for money to its members.

  • HCI Premier Hospital With $250 Excess. Comprehensive hospital cover with a $250 excess.
  • HCI Premier Hospital With $500 Excess. Comprehensive hospital cover with a $500 excess.
  • HCI Premier Hospital With $1,000 Excess. Comprehensive hospital cover with a $1,000 excess.
  • HCI Premier Extras. Comprehensive cover for an extensive range of general treatments.
  • HCI Essential Extras. Mid-level cover that combines affordability with benefits for a wide range of treatments.
  • HCI Select Extras. Designed for singles, this policy offers affordable cover for the most commonly-used extras.

Benefits

  • Agreements with more than 500 private hospitals and day surgeries
  • Wholly owned by its members
  • Value for money and personal service
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health.com.au

health.com.au is an online health cover provider that offers policies to suit a wide range of cover needs and budgets.

  • health.com.au High Hospital. High-level hospital cover for an extensive range of procedures and services.
  • health.com.au Basic Hospital. Entry-level hospital policy that only covers the essentials.
  • Extras 50. Receive cover for 50% of the cost of a wide range of general treatments.

Benefits

  • 24/7 online claiming
  • Award-winning customer service
  • Easy-to-understand cover
  • Ambulance cover included
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HIF

Health Insurance Fund of Australia (HIF), a not-for-profit member-based health fund.

Policies

  • GoldVital. Basic hospital cover to avoid the Medicare Levy Surcharge.
  • GoldStarter. Entry-level insurance covering all the hospital essentials.
  • GoldSaver. Intermediate insurance covering all the essentials including maternity.
  • GoldHospital. Comprehensive shared-room insurance with maternity cover and a choice of optional excesses.
  • GoldStar. Premium private-room insurance with everything covered.
  • Vital Options. Entry-level cover including general dental, emergency ambulance, chiro, physio and osteo.
  • Saver Options. Cover for common services like general dental, optical, chiro, physio, osteo, healthy lifestyle services, complementary therapies and ambulance.
  • Special Options. Cover for essential services including dental, optical, podiatry, chiro, pharmacy, physio and ambulance plus major dental services like orthodontics, crowns and bridges.
  • Super Options. Most popular insurance providing cover for practically every kind of service.
  • Premium Options. Covers everything, with larger rebates and higher annual limits.

Benefits

  • Premiums consistently among the lowest in Australia and benefits among the highest
  • Choice of GP and ancillary service providers
  • Access to over 500 private hospitals throughout Australia
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Latrobe

Established in 1951, Latrobe is a member-focused health fund, providing cover to more than 78,000 Australians.

Policies

  • Top Hospital. With no excess or co-payment.
  • MemberShare. Top hospital with co-payment options.
  • CoverWise. Top hospital with excess options.
  • Loyal Members. Top hospital with a reducing excess.
  • Family Care. Top hospital for families with adult children.
  • Premier Gold. Extras cover with higher rebates.
  • Premier Silver. Comprehensive cover including general, major dental and a range of lifestyle benefits.
  • Premier. Can be packaged with hospital cover for a bonus upgrade to Premier Plus.
  • Family Care Gold. Extras cover for families with generous benefits.
  • Family Care. Family extras cover including non-student dependants up to 25 years of age.
  • Dental. Covers general and major dental, but not orthodontics.
  • Premier Plus. Only available with hospital cover.
  • Premier Family. Only available with hospital cover.
  • Premier Singles. Only available with hospital cover.

Benefits

  • Optional known or no gap medical benefits cover
  • No exclusions in hospital products
  • A wide choice of extras cover to suit lifestyles and budgets
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Medibank

Medibank’s core business is the underwriting of private health insurance policies through Medibank and AHM. Headquartered in Melbourne, they have operations throughout Australia.

Policies

  • Accident Only. Basic hospital cover to avoid the Medicare Levy Surcharge.
  • Basic Hospital. More comprehensive cover including ambulance, colonoscopies, tonsils and adenoids.
  • Standard Hospital. Covers accidents, ambulance, treatment for heart-related services and more, with no hospital excess for children on a family membership.
  • Top Hospital Essentials. Top cover for things you may need like hip and knee replacements or major eye surgery and not for things you may not need like obstetrics or fertility services.
  • Top Hospital. Premium hospital cover which includes pregnancy-related services and IVF treatments.
  • Basic Extras. Cover for dental, optical, physio and natural therapies, with a choice of 55% or 70% back.
  • Top Extras. Covers general dental, major dental and orthodontics, podiatry, speech therapy and hearing aids, with a choice of 55%, 70% or 85% back and with 100% back on optical up to annual limits.

Benefits

  • Easy claiming for extras from your mobile
  • Free online advice and health tips for members
  • Over 12,000 provider locations Australia-wide
  • Medibank nurse 24/7 hotline with hospital cover
  • Rewards for healthy choices
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Mildura Health Fund

Mildura Health Fund, also known as Mildura District Hospital Fund, has been offering health cover to its members since 1929. It has agreements in place with hundreds of hospitals around the country.

  • Mildura Health Fund Five Star Hospital Benefits. Premium hospital cover option available with a choice of four excess amounts: $0, $150, $250 or $500.
  • Mildura Health Fund Basic Hospital Benefits. Entry-level cover for young and healthy fund members.
  • Mildura Health Fund Five Star. Top-level extras cover for a wide variety of general treatment options.
  • Mildura Health Fund Ancillary Plus. Mid-range extras cover with lower benefit limits than Five Star cover.
  • Mildura Health Fund Basic Ancillary. Entry-level extras cover.
  • Mildura Health Fund Dental. Covers general dental, major dental and orthodontics.

Benefits

  • List of no-Gap providers
  • Handy claims app
  • Discounted premiums when you pay via direct debit
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Navy Health

Offering competitive policies to suit the cover needs of Australian Defence Force members and their families, Navy Health is a not-for-profit fund and was founded in 1955.

  • Navy Health Premium Hospital. Comprehensive cover at more than 490 hospitals around Australia.
  • Navy Health Premium Hospital 200 & 500. The same cover as Premium Hospital but with a $200 or $500 excess.
  • Navy Health NT Hospital. High-level hospital cover for Northern Territory residents.
  • Navy Health NT Hospital 300. The same cover as the policy above but with a $300 excess.
  • Navy Health Saver Hospital. Entry-level cover for budget-conscious members.
  • Navy Health Premium Extras. Navy Health’s highest level of extras cover.
  • Navy Health Healthy Living Extras. Provides the same benefits as a Premium Extras policy but with lower benefit limits.
  • Navy Health Basic Extras. Affordable entry-level cover for essential extras.

Benefits

  • Cover for all Defence Force members
  • 10% discount for serving Defence Force members
  • Owned by its members
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nib

nib is one of Australia's fastest growing health insurers and began life as Newcastle Industrial Benefits (nib) Hospital Fund and Medical Fund, established by workers at BHP Steelworks in Mayfield.

Policies

  • Basic. Basic hospital cover at an affordable price.
  • Mid. More comprehensive cover including a number of surgical procedures not covered by Basic.
  • Top (no pregnancy). Comprehensive insurance covering everything apart from IVF, pregnancy and birth services.
  • Top Hospital. Top hospital cover for everything including pregnancy and birth services.
  • Core Extras. Cover for basic extras such as dental, optical, physio and ambulance.
  • Top Extras. Cover for a comprehensive range of services.

Benefits

  • Choose your own extras provider
  • No annual limits on ambulance transport anywhere in Australia (excluding QLD, and TAS state ambulance services)
  • No annual limit on preventative dental
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onemedifund

With a focus on providing private health insurance that is straightforward and easy to understand, onemedifund offers a wide range of hospital cover, extras cover and combined cover packages.

  • onemedifund Private Plus No Excess. Comprehensive hospital cover and Access Gap Cover arrangements in place with more than 19,000 doctors nationwide.
  • onemedifund Private Plus $250 / $500. The same level of cover as above but with a $250 excess for singles and a $500 excess for families.
  • onemedifund Extras Plus. Comprehensive extras cover for a large number of general treatments.
  • onemedifund Basic Extras. Entry-level cover that provides at least 75% cover for the cost of commonly used general treatments.

Benefits

  • Wide range of eye care discounts
  • Online health and wellness portal
  • Simple, affordable private health insurance
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Peoplecare

A not-for-profit health fund with a focus on providing value-for-money cover, Peoplecare was named the number-one open health fund in Australia by Australian Financial Review's Smart Investor magazine in 2014.

  • Peoplecare Premium Hospital. Top-level hospital cover with three excess choices: $0, $250 or $500.
  • Peoplecare Extras Mid-level cover with a $500 excess.
  • Peoplecare ExtrasCover for the essentials in a public or private hospital with a $500 excess.
  • Peoplecare Premium Extras. High-level cover for a huge range of general treatments.
  • Peoplecare High Extras. Cover for a broad range of treatments with generous benefit limits.
  • Peoplecare Mid Extras. Covers ambulance expenses and offers benefits for a selection of commonly-used extras.
  • Peoplecare Basic Extras. Affordable extras cover for the young and healthy, covering 100% of ambulance costs and 50% of the cost of popular extras treatments.

Benefits

  • Members Own Health Fund
  • Eyewear discounts available
  • Fast and simple claims process
  • Award-winning health fund
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Phoenix Health Fund

Founded in 1953 to meet the health cover needs of Stewarts and Lloyds employees, Phoenix Health Fund now offers competitive private health insurance to anyone in Australia who wants to join.

  • Phoenix Health Fund Top Hospital. High-level hospital cover including pregnancy, assisted reproductive services and major eye surgery.
  • Phoenix Health Fund Top Hospital $500 Excess. Offers the same cover as the above policy but requires you to pay a $500 excess when you’re admitted to hospital.
  • Phoenix Health Fund Mid Hospital $500 Excess. This policy combines a wide range of benefits with affordable premiums.
  • Phoenix Health Fund Basic Hospital $500 Excess. Cover for essential treatments with a $500 excess.
  • Phoenix Health Fund Top Extras. Phoenix’s top level of cover for dental, optical, chiro, occupational therapy, remedial massage and more.
  • Phoenix Health Fund Mid Extras. Mid-level extras cover for young people.
  • Phoenix Health Fund Basic Extras. Entry-level cover for ambulance, dental, physio, chiro and physio.

Benefits

  • 99% customer service satisfaction rating
  • Members Own Health Fund
  • No limit to your choice of providers
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Police Health

Run by police for police, Police Health is a not-for-profit fund that offers value-for-money cover.

  • Police Health Top Hospital. Cover for 100% of hospital costs for an extensive range of treatments and procedures.
  • Police Health SureCover Extras. Top-level extras cover for everything from general dental to speech therapy.

Benefits

  • Members Own Health Fund
  • Mobile claims app
  • Personal service
  • Generous rebates on extras
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Queensland Country Health Fund

Based in regional Queensland, Queensland Country Health Fund aims to offer top-quality cover to Queenslanders. It has more than 35,000 members.

  • Queensland Country Health Fund Top Hospital Cover. High-level cover for treatment in a public or private hospital, available with an excess of $0, $250 or $500.
  • Queensland Country Health Fund Intermediate Hospital Cover. More affordable cover that excludes some high-cost treatments and is available with a $250 or $500 excess.
  • Queensland Country Health Fund Public Hospital Cover. Basic cover for treatment in a public hospital, with no excess payable.
  • Queensland Country Health Fund Premium Extras. High-level extras cover that is only available with the purchase of hospital cover.
  • Queensland Country Health Fund Essential Extras. Mid-level cover that covers all the same treatments as Premium Extras but with lower benefit limits, and that must be purchased with hospital cover.
  • Queensland Country Health Fund Young Extras. Essential extras cover for young members that can be purchased as a standalone policy.

Benefits

  • Online health and wellness portal
  • Eyewear discounts available
  • Not-for-profit health fund

Reserve Bank Health Society

Reserve Bank Health Society is a restricted health fund for current and former employees of the Reserve Bank of Australia or Note Printing Australia and their families.

  • Reserve Bank Health Society Gold Hospital Cover. This policy offers high-level cover for treatment in a private or public hospital and does not feature an excess.
  • Reserve Bank Health Society Extras Cover. Covers up to 90% of costs for a large selection of general treatments.

Benefits

  • Australia-wide coverage through a national network of 460 hospitals and 21,000 doctors
  • Coverage for up to 90% of optical and dental costs
  • Online wellness program
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RT Health

With a history dating back more than 126 years, RT Health Fund is a not-for-profit fund that offers a large variety of hospital and extras cover options for its members.

  • RT Health Premium Hospital. High-level hospital cover for 500% of treatment costs in a public or private hospital.
  • RT Health Smart Hospital. Mid-level cover with comprehensive protection but that excludes or restricts certain high-cost treatments.
  • RT Health Value Hospital. Low-level private hospital cover for members who don’t have any specific health concerns.
  • RT Health Public Hospital. Entry-level cover for treatment in a public hospital.
  • RT Health Premium Extras. Top-level extras cover for a huge range of treatment options.
  • RT Health Smart Extras. Mid-level cover for the same services as a Premium Extras policy but to lower benefit limits.
  • RT Health Value Extras. Entry-level cover for commonly-used extras that features lower benefit limits.

Benefits

  • Optical and dental discounts available
  • Free health management programs
  • Members Own Health Fund
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St.LukesHealth

St.LukesHealth was founded in Tasmania in 1952. It offers affordable hospital and extras cover to members in every Australian state and territory.

  • St.LukesHealth Hospital Platinum. Top-level hospital cover with no excess.
  • St.LukesHealth Hospital 300, 500 and 1000. These policies offer the same cover as Hospital Platinum but come with a choice of excess when you are admitted to hospital: $300, $500 or $1,000.
  • St.LukesHealth Budget 500 Level 1. Hospital cover for the young and healthy, this policy features a $500 excess and restricts some high-cost services.
  • St.LukesHealth Budget 500 Level 2. This policy comes with a $500 excess and restricts some high-cost treatments to keep premiums more affordable.
  • St.LukesHealth Super Extras. High-level extras cover for those who want complete peace of mind.
  • St.LukesHealth Budget Extras. Entry-level policy with a basic level of extras cover.

Benefits

  • Not-for-profit health fund
  • Health and wellbeing program for members
  • Personalised service
  • Easy claims process
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Teachers Health Fund

Teachers Health Fund is a restricted access, not-for-profit health fund for those in the education community and their families.

Policies

  • Basic Hospital. Essentials cover for those who don’t want to pay for services they don’t think they will need.
  • Mid Hospital. Intermediate cover with a choice of excess levels, designed for those who want more than just the basics.
  • Top Hospital. Comprehensive cover for a wide range of services including pregnancy, heart procedures and hip and knee joint replacements.
  • Emergency Ambulance. Cover just for emergency ambulance trips, for those who don’t want hospital or extras cover.
  • Essential Extras. Cover for core, everyday services including preventative and general dental, optical, physiotherapy and complementary therapies.
  • Top Extras. Generous benefits and overall limits for a comprehensive range of services including major dental, optical and psychology.

Benefits

  • On average 20% lower contribution rates than all other health funds
  • Management and administration expenses well below the industry average
  • A private room in a private hospital with Mid and Top Hospital cover
  • Free access to health support programs
  • Access to a range of discounts from health providers
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Transport Health

With origins dating back to 1888, Transport Health offers affordable private health cover for all Australians.

  • Transport Health Top Hospital. Comprehensive hospital cover with no excess.
  • Transport Health Top Hospital With Excess. Comprehensive hospital cover with a $250 excess to lower the cost of premiums.
  • Transport Health Top Hospital With Co-Payment. Comprehensive hospital cover with a $100 a night co-payment when you are hospitalised.
  • Transport Health Healthy Choice. Mid-level hospital cover featuring a $100 per night co-payment.
  • Transport Health Public Hospital. Entry-level cover for treatment as a private patient in a shared room of a public hospital.
  • Transport Health Top Extras. Comprehensive extras cover for a huge range of general treatments.
  • Transport Health Healthy Choice Extras. Affordable extras cover for a broad range of treatments.

Benefits

  • Membership available to all Australians
  • 100% back on dental and physio
  • Flexible and affordable cover
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TUH

Established in 1972 by the Queensland Teachers' Union, TUH offers quality health cover to members of the union and their families. It provides private health insurance cover for more than 70,000 Australians.

  • TUH Total Care Hospital. Comprehensive hospital cover with the choice of a $0, $300 or $500 excess.
  • TUH Budget Hospital. Entry-level hospital cover combining cover for essential services and affordable premiums.
  • TUH Comprehensive Extras. High-level extras cover for a long list of general treatment options.
  • TUH Family Extras. Provides comprehensive extras cover for the whole family.
  • TUH Healthy Options (60%) Extras. Claim 60% of the cost of a large number of commonly-used general treatments.
  • TUH Mid Range Extras. This mid-level option combines a decent selection of benefits with affordable premiums.
  • TUH Basic Extras. Entry-level cover for some of the most popular general treatments.

Benefits

  • Members Own Health Fund
  • Wide range of cover options
  • Large selection of wellness programs and health initiatives
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Westfund

Westfund is a member-owned health fund that was established in 1929. It aims to offer top-quality health cover to a wide variety of Australians.

  • Westfund Platinum Hospital. Comprehensive hospital cover with no excess.
  • Westfund Platinum Hospital 500. Comprehensive hospital cover with a $500 excess.
  • Westfund Platinum Extras. The highest level of general treatments cover available from Westfund.
  • Westfund Gold Extras. High-level extras cover for optical, dental, physio, complementary therapies and more.

Benefits

  • Member Advantages program to reward member loyalty

  • Wide range of cover options available
  • Members Own Health Fund

Specific treatment cover amounts by provider

Now that you know the policy features of each insurer, you can use this table to find out what dollar amount some of the largest ones pay out for certain treatments:

ProcedureMBSHBFSt LukesAHSA*BUPA*Medibank#nibMDHFGMHBA
Appendicectomy$445.40$614.45$629.45$632.10$635.45$609.95$597.45$534.50$534.40
Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genitalia$221.35$335.85$311.85$366.10$315.80$303.15$296.90$265.65$265.65
Breast, benign lesion surgical biopsy of excision$260.05$355.20$367.25$356.40$380.55$355.30$348.80$312.10$312.10
Carpal Tunnel Release$276.80$459.05$426.80$440.20$453.75$404.90$417.55$332.20$332.20
Cataract Surgery$760.55$1,242.25$1,163.30$1,239.70$1,184.20$1,126.25$1,144.90$912.80$912.80
Cholecystectomy$739.35$1,019.80$1,045.10$1,091.90$1,054.85$1,012.45$993.60$887.25$887.25
Colonoscopy$334.35$456.45$461.95$435.00$470.25$442.50$429.80$401.22$401.22
Complicated Delivery (of baby)$1,629.35$2,649.15$2,307.90$1,855.90$2,406.65$2,198.50$2,280.10$1,955.20$1,955.25
Coronary Artery Bypass$2,200.00$3,665.20$3,404.40$3,783.30$3,294.85$3,265.15$3,064.80$2,640.00$2,640.00
Craniotomy$1,586.75$2,631.75$2,443.70$2,420.80$2,602.05$2,322.10$2,393.60$1,904.10$1,904.10
Cytotoxic Chemotherapy$97.95$127.55$119.60$107.80$118.05$115.30$111.00$117.55$117.55
Femoral on Inguinal Hernia$464.50$640.60$657.50$909.70$662.70$636.05$623.05$557.40$557.40
Haemorrhoidectomy$367.75$502.25$524.65$602.90$517.20$503.80$472.75$441.30$441.30
Hip Replacement$1,317.80$2,146.75$2,318.15$2,214.50$2,094.35$2,000.75$2,013.85$1,581.40$1,581.40
Knee Replacement$2,047.60$2,146.75$2,318.15$2,563.40$2,094.35$2,000.75$2,013.85$1,581.40$1,581.40
Overnight investigation for sleep apnoea$588.00$747.65$707.85$682.20$703.45$694.25$709.40$705.60$705.60
Tonsils or Tonsils and Adenoid$295.70$522.05$493.85$513.90$481.30$472.35$442.65$354.85354.85
Uncomplicated Delivery (of baby)$693.95$2,150.35$1,979.05$1,484.50$2,057.05$1,886.95$1,550.60$832.74$832.74
Vaginal Hysterectomy$674.70$1,252.85$1,024.65$1,066.20$1,076.80$986.20$1,012.05$809.65$809.65
Varicose Veins$109.80$149.95$169.05$164.80$164.45$160.70$148.35$131.80131.80
Vasectomy$229.85$317.20$365.95$343.80$353.15$348.95$349.30$275.85$275.85

*NSW, #AHM

I recognise most of these funds except for the AHSA, what is that?

The Australian Health Service Alliance is a management services organisation that represents a number of small to medium sized health insurance funds, allowing them to combine resources to deliver a higher quality of service to their members.

The funds represented by the ASHA are:

  • ACA Health Benefits Fund
  • Australian Unity Health Limited
  • CBHS Health Fund Limited
  • CUA Health Limited
  • Defence Health
  • GMF Health
  • GMHBA
  • Budget Direct Health Insurance
  • Frank Health Insurance
  • GU Health
  • HBF Health Ltd
  • Health Care Insurance Limited
  • health.com.au
  • Health Insurance Fund of Australia Limited
  • Health Partners
  • Navy Health
  • onemedifund
  • Peoplecare Health Insurance
  • Phoenix Health Fund
  • Police Health Limited
  • Queensland Country Health Fund Limited
  • Reserve Bank Health Society Ltd
  • rt health fund
  • Teachers Health Fund > UniHealth Insurance
  • Teachers Union Health
  • The Doctors' Health Fund Pty Ltd
  • Transport Health
  • Westfund
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Health insurance tips

Finding the right health cover is like taking out any form of insurance. You need to compare policies and identify the one that is the fit for you and represents the value for money. The following are some things to bear in mind when doing so.

  • Review your cover regularly (at least once a year), as circumstances change (both your insurer’s and your own)
  • If you find a better deal, switch insurers, as it is easier than you think and your current benefits and status are fully transferable under law
  • Consider having your hospital cover and extras cover with separate insurers if you find good independent offers on each
  • Select a higher excess if you can afford it, to reduce the cost of your premium
  • Be wary of policies that have both an excess and a co-payment, as you could end up paying both
  • Look for policies that offer full ambulance cover, not just emergency cover
  • Make sure your insurer has agreements with your doctor and local hospital to avoid paying a gap.
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How are health insurance companies regulated?

When looking for health cover, it’s important to look at the insurer as well as the policy to make sure they would be able to fulfil their part of the bargain if you make a claim. You can learn something about an insurer’s industry standing, claims record and customer service levels from their online presence and also through industry forums on social media.

The health insurance industry in Australia is regulated by the Private Health Insurance Administration Council (PHIAC), which conducts quarterly reviews of health funds to ensure compliance. The Private Health Insurance Act 2007 gives the PHIAC the power to issue directives and enforce compliance if necessary, so consumers can be fairly confident that, in Australia at least, our private health insurance industry is well regulated and financially sound.

Speak with an adviser now about getting cover

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