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What you need to know
There are over 30 Australian private health insurance funds.
The largest private health funds in Australia include Medibank, ahm, Bupa, hbf, HCF and nib.
Australian health insurance providers are subject to regulations set by the government to ensure they provide fair and affordable coverage.
In Australia, there are 2 main types of health funds: for-profit and not-for profit. For-profit funds like Bupa and Medibank operate like private businesses. Not-for-profit health funds like HCF and hbf are member-owned and ostensibly give all their profits back to members, in some way. For most people, the choice is mostly preference - both types of funds operate pretty much the same.
What should I look for in a health fund?
Funds come in all shapes and sizes, and finding the right one for you involves comparing funds and their policies until you find the perfect fit. Things to look for in a health fund 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 fund
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.
Benefits
$17 million in benefits paid each year
Optical discounts available to holders of ancillary cover
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
Hunter Health Insurance
Hunter Health Insurance is the new name of Cessnock District Health Fund, which has been offering cost-effective private health cover for its members for more than 60 years. Hunter now offer coverage nationwide.
Benefits
Cost-effective cover for singles and families
Affordable premiums
Friendly and professional service
CUA
Credit Union Australia Limited (CUA) is a private health fund registered under the Private Health Insurance Act and committed to the principles of the Private Health Insurance Code of Conduct.
CUA Health Hospital Cover
CUA Health Extras Cover
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
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 Limited Extras Health Insurance
Benefits
Discounts available from optical network partners
15% off at network dentists
Affordable cover
Doctors Health Fund
Doctors Health Fund provides a range of private health care solutions for health professionals and their families.
Doctors Health Fund Hospital Cover
Benefits
Products tailored to suit the unique needs of its members
Benefits can carry over to the next year
Emergency Services Health
Emergency Services Health is a not-for-profit health fund for Australia’s emergency services community.
Benefits
Same-day hospitalisation and day surgery
Extras policy covers 80% of the cost of most extras services
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
GMHBA
Geelong Medical and Hospital Benefits Association (GMHBA) is a regionally-based not-for-profit member-based health fund.
GMHBA Extras Health Plans
GMHBA Health Insurance Hospital Cover
GMHBA Ambulance Cover
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
GU Health
GU Health, also known as Grand United Corporate Health, is a specialist corporate health fund that services more than 300 companies.
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
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.
A wide choice of extras cover to suit lifestyles and budgets
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.
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 Extras
Benefits
List of no-Gap providers
Handy claims app
Discounted premiums when you pay via direct debit
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 Hospital Cover
Navy Health Extras Cover
Navy Health Combined Hospital and Extras Cover
Benefits
Cover for all Defence Force members
10% discount for serving Defence Force members
Owned by its members
nib
nib is one of Australia's fastest growing health funds and began life as Newcastle Industrial Benefits (nib) Hospital Fund and Medical Fund, established by workers at BHP Steelworks in Mayfield.
No annual limits on ambulance transport anywhere in Australia (excluding QLD, and TAS state ambulance services)
No annual limit on preventative dental
Nurses & Midwives
Nurses & Midwives Health is exclusively for the needs of the Australian nursing and midwifery community.
Nurses & Midwives Health StarterPak
Benefits
Preventative dental cover
Emergency and non-emergency ambulance cover
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.
Benefits
Wide range of eye care discounts
Online health and wellness portal
Simple, affordable private health insurance
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.
Benefits
Members Own Health Fund
Eyewear discounts available
Fast and simple claims process
Award-winning health fund
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.
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
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 Extras Cover
Benefits
Optical and dental discounts available
Free health management programs
Members Own Health Fund
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.
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.
Benefits
Members Own Health Fund
Wide range of cover options
Large selection of wellness programs and health initiatives
UniHealth
UniHealth is created exclusively for the higher education community and their families.
Benefits
Full private room cover
Get 10% off Allianz Global Assistance travel insurance
Westfund Health
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 Hospital Cover
Westfund Overseas Cover
Westfund Hospital and Extras Cover
Benefits
Member Advantages program to reward member loyalty
Wide range of cover options available
Members Own Health Fund
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 fund’s and your own)
If you find a better deal, switch fund, 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 funds 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 fund has agreements with your doctor and local hospital to avoid paying a gap.
When looking for health cover, it’s important to look at the fund 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 a fund’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.
Why compare health insurance with Finder?
We don't ask for your phone or email to see prices.
With 1 click, you can open your results to nearly every fund in Australia.
You pay the same price as going direct – we charge no fees.
Compare prices from 30+ Aussie funds in under 30 seconds.
Why you can trust Finder's health insurance experts
We're free
Our health insurance engine is completely free to use. You pay the same as buying directly from the health insurer. Better still, we regularly run exclusive deals that you won't find on any other site.
Unlike other comparison sites, we're not owned by an insurer. That means our opinions are our own and you can compare nearly every health fund in Australia on the site (and find a better deal).
We're here to help
Since 2014, we've helped 350,000+ people find health insurance by explaining your options simply. We'll never ask for your number or email to see prices. We're here to help you make a decision.
Richard Laycock is Finder’s insights editor after spending the last five years writing and editing articles about insurance. His musings can be found across the web including on MoneyMag, Yahoo Finance and Travel Weekly. Richard studied Media at Macquarie University and The Missouri School of Journalism and has a Tier 1 Certification in General Advice for Life Insurance.
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