What Are the Best Health Insurance Funds in Australia?
What Are the Best Health Insurance Funds in Australia?
Is there a best health insurance fund in Australia?
While it would sure make things simpler, there just isn’t a ‘best’ health insurance fund. Health insurance isn’t one-size-fits-all. Instead, you need to align your health needs and budget with a policy that delivers value for you.
How can I compare health insurers, then?
To find your health insurer perfect match, it’s about more than simply just price. Think about which insurer suits your individual needs, whether that’s just your own or the whole family’s needs. You wouldn’t want to score a low premium but end up with a policy that doesn’t fit well.
Which health insurers are available in Australia?
Australia has lots of private health insurers (more than 30 at last count!), although some of them have larger membership bases then others. To help keep things straightforward, we’ve narrowed the list down to health funds with at least a 1% slice of the 2022-2023 health insurance market share pie. That’s 10 funds in total, and they sell 92.3% of health insurance policies in Australia.
Did you know that ahm is actually a part of Medibank, and Frank is a part of GMHBA? The figures we’ve used throughout this page incorporate sub-brands into their parent brands. That means ahm’s stats have been rolled into Medibank’s, and Frank’s into GHMBA’s.
This graph gives you an idea of the scale of each fund in terms of membership, as of 2022–23.
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Source: Australian Prudential Regulation Authority – Operations of private health insurers annual report
Which health insurance is most likely to cover all of my claim?
Even if a service is covered by your health insurance, your insurer might not cover the full cost. The money you’re left to pay is called a ‘gap’.
When you’re comparing health insurers, it can be helpful to look at how many medical services they cover without a gap (also called ‘no-gap’ services). The greater the percentage, the more value you could get when you make a claim.
This graph shows which health insurers covered the highest proportion of services without a gap in 2022–23, along with the industry average.
Can I expect the same gaps everywhere in Australia?
The percentage of no-gap services can actually change between states, even for the same insurer. It tends to come down to doctors’ fees, which can vary between states, as well as between urban and regional areas.
For instance, Medibank covers 90.9% of services in Tasmania without a gap but only 74.7% in the ACT. And this discrepancy plays out across other insurers, too – looking at the industry average for each state, the ACT is consistently at the bottom of the list.1PrivateHealth.gov.au – Medibank Private Limited (MBP) This could suggest that the ACT’s health services are generally more expensive.
Gaps can occur whether you’re claiming for hospital cover or extras cover. However, the gap tends to be bigger for extras. If you’ve ever had to claim for any dental service more extensive than a check-up and clean, you might be all too aware of this.
If gaps are a big factor for you when you’re picking a health insurer, you might want to drill down into hospital gaps and extras gaps separately.
These graphs show which health insurers covered the highest number of gap payments in 2022–23, split up by hospital and extras, along with the industry averages.
Should I opt for more gaps paid on hospital or extras cover?
Looking at 2022–23, both Medibank and HBF sit above the industry average when it comes to the proportion of no-gap extras services. For these two health insurers, extras-only policies also made up a higher proportion of their total policies than the other eight insurers.2Australian Prudential Regulation Authority – Operations of private health insurers annual report
Medibank’s and HBF’s reputations for covering more extras services without gaps may make them a popular choice for customers looking to get just extras.
However, which way you’re swayed could depend on your needs and what kinds of services you’re likely to want to claim on. And don’t forget that different policies – even if they’re from the same insurer – can have different gaps. If you’re really keen on getting as much back as you can when you claim, you may need to be prepared to read plenty of fine print and to search for a policy that has services you’ll use.
Which health insurers are customers happiest with?
While it can be a bit tricky to ask every single customer their honest opinion on their health insurer, looking at how many customers stay with the same insurer could help you answer that question. After all, unhappy customers tend to vote with their feet!
This graph shows which health insurers retained the highest number of memberships in 2022–23, along with the industry average.
Why do customers seem to stay with restricted health insurers more?
Obviously, individuals’ personal preferences can vary, but there’s industry acknowledgement, too, that restricted funds tend to score a little better when it comes to customers sticking by them. This could be the result of being able to offer features and products that are specific to a certain group of people, rather than needing to keep things broad and appeal to everyone. Also, a restricted health fund might have links to members’ employment and be treated as the norm for their industry.
Open health insurers, though, can still be very popular. After all, four of the seven open health insurers we’ve zoned in on had rates above the industry average. Those that were below the industry average were not that far behind the pack, either.
Helpful tip:

iSelect’s own 2024 research into health insurance policy and provider loyalty revealed that Australians on average have been on their current policy for almost seven years.3iSelect commissioned YouGov Galaxy Pty Ltd to conduct a national online survey between 15 and 21 July 2024. The sample is n=1,532 Australians aged 18 years and older who have private health insurance and are the main or joint decision maker for their cover. The survey results were weighted by age, gender and region to reflect the latest ABS population estimates.
This commitment could certainly be thanks to finding and staying with a good thing, but it may also be the result of simply setting and forgetting. Many Australians may not be getting the best bang for buck when it comes to their health insurance.
Andres Gutierrez
General Manager – Health
So, who comes out on top?
That’s up to you! The information above may have helped you start a shortlist, or you might want to do further research to keep narrowing things down.
Remember, although price can certainly be a factor, having a policy that offers you value is key. This could mean getting more extras services covered, having fewer gaps on hospital visits, or something else entirely.
If you’re feeling overwhelmed, don’t worry – we’re here to save you time and effort. Using our online health insurance comparison tool, you can tailor a search to see how a range of different policies and providers shape up. Alternatively, you can speak with one of our health comparison experts on 1800 784 772 to be guided through the process.