Best Health Insurance in 2026 as reviewed by Australian consumers

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To see the best health insurance plans, start by providing a few details about yourself:

Where will you be living?

The state or territory that the people covered by this policy will be living in most of the time. New South Wales includes Norfolk Island.

How many adults will be covered by this policy?

Adults include all people over 18 years who live in the same household. Age limit may vary for some insurers - see dependants below.

Who are the oldest dependants to be covered by this policy?

Some insurers will cover older dependants aged 18-24 if, for example, they are full-time students. Some may also allow a young adult dependant (18-24) to be covered on the same policy as adults in exchange for a higher premium - check with the insurer for details.

What type of policy do you need?

Hospital Only

Hospital policies cover most or all of your costs as a patient in hospital, including hospital accommodation, medical treatment & (in some states) ambulance.

Extras Only

General treatment policies cover health services not covered by Medicare, such as dental, optical and physiotherapy & may also cover ambulance.

Hospital and Extras

Combined policies cover both Hospital and General treatment.

Private health insurance in Australia
Hospital cover
- Do I need hospital cover?
- Tiers of hospital cover
Extras cover
- Do I need extras cover?
- Dental cover
Combined cover
Ambulance cover
What to consider when choosing health insurance
Decision time

A woman and man happily jogging outdoors together.

Private health insurance in Australia

When you first take out private health insurance, you will need to decide if you require one or a combination of the following options:

Hospital cover
Extras cover
Ambulance cover

If you don’t want any of them, you’re still covered for public hospital visits and basic checkups under Medicare, the Australian public healthcare system.

Getting private health insurance does not mean you give up your Medicare coverage; you can have both at the same time. Under Medicare, you can visit a public hospital as a public patient, but may be placed on a waitlist and cannot select your own doctor.

Medicare also covers your visit to a GP and most of the Medicare Benefits Schedule (MBS) fee for visiting a specialist, so if all you need are basic checkups, you may be fine relying on Medicare alone.

If you do decide to take up private health insurance, remember that you’re entitled to the same cover at the same price as anyone else, regardless of your risk profile. At the same time, if you're going to take out health insurance, it's important to choose a type that you actually use and aren't wasting money on. We go through the different types below.

Hospital cover

Private hospital cover is designed to take the strain off the public health system. To encourage people to join and spread the load across both systems, the government has several financial incentives for people to join a private health insurance fund.

If you’re interested in the financial benefits of private health insurance, or what rebates are available, you can read our article on the tax benefits of private health insurance.

Do I need hospital cover?

With hospital cover, you'll have peace of mind should any medical emergency or illness arise. You could otherwise be out of pocket for thousands of dollars or be put on a long waitlist for surgery.

Here are a few other reasons to take up private hospital cover:

You get to choose your own doctor in either a private or public hospital.
If you decide to go to a private hospital, you can choose from any that your provider has an agreement with.
You have a higher chance of getting a private room when you go to a public hospital as a private patient.
You may have reduced waiting times for some hospital procedures, such as elective surgery.
Additional MBS fees and other costs may be covered as part of your policy.
You can avoid paying the Medicare Levy Surcharge, which applies if you earn over $90,000 per year, or over $180,000 for families.
You can avoid paying Lifetime Health Cover loading, which applies if you haven't taken hospital cover by the time you're 31.

If you have no problems admitting as a public patient to a public hospital should the need arise, then you may decide you don’t need private hospital cover. If the costs you incur during an unexpected hospital visit are less than the amount you would have spent on hospital cover up until that point, then you could finish out ahead without hospital insurance.

Unfortunately, there’s no way to tell if this will be the case, so many people take out hospital cover just for ‘peace of mind’, especially as they get older and the chances of needing it become more likely.

Here are some reasons to not get private hospital cover:

Australia's public hospital system is generally good for those needing emergency surgery.
The premium of your health insurance (which is what you pay for your policy) can be expensive, and unaffordable for many people.
You may end up in a public hospital anyway for more complex medical conditions or treatments, as public hospitals usually have a wider range of medical equipment.
You may pay more out of pocket for certain doctors, as private patients are often charged more than public patients, and your health insurance will probably only cover part of the cost.

Tiers of hospital cover

The tier system applies only to Hospital Cover and began rolling out in April 2019, becoming mandatory on April 1st 2020. It was designed to make comparison between providers more straightforward by dividing levels of cover into four tiers:

Basic
Bronze
Silver
Gold

Each of these tiers has its own minimum requirements that must be met in order for a policy to be classified as being part of that tier. These minimum requirements are cumulative, meaning that each increasing tier includes all the minimums of the tiers below it.

This graphic shows the minimal coverage requirements for each tier:

Minimal coverage requirements for each product tier updated

'Plus' policies

There is some wiggle room allowing providers to include additional coverage on top of the minimum requirements for a tier - these are referred to as ‘Plus’ policies. If an insurer offers a policy that provides cover that's above the minimum requirements of a tier, then they can advertise the policy as Basic Plus (+), Bronze Plus (+), or Silver Plus (+). Because a Gold policy covers everything, there’s nothing additional that can be added to it in order to make a ‘Plus’ version.

For example, surgery to remove wisdom teeth is covered under Dental Surgery, which is mandatory for Silver cover, but not Bronze. However, a provider may choose to include it on top of their normal Bronze policy to create a Bronze Plus policy.

This means you can claim this benefit without the full price increase that would come with an upgrade to Silver. This allows you to avoid paying for other mandatory benefits covered under Silver that you might never use, such as podiatric surgery.

It’s important to note that not all ‘Plus’ versions of the same tier are directly comparable, since each provider may choose to include different clinical categories as optional inclusions. For example, Provider A may offer a Bronze Plus package that includes bloodwork, while Provider B offers a Bronze Plus package that includes reconstructive surgery instead - they are both still Bronze Plus policies.

Extras cover

Extras insurance will help cover the cost of ancillary health needs, like dental care, clinical therapies and prescription glasses or contact lenses. If you don't use these services, you may prefer not to purchase Extras Cover as there is no tax benefit to having it.

If you're after just the basics and don't require more expensive treatments like orthodontics, you'll be able to extract the most value out of an entry-level policy. However, don't expect to get 100% back on your bills; most funds offer a 50-60% rebate.

Do I need extras cover?

There’s more value to be had from Extras Cover when you're using your extras regularly, so assessing your present and potential future needs is the best place to start.

Many providers won’t include extras cover for pre-existing conditions, so if you have a family history of a condition like osteoporosis or diabetes, you may need to be covered before these issues arise so that they’re not counted as a pre-existing condition.

Providers approach extras insurance in different ways. Some will give you a lot of flexibility over which services you want to include, while others have strict packages you must choose from.

If you start by writing down a list of your personal must-haves (e.g. complex dental, physiotherapy, and hearing aids) you can then whittle down the list of possible policies to only those that include exactly what you’re looking for.

If you're getting cover for your family or if you're aged between 55 to 79, then there are some perks to getting extras insurance:

Families pay the same premium as couples, so children are covered for free. However, children under 5 on average typically get less than $100 in benefits each year, while children between 10 and $14 typically get almost $400.
People aged 55 to 79 tend to get more use of extras insurance benefits than other age groups, and typically receive an average benefit of over $600 a year.

Dental cover

One of the most popular reasons to take out extras is dental cover. Dental is typically split into different levels of cover from routine or general up to major and complex procedures, with orthodontics usually being a separate option as well.

Additionally, depending on what procedures you have done and where, not everything may be covered under your Extras policy. For example, if you elect to have wisdom teeth taken out in a hospital, some of the hospital and doctor fees may not be covered under your Extras policy and you’ll have to pay these out-of-pocket.

Man looking relaxed as a chiropractor releases tension in his head and neck

Combined cover

Combined cover is hospital cover and extras cover combined in a single policy. Private hospital and extras insurance are different types of insurance, and you don't necessarily need both. Often, you can get a better deal by buying extras and hospital cover from two separate health funds.

Some people like the convenience of having to only deal with one health fund for both insurance types. Before you take out combined cover, think about whether you need both hospital and extras insurance.

Ambulance cover

Ambulance cover is the most basic type of cover, and covers the cost of an ambulance in an emergency.

Unless you live in Queensland or Tasmania, ambulance call-out fees are not covered under Medicare and will have to be paid for out-of-pocket. You can find out more about ambulance fees for your state in our ambulance cover article.

When shopping around, check with an insurer to see what kind of ambulance cover they offer. Some only offer ground transport in an emergency and will not offer air ambulance. Some might just cover emergency ambulance and exclude transport to transfer patients between hospitals.

What to consider when choosing health insurance

Once you've decided what level of cover is right for you, you can start comparing different providers and policies. Each policy will have a product disclosure stateent (PDS) - read these to understand the inclusions and exclusions.

Here are some more things to consider when choosing health insurance.

Your personal circumstances

What's going on in your life will usually have a significant impact on which type and level of cover will best suit you.

Consider the following questions:

Do you have any pre-existing conditions that may require medical treatment in the near future?
Are there any hereditary health conditions in your family that could have an impact on you?
Are you planning on starting or growing a family and will you require obstetrics cover?
Do you need cover for partners or dependants?
How will your health needs and requirements change as you get older?

You should be honest about your health history when you take out a policy. Your insurer may not pay your claim if they believe that you have misled them.

Premiums

Generally, the higher your premium, the more benefits you can claim. You can usually tweak your health insurance policy to make your premium more affordable. Consider doing the following:

Customise your excess. Choosing a higher excess (what you agree to pay towards a Hospital claim) will usually reduce your premiums.
Choose a co-payment. This is a fee that you agree to pay for each day you're a patient in a hospital. It could be a more affordable option if your co-payment is less than what the excess would be and if you know how long you'll need to stay in hospital.

Waiting periods

Most health funds have a waiting period before you're able to claim on any services. The length of the waiting period usually depends on the type and complexity of the medical treatment.

For hospital cover, waiting periods for pre-existing conditions or obstetrics (pregnancy) are usually 12 months.
Waiting periods for extras vary; it can be 2 months for many services, and is usually 12 months for major dental treatment.
Waiting periods typically won't apply if you're switching policies or health funds to a similar level of cover.

Decision time

One thing to remember that will help you avoid confusion when browsing policies is that hospital cover is sorted into Basic / Bronze / Silver / Gold tiers, while extras will be called whatever marketing name the provider has come up with for themselves (e.g. 'Lifestyle Extras,' 'Black Extras 60,' 'Essential Extras,' or 'Top Extras.')

It may be possible to mix-and-match your hospital and extras cover in many ways, such as combining the most expensive hospital cover with the most basic extras cover or vice-versa. Your provider may also offer some pre-selected hospital & extras combinations.

ProductReview.com.au is a great tool for seeing feedback about Health Insurance providers from real customers. You can browse our list of health insurance providers and easily see a summary of how other Australians rate their health fund for customer service, value for money, and transparency.

If you click through to an individual fund, you can use the Filter Reviews button to narrow down the reviews to see just those that are similar to you, or that you might be interested in reading.

Remember: insurance isn't forever. Reassess your policy regularly to ensure that it's meeting your needs and you're making the most of it.

This article is part of our series on private health insurance.

Disclaimer: The information on this website is for general information only. It should not be taken as constituting professional advice from the website owner - ProductReview.com.au. ProductReview.com.au is not a financial adviser. You should consider seeking independent legal, financial, taxation or other advice to check how the website information relates to your unique circumstances. ProductReview.com.au is not liable for any loss caused, whether due to negligence or otherwise arising from the use of, or reliance on, the information provided directly or indirectly, by use of this website.

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