Health insurance comparison: how to compare 30+ funds yourself

How do you compare health insurance in Australia?

Comparing health insurance in Australia comes down to reading the same government document for every policy you are considering. That document is the Private Health Information Statement (PHIS), and every Australian insurer must publish one for each policy it sells, according to PrivateHealth.gov.au’s statement guide, read 8 November 2026. Five steps cover most of the work:

1. Decide the cover type. Hospital, extras or both. Only hospital cover can remove the Medicare Levy Surcharge.
2. Search the whole market. PrivateHealth.gov.au holds a statement for every policy from all 28 registered insurers. A commercial comparison site shows its own panel.
3. Shortlist by clinical category first. A policy that leaves out joint replacements or pregnancy is not a cheaper version of one that includes them.
4. Check the money fields. Excess, co-payments, waiting periods, extras limits and ambulance.
5. Price it after the rebate. The premium on a statement is before the Australian Government Rebate, which depends on income and age in 2026–27.

This is general information about how the system works, not advice about which policy suits you. It does not take your income, health or needs into account.

How many health insurers are there in Australia?

There are 28 registered private health insurers in Australia, and 8 of them are restricted to set membership groups. That count comes from APRA’s register of private health insurers, updated 30 July 2026 and opened 8 November 2026. The other numbers in circulation count something else.

Counts by Plain Cover from each list, read 8 November 2026. Last verified 8 November 2026.

The gap between 28 and 33 is brands. PrivateHealth.gov.au lists ahm (owned by Medibank), GU Health (owned by nib), RT Health (a division of HCF), see-u by HBF and Queensland Country Health Fund (both part of HBF) and TUH (part of the Teachers Health Group) as separate names, while APRA registers the parent once. APRA also lists CBHS Corporate Health Pty Ltd, which the PrivateHealth.gov.au list does not show. PrivateHealth.gov.au explains that insurers can sell cover through other organisations by underwriting their policies, which is how a “40+ funds” figure arises. A restricted insurer, such as Defence Health or Teachers Federation Health, sells only to people in its employer, profession or union group and their families.

Which health funds do comparison sites actually compare?

Australian comparison sites compare a panel of partner funds, and the two that publish their lists name 9 and 10 brands. Turning those lists into a share of the market needs one more source: PrivateHealth.gov.au shows each insurer’s market share on its insurer page. The site does not state the period these figures cover; they were read on 8 November 2026. The figure is for the whole insurer, so ahm’s page shows Medibank’s 26.5%.

Plain Cover calculation: each brand mapped to its registered insurer using PrivateHealth.gov.au’s insurer pages, then that insurer’s market share added once. Last verified 8 November 2026.

“Up to” matters. iSelect lists ahm, not Medibank’s own policies, yet the 26.5% belongs to Medibank as a whole. Both sites also say they do not compare every policy from the funds they list. The share is a ceiling, not the share of policies a reader actually sees.

What does a health insurance comparison site have to tell you?

A comparison site in Australia must not mislead about how much of the market it covers, under the Australian Consumer Law. The ACCC’s comparator website guide, published 3 August 2015, sets out what it expects, and uses health insurance as a worked example. Operators should:

• name the suppliers whose products they compare, and not show logos of suppliers they do not compare;
• not overstate the percentage of the market compared, and say when not all of a supplier’s products are listed;
• disclose commercial relationships, even where results are not affected, and keep paid placements separate from results;
• disclose any assumptions that filter results, such as leaving out pregnancy cover for a young single;
• not pay call-centre staff more for selling higher-commission products.

The ACCC has acted on coverage claims twice. On 11 August 2014 it announced Compare The Market had paid A$10,200 over a pamphlet claiming it compared “more health funds than any other website”, when the Ombudsman’s own site compared more (MR 204/14). On 22 November 2017 it announced Finder had paid A$10,800 over a claim to compare “roughly 65,000 policies” (MR 215/17). Paying an infringement notice is not an admission of a breach.

Sales by phone carry a separate rule. A Compare Club subsidiary admitted to the ACCC on 5 September 2022 that it had not told people sold cover in unsolicited calls about their 10-business-day right to cancel (ACCC undertaking register).

How do you use PrivateHealth.gov.au to compare policies?

PrivateHealth.gov.au is the Australian Government’s policy comparison site, run by the Private Health Insurance Ombudsman, and it is the one place that lists every policy. Its Compare Policies page, read 8 November 2026, states that all Australian insurers are required by law to give the Ombudsman details of each product. The Department of Health, Disability and Ageing’s choosing private health insurance page points readers to it.

A search needs three answers: who is covered (one person, a couple, a family or a single parent), the state or territory, and the cover type. Choosing specific hospital services or extras narrows the results but takes longer. The site suggests checking the restricted insurers, because a reader who qualifies for one widens the list.

Three habits make the search more useful. Save the personal key the site offers, so the same answers can be reloaded later. Open the statement for each shortlisted policy rather than relying on the results table. And read the “closed to new members” line: the RT Health Silver Plus Advantage Hospital statement for NSW and the ACT, issued 1 April 2026, carries it, so a new member cannot buy that policy at its listed A$267.09 a month. PrivateHealth.gov.au does not sell policies, so the last step is contacting the insurer.

How do you read a Private Health Information Statement, field by field?

A Private Health Information Statement is a one-page summary in a fixed government format, so the same field sits in the same place for every Australian policy. PrivateHealth.gov.au describes three kinds: hospital, general treatment (extras) and combined. Read 8 November 2026, a hospital statement carries these fields.

The extras statement is laid out differently. Bupa’s Top Extras 90, issued 13 July 2026 at A$217.10 a month for one person in NSW and the ACT, lists each service with its waiting period, its yearly limit and an example benefit. Major dental and endodontics share one A$1,200 limit per policy, optical is A$280 and physiotherapy A$900. The statement also says members get at least 90% back, up to yearly limits, at providers in Bupa’s network.

What should you compare between health insurance policies?

Seven fields decide most of the difference between two Australian policies at the same tier. The table sets out what each one means and the limit the law or the statement sets, as read on PrivateHealth.gov.au on 8 November 2026.

Tiers and categories are set out in Gold, Silver, Bronze and Basic compared and the full list of clinical categories. Waiting periods on a switch are explained in do you re-serve waiting periods when you switch, and ambulance rules state by state in ambulance cover by state.

PrivateHealth.gov.au’s registered insurers page explains why the network row matters. Many insurers operate mainly in one state or region, so they may have more agreement hospitals and gap cover doctors there, and agreements make it more likely that hospital, medical, pathology and imaging fees are covered.

Worked comparison: three Silver Plus hospital policies in NSW, November 2026

Three open Silver Plus hospital policies for one person in NSW and the ACT show how far the fields move at a single tier. They are listed by insurer in alphabetical order. They are examples, not a ranking and not a search of the whole market.

Each insurer’s PHIS on PrivateHealth.gov.au, opened 8 November 2026. All three restrict hospital psychiatric services and show the legal maximum waiting periods. Last verified 8 November 2026.

The lowest premium belongs to the policy that covers the least. Bupa’s statement costs A$69.01 a month less than HBF’s, or A$828.12 a year before the rebate, and it leaves out joint replacements and cataracts. Those two categories are a minimum only at Gold, so a Silver Plus policy may add them or not, as PrivateHealth.gov.au’s tier table shows. The nib and HBF statements sit A$7.31 a month apart and differ on dialysis, insulin pumps and ambulance terms. Excess pulls the other way: Bupa’s is A$250 lower per admission.

What does each policy cost after the 2026–27 rebate?

The Australian Government Rebate turns the three Silver Plus premiums in the worked comparison into a different net price for each income tier. For 2026–27 the singles thresholds are A$105,000, A$123,000 and A$164,000, according to PrivateHealth.gov.au’s rebate page, read 8 November 2026, and the rates below apply to people under 65 from 1 April 2026.

Plain Cover calculation: monthly premium times 12, less the rebate rate for a single under 65 in 2026–27. Tier 3 gets no rebate. Last verified 8 November 2026.

The year before had lower thresholds. These are the rates that applied from 1 July 2025 to 31 March 2026.

PrivateHealth.gov.au rebate page, read 8 November 2026. Last verified 8 November 2026.

Take Jordan, 45, single in Sydney, earning A$115,000 in 2026–27, with continuous hospital cover since 30 and no loading. Jordan is in tier 1 at 16.079%. Bupa nets A$1,874.12 a year and nib A$2,642.71, a gap of A$768.59. In a year with one admission, the excess makes it A$2,374.12 against A$3,392.71. Without hospital cover Jordan would pay a 1% surcharge, A$1,150. The full rebate table is in the rebate tiers guide, and prices for other tiers in what private health insurance costs.

How do health insurers compare on gaps, benefits and complaints?

PrivateHealth.gov.au publishes a performance table for every Australian insurer, drawn partly from the Ombudsman’s State of the Health Funds report. It does not state the period the figures cover; they were read on 8 November 2026. The figures describe the insurer, not any one policy.

Bupa, HBF and nib insurer pages on PrivateHealth.gov.au, period not stated, read 8 November 2026. Last verified 8 November 2026.

Two readings are useful. A complaint share below the market share, as with HBF’s 4.4% against 7.9%, means fewer complaints than its size alone would suggest. And the no-gap figure shows how often an insurer’s medical benefits left nothing to pay, which matters because a covered operation can still leave a doctor’s gap, explained in gap fees and out-of-pocket costs.

Why the lowest price on a comparison site may not be the lowest price in the market

The most common mistake in comparing Australian health insurance is treating a site’s result list as the whole market. On the fund lists the two sites publish, iSelect’s panel leaves out insurers holding at least 12.6% of market share and Compare the Market’s at least 39.3%, as at 8 November 2026. Neither list includes a restricted fund, and 8 of the 28 registered insurers are restricted. So “the lowest price shown” means the lowest price among the policies that site sells.

Three other gaps follow from the same cause:

• Brand is not insurer. PrivateHealth.gov.au lists AAMI, Apia, ING, Qantas, Real and Suncorp among the brand names nib sells under. Two “different funds” can be one insurer.
• Same tier, different cover. In the worked comparison the lowest Silver Plus premium came without joint replacements or cataracts.
• Before or after the rebate. A statement shows the premium before the rebate, and a quote may show it after the base-tier rebate. Setting one against the other can make a saving look bigger by up to 24.118% of the premium in 2026–27.

The ACCC’s 2015 comparator guide treats each of these as a disclosure duty for the comparison site. Checking the panel, the statement and the rebate tier is the reader’s own protection.

When does it make sense to have someone compare for you?

A guided comparison suits people who would rather talk the fields through than read the statements. Plain Cover does not compare, rank or sell policies. Readers who use the quote form are contacted by a consultant from a commercial partner, by phone, SMS or email, who goes through policies from the funds that partner works with, and Plain Cover may be paid a fee. Like every commercial panel in Australia, that partner’s funds are not the whole market.

The ACCC’s 2015 guide gives the questions worth asking any comparison service in Australia:

• Which insurers and brands do you compare, and do you compare all of their policies?
• How are you paid, and does it differ between insurers?
• Does the price you quote include the rebate, and at which tier?
• Have any results been left out because of assumptions about me?

Whatever the source of a recommendation, the policy’s Private Health Information Statement on PrivateHealth.gov.au is the document to check before paying. Moving funds once a policy is chosen is covered in how to switch health insurance.