Australia: What Are the Best Private Health Insurance Plans in 2025?

Did you know that a single night in a private hospital room in Australia can cost you over AUD 1,000 if you're not covered by private health insurance?

Consultations, hospital stays, dental care, glasses... do you know what Medicare actually covers, and more importantly, what it doesn’t? Whether you're a resident, a new migrant or an expat, a good private health insurance policy can make all the difference when it comes to managing unexpected medical expenses.

At HelloSafe, we help over a million users every month compare health insurance policies. Our experts have analysed dozens of health cover options available in Australia to bring you a detailed comparison and tailored advice suited to the local market.

Health insurance: What to remember?

Mandatory? Basic health coverage is provided by Medicare in Australia. It covers public hospital treatment and many GP or specialist visits. However, private health insurance is optional—but strongly recommended to avoid long waiting times and out-of-pocket costs in the private system.

Why take it out? Medicare doesn’t cover private hospital stays, ambulance services in some states, dental care, optical, or physiotherapy. Private health insurance helps reduce out-of-pocket expenses and gives you more flexibility and comfort.

What does it cover? Depending on the policy, it may cover private hospital accommodation, dental and optical treatments, physiotherapy, pregnancy-related care, mental health services, and more.

How much does it cost? A basic hospital policy starts around AUD 80 to 120/month for a single adult. For more comprehensive hospital + extras cover, expect to pay AUD 150 to 250/month or more depending on age and benefits.

Young, family or expat? Many funds offer youth discounts, family packages with child benefits, and expat-friendly covers with flexible hospital access and limited waiting periods. Some, like CBHS, are restricted to certain groups.

Local tip: Some insurers like HCF and Bupa offer 100% cover for dental check-ups or online GP consultations—worth checking if you use these services regularly.

What benefits should you include in your health insurance?

Taking out private health insurance means choosing the right benefits for your specific needs. Here’s an overview of the key types of coverage, ranked by importance.

Hospital cover

Importance: 🟥 Essential

• What it covers: overnight hospital stays, surgery, private room, theatre fees, nursing care.
• What Medicare covers: treatment in a public hospital as a public patient, but no cover for private hospital costs or choice of doctor.
• With private insurance: access to private hospitals, shorter waiting times, choice of specialist and room.
• Impact on price: 🔺 high, especially with full cover and low excess.
• Recommended for all profiles, especially families, seniors, or anyone wanting access to private facilities.
• ⚠️ Actor to avoid: CHBS does not provide hospital cover for the general public—it’s limited to Commonwealth Bank Group affiliates only.

General treatments (GP, specialists, pharmacy)

Importance: 🟥 Essential

• What it covers: GP visits, specialists, prescriptions, pathology, radiology.
• What Medicare covers: 100% for GP visits (bulk billing) and 85% of the Medicare Schedule Fee for specialists.
• With private insurance: helps cover out-of-pocket costs and non-subsidised medicines.
• Impact on price: 🔻 low to moderate.
• A must-have if you see specialists regularly or need ongoing treatment.
• ⚠️ Actor to avoid: Defence Health limits general treatment benefits to those with full Medicare entitlements and ADF eligibility—unsuitable for most expats.

Dental

Importance: 🟠 Important

• What it covers: check-ups, cleaning, fillings, crowns, orthodontics.
• What Medicare covers: nothing except in rare public dental schemes.
• With private insurance: partial or full refunds on basic and major treatments, annual limits apply.
• Impact on price: 🔺 moderate to high depending on coverage level.
• Recommended if you want to avoid large bills for common treatments or have children needing orthodontics.
• ⚠️ Actor to avoid: GMHBA sets relatively low annual limits on major dental work, even in top-tier extras covers.

Optical

Importance: 🟡 Optional

• What it covers: glasses, contact lenses, eye tests, laser eye surgery.
• What Medicare covers: basic eye tests only—no refund for glasses or contacts.
• With private insurance: fixed annual allowance (typically AUD 150–300) or no-gap options with partners.
• Impact on price: 🔻 low to moderate.
• Useful if you wear glasses or replace them regularly.
• ⚠️ Actor to avoid: Australian Unity excludes non-prescription lenses and applies a 6-month waiting period—less flexible than others.

Maternity

Importance: 🟠 Important (depending on profile)

• What it covers: prenatal care, delivery in private hospital, postnatal care, midwife support.
• What Medicare covers: shared care with public hospitals, but no private room or obstetrician of choice.
• With private insurance: choice of hospital and doctor, shorter wait times, more personalised follow-up.
• Impact on price: 🔺 high, especially with full obstetrics cover.
• Highly recommended if you're planning a pregnancy and want continuity of care in the private sector.
• ⚠️ Actor to avoid: Bupa includes maternity in only some hospital policies—be sure to check inclusions carefully before enrolling.

Alternative therapies (osteopathy, acupuncture, homeopathy)

Importance: 🟡 Optional

• What it covers: natural and complementary therapies like acupuncture, osteopathy, remedial massage.
• What Medicare covers: nothing.
• With private insurance: fixed refund per session (typically AUD 30–60), capped annually.
• Impact on price: 🔻 low to moderate.
• A good extra if you regularly use non-conventional treatments for wellbeing or pain management.
• ⚠️ Actor to avoid: CHBS offers no extras-only policy and limited access to natural therapies unless bundled with hospital cover.

Telehealth and digital services

Importance: 🟠 Important

• What it covers: online GP consults, mental health support, repeat prescriptions, health apps.
• What Medicare covers: partial coverage for some teleconsultations (temporarily extended).
• With private insurance: often includes 24/7 telehealth, psychology apps, digital coaching.
• Impact on price: 🔻 low.
• A great option for remote workers, parents, or those in rural areas needing easy access to care.
• ⚠️ Actor to avoid: Medibank offers limited digital mental health options in base-level extras covers—check higher tiers for full access.

Assistance and repatriation

Importance: 🟡 Optional

• What it covers: medical evacuation, travel assistance, repatriation from abroad, hospital transfers.
• What Medicare covers: domestic ambulance in some states only—no international coverage.
• With private insurance: international assistance, emergency transport, some accommodation costs.
• Impact on price: 🔻 low.
• Worth considering if you travel frequently or are not eligible for reciprocal Medicare agreements.
• ✅ Recommended actor: Defence Health offers comprehensive ambulance and overseas assistance cover, even including air and sea transport.

Why take out private health insurance in Australia?

Australia’s healthcare system is built on Medicare, which provides free or subsidised treatment in public hospitals and covers part of GP and specialist fees. However, it does not cover everything—private hospital costs, dental, optical, ambulance services (in some states), and physiotherapy often fall outside the scope.

This is why many Australians choose private health insurance: for faster access to care, greater comfort, and lower out-of-pocket expenses.

Here are some examples of how private health insurance can boost your coverage:

Good to know

Australia has Reciprocal Health Care Agreements with some countries (e.g. UK, NZ, Ireland). This grants temporary Medicare access, but doesn’t replace full private health cover.

How to choose the right health insurance for me?

Health insurance offers vary depending on the insurer, the level of benefits and your personal situation. Here are the key criteria to consider.

1. Define your profile and needs

Start by identifying your situation. Health needs differ greatly depending on:

• Young adults (under 30): often eligible for discounts, they may prefer basic hospital cover to avoid the Medicare Levy Surcharge.
• Families with children: frequent GP visits, orthodontics, and physiotherapy are common—choose extras with good dental and optical limits.
• Pregnant women or couples planning to: must choose a policy with maternity benefits at least 12 months in advance.
• Seniors: likely to need hospital access, chronic condition management, and high limits on therapies or hearing aids.
• Expats and new residents: may not have full Medicare access, so hospital cover is essential to avoid full-price care.

2. Compare the benefit levels

Each policy includes different benefit levels depending on the treatment type. Here's a comparison:

3. Assess the cost and value for money

Health insurance prices depend on:

• Age: premiums increase significantly with age.
• Selected benefits: more coverage means higher cost.
• Reimbursement levels: 100% cover is more expensive than 60–80%.
• Insurers: premiums vary; compare Medibank, HCF, Bupa, and not-for-profits like HBF or CBHS.

Good to know

Expect to pay AUD 80–120/month for basic hospital only, and AUD 150–250/month or more for combined hospital + extras policies.

4. Check waiting periods and activation conditions

Many policies include waiting periods, especially for:

• Maternity: 12 months
• Major dental and orthodontics: 12 months
• Optical, physio, natural therapies: 2 months on average
• Accident cover: usually immediate

Tip

Plan your membership in advance if you know you'll need treatment soon.

5. Look at extra services included

Some funds include valuable extras beyond reimbursements:

• Mobile app to manage claims and limits
• 24/7 teleconsultations
• Digital mental health programs
• Wellness apps and online coaching
• International travel support (repatriation, vaccinations)

6. Read exclusions and terms carefully

Before signing up:

• Check what’s not covered, especially pre-existing conditions and specific treatments.
• Review annual limits and sub-limits per service.
• Confirm cancellation and switch conditions (some require 30+ days’ notice).

Expert advice

Choosing the right health insurance in Australia means balancing what you truly need with what you can afford. With our comparison tool, you can instantly view the most relevant policies for your profile and compare their benefits with complete transparency.

How to reduce the cost of my health insurance?

Health cover can be expensive, but there are smart ways to cut costs without sacrificing quality.

What’s the best health insurance for my profile?

Tip for young Australians

Australians who take out hospital cover before turning 31 can avoid the Lifetime Health Cover (LHC) loading later. Those aged 18–29 may also be eligible for youth discounts of up to 10%.

FAQ

Jennifer Taylor

Jennifer is an Australian personal finance writer passionate about helping people take control of their financial lives. She holds a degree in Economics from the University of Melbourne and completed a postgraduate diploma in Financial Planning at UNSW. Before joining HelloSafe, she worked in both consumer finance and digital publishing, focusing on simplifying complex financial topics for a wider audience. At HelloSafe, Jennifer creates clear and practical content about insurance, loans, savings, and budgeting—tailored to the realities of everyday Australians looking to make smart money decisions.