Our analysis has found the price of top level Gold hospital cover has increased by about 71% over six years
These price hikes are much higher than the 21% average increase across all cover reported by the Department of Health, Disability and Ageing over the same period
Insurers’ sneaky tactics include quietly closing cheaper Gold policies and then releasing more expensive policies for new customers
Every year, health insurers must seek government approval to increase their premiums on 1 April.
This year, the Minister for Health and Aged Care Mark Butler announced a 4.41% average annual increase to health insurance premiums across all existing hospital and extras policies.
But currently, the insurers only need approval to raise premiums for existing policies, not new policies. This allows them to quietly close an existing policy, and then open a new policy with the same or similar cover, but with a jacked up price – bypassing government oversight.
This year the government has drafted new legislation that will require funds to seek approval for new policies too, aiming to outlaw this practice, known as “phoenixing”.
The insurers were quietly closing an existing policy, and opening a new policy with the same or similar cover, but with a jacked up price
CHOICE has discovered that phoenixing has contributed to an increase in the price of Gold hospital insurance of about 71% over six years. The “approved” premium increase over the same period was just 21% across all hospital and extras policies.
Top cover even less affordable
A single person in 2021 paid around $239 per month, or $2874 a year, for Gold hospital cover (with a $750 excess). In 2026, they were slugged with premiums closer to $410 per month, or $4915 per year, on average for the same level of cover.
The big five health funds – Medibank, Bupa, HCF, HBF and NIB – have all implemented substantial price rises.
Our analysis, which compared policies available to new customers in 2021 with those available in 2026, found the cost of Gold hospital policies from the big five has skyrocketed, all with increases even higher than the Australian average of 71%.
The big five health funds – Medibank, Bupa, HCF, HBF and NIB – have all implemented substantial price rises
Looking at Gold policies in NSW with a $750 excess, Bupa’s April 2026 Gold hospital policy cost 75% more than the policy they offered in January 2021. Medibank’s policy cost 85% more, and NIB’s Qantas Gold policy was 92% more expensive. But HCF’s whopping policy increase was more than double the average with a 147% increase.
In WA, HBF’s 2025 Gold policy was 97% more expensive than the Gold policy it was selling six years ago.
Text-only accessible version
Sneaky sky-high increases to top hospital cover
Government figures say average health insurance premiums have increased by 21% over the past six years, but CHOICE research has found the cost of top cover Gold hospital policies has skyrocketed far beyond that.
Medibank – 85% (New South Wales)
NIB (Qantas) – 92% (New South Wales)
Bupa – 75% (New South Wales)
HCF – 147% (New South Wales)
HBF – up to 97% (Western Australia)
We compared Gold policies available to new customers in January 2021 with those available in April 2026 in New South Wales, except for HBF where we looked at Western Australia, as this is their largest customer base.
How it works: Close cheaper policies; replace with more expensive ones
As mentioned above, we’ve found many instances of funds closing existing policies to new members while at the same time opening new policies that offer essentially the same cover but with a slightly different name and a much higher price tag.
On 26 February 2025, the day the Health Minister announced the 2025 health insurance increase, HCF released Optimal Gold, with a NSW premium of $440 per month and closed (to new members) its Premium Gold with a cost of $325 per month with $750 excess.
This is an annual increase in the price of HCF’s Gold hospital cover of $1353, or a staggering 34.6%. And earned HCF a Shonky award.
HCF closed their existing Gold policy, and opened a new one with more restrictions and a 35% price increase
In June 2022, HBF closed their Gold Hospital policy in WA, which cost $215 per month with a $750 excess. They then released their Gold Hospital Elevate policy to new members at $280 per month, which was essentially the same cover with a 30% increase in price.
In November 2023, Medibank closed its Gold Complete Hospital, which cost NSW customers $255 a month and released Gold Protect. This was essentially the same cover, but costs $300 per month at the same excess level – which is an extra $525 per year, or 17% more.
Other price jumps we found include these NSW policies with $750 excess:
In August 2023 NIB closed their Qantas Gold Hospital policy, which cost $280, and released Qantas Gold Top Hospital for $325 (17% jump).
In April 2023 Bupa closed their Gold Complete Hospital policy, which cost $265, and released Gold Comprehensive Hospital for $305 (15% jump).
In March 2022 HCF closed their Hospital Gold policy, which cost $235, and released Hospital Premium Gold for $285 (more than 21% jump).
For our analysis, we looked at individual policy examples in NSW for Bupa, Medibank, HCF and NIB, and we looked at WA for HBF. Read more under ‘How we calculated the increases’ at the end of this article.
We’ve also discovered that even when some funds keep cheaper Gold policies open to new customers, they don’t advertise them – they spruik their newer, pricier policies instead.
Medibank has two Gold policies available to new customers – at the $500 excess level there’s Gold Advanced, which costs $313 per month in NSW, and Gold Protect, which is $380 per month.
Even when some funds keep cheaper Gold policies open to new customers, they don’t advertise them
But only the Gold Protect policy is shown on the Medibank website. Medibank will go to great lengths to dissuade you from buying the cheaper Gold Advanced policy with the same cover.
In an inquiry with Medibank’s “virtual concierge” (online chat) we were told the “Gold Advanced isn’t marketable and that’s why it’s not on our website”.
If you call the insurer and specifically ask for it, you should still be able to buy the cheaper policy, but you may need to persist. You can search all currently available health insurance policies using our independent health insurance finder.
With so many policies on offer, it pays to do your research before choosing one.
How to avoid paying too much for health insurance
With the sky-high increases to the cost of Gold hospital insurance over the past few years and another premium increase on the way, health insurance has become even less affordable for people who really need it.
If you opted for top level Gold hospital insurance “just in case”, now is the time to seriously think about dropping it or downgrading to more affordable cover.
And if you’re thinking of upgrading to a Gold policy – for example, if you’re planning to have a baby and want to deliver in a private hospital or you anticipate you’ll need premium cover in the next few years – don’t just automatically upgrade with your current fund.
We often see that the best deals available are with smaller funds and restricted membership funds.
If you opted for top level Gold hospital insurance ‘just in case’, now is the time to seriously think about dropping it or downgrading to more affordable cover
To help you make sense of your options, our health insurance comparison tool lets you compare policies from over 40 insurers. We’re a nonprofit organisation and we don’t take any commissions, so you can be sure we’ll help you find the best policy for you (not what’s best for the insurer).
Do you need Gold health insurance?
Gold hospital insurance policies are designed for people who want to be covered for specific health needs. For example:
young families who are planning to have a baby and want to deliver in a private hospital
people who need hip or knee replacements or cataract eye surgery
people who need end-of-life palliative care
families with a child who has a serious eating disorder needing in-hospital care
young people with mental illness and mothers with serious postnatal depression who need in-hospital psychiatric care
people who need rehabilitation after an accident or stroke
people who need weight-loss surgery
people with chronic pain; for example, because of coronary heart disease.
Why are the insurers increasing the cost of Gold Hospital policies?
Health insurers justify their price rises as they say they are in line with the increasing cost of health care, particularly on the services covered by Gold policies, as well as the risk profile and claims statistics associated with top cover Gold policies.
Nonprofit insurer HBF told us: “In looking specifically at our Gold policies, the claims HBF pays to members continue to be higher than the premiums we receive.”
Insurers also said that by opening new policies they were able to limit the premium increases for people on closed policies.
Australia’s creaking health system
Insurers, especially nonprofit funds, set prices based on their costs. But transparency is important, especially in an area such as health care where potentially sick and vulnerable people need to be able to rely on their health insurance.
When there is such a considerable difference between the highly publicised average premium increases and the reality of the higher prices affecting a range of Australians, it hinders our ability to make informed choices about health insurance.
Australian taxpayers are propping up private health insurers who are selling us increasingly unaffordable health insurance
Top level Gold cover is designed for the many Australians who have specific high-level needs, such as management for mental health conditions or care in a palliative or rehabilitation facility.
Health insurers are using these sneaky tactics to inflate prices for people who need health insurance for things such as surgery, management of chronic pain, or end-of-life care. Often these are the people who can least afford higher premiums.
Taxpayers fork out almost $8 billion annually to private health insurers. In return, private health insurance is meant to complement the creaking public Medicare system to help Australians pay their medical bills.
Instead, Australian taxpayers are propping up private health insurers who are selling us increasingly unaffordable health insurance.
How we calculated the increases
To analyse the average increase in the cost of Gold hospital cover over the past four years, we compared premiums for Gold policies available to new customers with a $750 excess on 1 January 2021 with those available on 1 April 2025. Restricted membership funds and corporate policies were not included in the analysis.
Using this method, we found the national average price increase of Gold hospital policies over the past five years was 58%. There may be small differences in cover between the policies we compared in 2021 and 2025.
All prices given in the article are monthly premiums for single policies with a $750 excess for people living in NSW, with the exception of HBF policies, where we used premiums for WA, HBF’s largest customer base. Premiums are rounded to the nearest $5, and do not include the health insurance rebate, any discounts (such as for prepay or direct debit) or Lifetime Health Cover surcharges.
Jane Bardell is a Content producer in the Insurance and utilities team. She writes about home, car, pet and health insurance.
Previously at CHOICE, she checked facts, figures and statistics as a Verifier with the Editorial and investigations team.
Jane has a Bachelor of Science from the University of New South Wales. LinkedIn
Jane Bardell is a Content producer in the Insurance and utilities team. She writes about home, car, pet and health insurance.
Previously at CHOICE, she checked facts, figures and statistics as a Verifier with the Editorial and investigations team.
Jane has a Bachelor of Science from the University of New South Wales. LinkedIn
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