Private health insurance industry statistics

On this page:

• How many Australians have private health insurance?
• Hospital insurance policyholders by age group
• Which health insurers are Australia’s biggest?
• Health funds and their brands

Private health insurance in Australia is a complex, ever-evolving beast. Cost-of-living pressures have affected industry trends significantly, with people balancing their health needs with their wallets.

Read on to find out more about who has private health insurance, what the latest trends are, and the major private health insurance players in Australia.

How many Australians have private health insurance?

From 2015–2019, the rate of Australians with private health insurance steadily declined, but this trend reversed during COVID-19. People took up private health insurance during the pandemic as they became more focused on their health.

Somewhat surprisingly, Australians took up extras cover as well, even though out-of-hospital health services such as dental, optical, chiropractic and physiotherapy were restricted due to social distancing. 

Currently, overall health insurance membership numbers hold steady.

In 2025:

• 55.3% of Australians have extras cover
• 45.6% of Australians have hospital cover
• most people have a combined health insurance policy.

Source: The Australian Prudential Regulation Authority (APRA).

It will be interesting to see how health insurance membership figures develop in the next few years.

Thinking about buying health insurance? Our experts explain what you need to know about hospital cover and extras cover as well as a few other things you should be aware of before you commit.

More Australians downgrading level of cover

While the proportion of people who have health insurance has been stable, the amount of coverage held by those who have a hospital cover policy has shifted in recent years.

Comprehensive private hospital cover, or ‘Gold cover’, has fallen from 40% of all hospital policies to less than 30% in the five years from 2020 to 2025. Premiums for Gold-level cover have also increased significantly over this time at a much faster rate than the overall average of all policies.

Increasingly, more Australian’s are downgrading their cover and choosing policies with exclusions. While downgrading coverage can be an easy way to reduce premiums, consumers should beware that they don’t love coverage for something they do need.

Hospital insurance policyholders by age group

When looking at total membership numbers for hospital insurance per age bracket, the highest amounts are in the groups aged 35 through 55 years – likely because there are more Australians in these age categories.

The proportion of the population with hospital insurance increases with age, though. People are most likely to have private hospital insurance when they’re aged 70 to 84.

Young adults aged 25 to 29 are the least likely age group to have hospital insurance. This group has generally matured beyond relying on their parents’ family policy for their health needs, but are not yet affected by the Lifetime Health Cover loading for hospital insurance, which kicks in at age 31.

They’re also less likely to incur the Medicare surcharge tax, which kicks in above a certain income if you don’t have hospital insurance.

If you currently have health insurance and want to check whether you’re getting the best deal, we developed a tool that lets you compare health insurance policies based on your needs so you can find cover that works for you, and potentially save yourself hundreds.

Which health insurers are Australia’s biggest?

Private health insurance in Australia is dominated by Medibank and Bupa, who hold 52% of the market between them, with HCF, NIB and HBF rounding out the top five.

• Medibank (including AHM) – 26.5%
• Bupa – 25.5% 
• HCF – 12.8%
• NIB – 9.8%
• HBF – 7.9% (most HBF members are based in Western Australia)
• Teachers Health – 2.6%
• Australian Unity – 2.1%
• GMHBA – 2.1%
• Defence Health – 1.9%
• CBHS – 1.4%
• Others – 7.4%

Market share of smaller health funds

There can be some distinct advantages to going with a smaller health fund. All health funds, big and small, are required to meet the same standards, and small funds will give you just as much choice over who treats you as larger funds – in a lot of instances, the smaller funds will even be cheaper.

These 18 health funds have less than 1% market share each:

• ACA
• AIA Health
• CBHS Corporate
• Doctors’ Health
• HCI
• Health Partners
• HIF
• Hunter Health (CDH)
• Latrobe Health
• Mildura Health Fund
• Navy Health
• Onemedifund
• Peoplecare
• Phoenix
• Police Health
• Reserve Bank
• St.Lukes Health
• Westfund.

Health funds and their brands

What can make health insurance confusing is the sheer number of funds you can choose from – something that gets trickier when you realise a single health insurer can operate multiple brands. In some cases it’s a matter of a premium brand and a budget brand, like in the case of Medibank (premium) which also operates AHM (budget). It’s the same for GMHBA (premium) and Frank (budget).

There are some funds with restricted membership which market themselves across multiple sectors. For example: UniHealth, Union Health, TUH Health Fund and Nurses & Midwives Health are all part of Teachers Health fund.

Some health insurers will sell the same policy under different brand names, and sometimes with different premiums. For example, NIB sells policies under the following brand names:

• AAMI
• Apia
• Australian Seniors
• Grand Union or GU (for corporate policies)
• ING
• Qantas
• Priceline
• Real
• Seniors
• Suncorp.

Other health insurers which operate different brandings:

• HBF operates the brands of Queensland Country Health and see-u
• RT Health is part of HCF.

When our experts analyse and compare health insurance, they compile data on thousands of policies from more than 40 insurers, including the brands that insurers like NIB own or administer. Unlike other comparison sites, we don’t take commissions from any insurers, which means we can show you more of the market and find the best-value policies that match your needs. 

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Mark Blades