With the multitude of health insurance companies and brands available in Australia, choosing the right one can be challenging. It is crucial to select a health fund that provides reputable hospital coverage, fair extras rebates, flexible policy options, and exceptional customer service.
In this article, we will examine the top five health funds in Australia for 2024. Our rankings are based on key performance data that is Publicly available from the latest annual State of the Health Funds Report by the Commonwealth Ombudsman for Private Health Insurance
Who are the *best health insurance funds in Australia?
Different Private Health Funds excel in various areas, so it’s not as straightforward as simply naming the top five. Interestingly, the big for-profit Private Health Insurers rarely top the charts. In Australia, not-for-profit Private Health Insurance funds tend to perform at a higher standard in the areas we have listed below. However, many not-for-profit funds have restrictions and are not accessible to everyday Australians.
While the funds highlighted in this article are notable, it’s important to understand that these are general statistics. Any fund can have a mix of both poor-performing and high-value policies. The *best Private Health Insurance in Australia is one that is precisely matched to your needs and/or your family’s health needs – a process that requires expert advice from CheckYourBill.
What Makes the *Best Health Insurance in Australia?
We’ll start with an essential disclaimer: the following assessment of what makes the “*best” Private Health Insurance in Australia is based on general performance statistics. In other words, just because a Private Health fund appears strong on paper doesn’t mean it will be the best fit for you or that it will have a policy that suits your unique needs. This is why obtaining reliable Private Health Insurance advice and a transparent, informative comparison with CheckYourBill is crucial. Several key indicators help measure the effectiveness of a Private Health Insurance company, including:
– Gap-Cover performance in private hospitals
– Coverage of hospital-related charges
– Extras benefits provided
– Total benefits returned to members compared to premiums paid
– Member retention (customer satisfaction)
– Share of total complaints relative to market share
We will guide you through these performance indicators to help you understand their significance when comparing a Private Health Insurance company or brand.
*Best Health Insurance for Member Retention
Member Retention means the percentage of members who join the health fund that remain as a member and do not leave. A high customer retention number means the fund members are happy and are less likely to cancel or switch to another insurer – a fair indicator that the fund is doing something right. Other factors may include a very convincing retention team that contact members when they leave to entice them to stay.
*Top 5 Health Insurance Companies for Member Retention (Open vs Restricted)(Stats source)
Who is the *best Health Insurance for Benefits vs Premiums paid
The benefits-as-a-percentage-of-contributions score indicates how much a Private Health Insurer returns to members compared to what members pay for their policies. This figure can be understood as cents returned per dollar. For instance, if a Private Health Fund has a 90% benefits score, it means the fund returns 90 cents for every dollar received. The term ‘benefits’ includes any payouts across private hospital and extras cover. This metric serves as a general indicator, revealing that any fund can have both highly generous policies and less favorable ones. Therefore, this performance indicator shouldn’t be the sole deciding factor when choosing a new Private Health Insurer. When evaluating Private Health Insurance, consider that the benefits percentage score is just one aspect. Ensure you look at other key performance indicators to make an informed decision.
*Top 5 Private Health Insurance Companies for Benefits % (Open vs Restricted) (Stats source)
Percentage of Total Complaints Vs Market Share
We created this metric by comparing the Health Fund’s share of total industry complaints versus their market share. For example, if a health insurer has a 20% Market share but only 10% of all complaints, we can surmise that the Fund has a 0.5 Quality Score (the lower, the better) and significantly fewer complaints than they should have. In other words, they’re looking after their members and minimising areas where customers may need to complain.
*Top 5 Health Funds for Quality Score (Complaints vs Market Share) (Stats source)
Who is the *best Health Insurance in Australia for hospital related charges covered?
When a member with Private Health Insurance visits a private hospital for in-patient services, numerous hospital-related charges can be covered by their insurance provider. These charges often include accommodation, theatre-room fees, and associated doctor’s fees. The following list highlights the *top Private Health Funds that cover the most hospital-related charges across Australia. It’s important to note that performance can vary by state, so consider the specific performance of each fund in your region.
By understanding which Private Health Insurance companies excel in covering hospital-related charges, you can make a more informed decision about the best coverage for your needs. This evaluation is based on a broad average across the country, highlighting the top performers in providing comprehensive hospital coverage.
*Best Private Health Funds for Hospital-Related Charges (Australia-Wide)(Stats source)
Which Health Insurance companies performed *best for No Gap Cover in Hospital?
The hospital “Gap” refers to the difference between what your Private Health Insurance pays for a specific surgery and the total charges by the private doctor or anesthetists. Private Health Insurance covers up to 100% of the Medicare Benefit Schedule fee for a procedure, but doctors can charge above this fee, creating a gap that the member must pay. When doctors participate in “gap cover” with the insurance company, the fund will pay more if the doctor agrees to a lower fee, resulting in no gap or a reduced gap for the patient.
Understanding how gap cover works is crucial for minimizing out-of-pocket expenses. The *best Private Health Insurance funds for gap cover ensure that members face little to no additional costs for surgeries. Here are the top five funds that excelled in providing no-gap cover last year.
Overall *best Private Health Insurance for Gap-Cover in Private Hospital (Australia-wide)(Stats source)
Which Health Funds pay the most back in total on Extras claims?
Extras claims are lifestyle benefits that Private Health Insurance can cover outside of private hospital, like dental, optical, physiotherapy etc. The following tables demonstrate last year’s best Health Funds regarding the average amount covered across all extras claims. Once again, this is a national average, and each health insurer performs differently in each State.
Which Health Funds paid the most back on Extras last year? (Stats source)
Conclusion
We’ve learned that different Private Health Insurance companies excel in various areas. The *best Private Health Insurance in Australia isn’t solely determined by impressive statistics but by how well a policy matches your unique health needs. Factors like the applicant’s health requirements, frequency of visits for extras, the state or region they reside in, and the healthcare providers they prefer all significantly impact which Private Health Insurance is best for them.
This is why obtaining clear and trustworthy Private Health Insurance advice is crucial. Contact CheckYourBill for a quick Private Health Insurance quote, and we’ll help you find a policy that is perfectly matched to your needs.
