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Not all cover is created equal. Whether you’re after hospital cover, extras, or a mix of both, Konkrd compares every fund with hundreds of Health insurance products, side by side. No favourites, no filters, no fluff. Just the right cover, for you.
Hospital cover contributes to the cost of being treated as a private patient in hospital. It allows you to choose your treating doctor and may reduce waiting times for certain elective procedures.
Extras cover helps pay for healthcare services that Medicare doesn’t include. It usually applies to treatments outside of hospital, such as dental, optical, physiotherapy, and similar services.
In some states, emergency ambulance services are provided at no cost – but not everywhere. Where it isn’t free, ambulance cover can help with the cost of transport in an emergency.
Life keeps moving, your cover should too. From singles starting out, to couples, pregnancy, young families, or retirees, Konkrd shows you every option available across all funds. No cherry-picking, no surprises – just health cover that actually matches your stage of life.
Health insurance options tailored for single individuals starting their journey.
Joint health insurance plans designed for couples building their future together.
Comprehensive coverage options for single parents and their children.
Health insurance options tailored for single individuals starting their journey.
Joint health insurance plans designed for couples building their future together.
Comprehensive coverage options for single parents and their children.
Health insurance can feel like another language. That’s why Konkrd breaks it down with AI-powered comparisons and humans in the background if you need them. We’ll explain hospital tiers, waiting periods, rebates, and all the fine print that way so you can finally feel confident in your choice.
Most Australians see an annual rate increase letter land in their letterbox, fund app or buried in an email but aren’t entirely sure how this number comes about. The industry average premium increase for 2025 is 3.73%, which sits between most insurers’ 10-year and 20-year averages of 3.56% and 4.56% respectively. This indicates that 2025 increases are moderating compared to longer-term historical trends.
Lifetime Health Cover (LHC) loading is a penalty for taking out private hospital cover later in life. If you don’t have hospital cover by 1 July after your 31st birthday, you’ll pay an extra 2% on premiums for every year you delay, up to a maximum of 70%. Once applied, LHC stays for 10 years of continuous cover.
The Private Health Insurance Rebate is a government discount that helps reduce the cost of your premiums. It’s income- and age-based, and you can choose to: apply it directly to lower your premium upfront, or claim it as a tax offset when you lodge your return. The rebate is intended to make private health insurance more affordable and accessible.
The Medicare Levy Surcharge (MLS) is an additional tax of 1–1.5% that applies if you earn above a set income threshold and don’t hold private hospital cover. Its purpose is to encourage higher-income earners to take out private hospital insurance and help reduce demand on the public health system.
The Medicare Levy is a tax that most Australians pay to support the public healthcare system. It’s set at 2% of your taxable income and is separate from private health insurance. For most people, it’s collected automatically through their tax return, unless they qualify for a reduction or exemption based on income.
purpose is to encourage higher-income earners to take out private hospital insurance and help reduce demand on the public health system.
Most Australians see an annual rate increase letter land in their letterbox, fund app or buried in an email but aren’t entirely sure how this number comes about. The industry average premium increase for 2025 is 3.73%, which sits between most insurers’ 10-year and 20-year averages of 3.56% and 4.56% respectively. This indicates that 2025 increases are moderating compared to longer-term historical trends.
Lifetime Health Cover (LHC) loading is a penalty for taking out private hospital cover later in life. If you don’t have hospital cover by 1 July after your 31st birthday, you’ll pay an extra 2% on premiums for every year you delay, up to a maximum of 70%. Once applied, LHC stays for 10 years of continuous cover.
The Private Health Insurance Rebate is a government discount that helps reduce the cost of your premiums. It’s income- and age-based, and you can choose to: apply it directly to lower your premium upfront, or claim it as a tax offset when you lodge your return. The rebate is intended to make private health insurance more affordable and accessible.
The Medicare Levy Surcharge (MLS) is an additional tax of 1–1.5% that applies if you earn above a set income threshold and don’t hold private hospital cover. Its purpose is to encourage higher-income earners to take out private hospital insurance and help reduce demand on the public health system.
The Medicare Levy is a tax that most Australians pay to support the public healthcare system. It’s set at 2% of your taxable income and is separate from private health insurance. For most people, it’s collected automatically through their tax return, unless they qualify for a reduction or exemption based on income.
purpose is to encourage higher-income earners to take out private hospital insurance and help reduce demand on the public health system.
The numbers that should make every policyholder compare their options.
Australians with some form
of private health cover
National average for Family Hospital Cover
The government approved an average 4.41% increase — but some funds are raising prices much more. Here’s what the major funds look like.
| Fund | Approved Increase |
|---|---|
| AIA Health Insurance | 5.98% (highest) |
| nib | ~4.2% |
| Bupa | ~4.0% |
| Medibank / ahm | ~3.8% |
| HCF (Non-profit) | ~3.4% |
| GMHBA | 1.98% (lowest) |
On an average combined Hospital & Extras policy at $3,560/yr, a 4.41% increase adds $157 per year — or $13 extra per month. For families on ~$6,530/yr, that’s an extra $288.
But here’s the thing: you don’t have to accept it. Under Australian portability rules, you can switch to a different fund without re-serving waiting periods — as long as your new cover is equivalent or lower.
See how Konkrd stacks up against the comparison sites Australians currently use.
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These policies can cost you thousands — or save you thousands — depending on when you act.
If you don’t take out hospital cover by July 1 after your 31st birthday, you’ll pay a 2% loading on top of your premium for every year you delay — up to a maximum 70% loading.
Example: If you first take out hospital cover at age 40, you’ll pay a 20% loading(10 years × 2%) on top of the base premium. On a $200/month policy, that’s an extra $40/month — or $480/year — for 10 consecutive years.
If you earn over $101,000 (single) or $202,000 (family) and don’t hold hospital cover, you’ll pay an extra 1%–1.5% of your taxable income as a surcharge — on top of the standard 2% Medicare levy.
Example: A single person earning $120,000 without hospital cover pays a 1% MLS = $1,200/year in extra tax. A basic hospital policy to avoid this might cost ~$1,100/year — and you’d actually have cover.
People finding better cover and paying less. Without the runaround from comparison sites.
Just chat naturally about what you need. The AI asks smart follow-up questions to understand your situation.
AI instantly compares every plan in Australia and shows you the top 3 that fit your needs and budget.
Review the details, ask any questions, and switch when you’re ready. Or save it and come back later. Zero pressure.
You deserve control over decisions that affect your money and your life.
No forms. No phone queues. Just a conversation that actually understands what you need.
A smarter way to compare health insurance — powered by AI, built for humans.
Paul Mineo, Chief Operating Officer of Konkrd Life Admin AI service, is a true expert in private health insurance, from time on the phones helping customers, to leading commercial strategy, and everything in between, with over two decades of experience across sales, operations, and insurance markets.
Driven by a belief that the customer should always come first, Paul is helping shape a new kind of service, one that challenges the old model and redefines what great advice and genuine support can look like.
Private health insurance in Australia is designed to give you more choice and control over your healthcare. It’s generally split into two main types of cover: Hospital cover; helps pay for the costs of being treated as a private patient in hospital and Extras cover (also called general treatment cover); that helps cover everyday health services that Medicare doesn’t, like dental, optical, or physio. You can choose either type of cover on its own, or combine them into a single policy, depending on your needs. In some states, there’s also ambulance cover, which may be offered separately or included in your hospital or extras policy.
Because private health insurance is community rated, everyone pays the same base premium for the same policy regardless of their health or medical history. Health funds can’t refuse to cover anyone who’s eligible. To balance this fairness, insurers apply waiting periods, specific timeframes you must wait before claiming benefits on certain treatments or services. The government sets the maximum waiting periods for hospital cover:
For extras cover, unlike hospital cover, waiting periods vary between health funds and depend on your policy and treatment type. To claim benefits, your policy must include the treatment you’re receiving, and your waiting period must be complete.
If you switch insurers but keep the same level of cover, most funds will recognise waiting periods you’ve already served, this goes for both Hospital and Extras cover.
Private health insurance can cover a wide range of treatments and services, but exactly what’s included depends on your policy, your provider, and whether you have hospital cover, extras cover, or both.
Hospital cover
Hospital cover helps pay for the costs of being treated as a private patient, either in a public or private hospital. To make it easier to understand what you’re covered for, the Australian Government introduced four standard hospital cover tiers in April 2019:
Basic
Covers you as a private patient in a public hospital for:
Bronze
Includes all Basic services, plus private hospital cover for:
Silver
Includes everything in Bronze, plus cover for:
Gold
The highest level of hospital cover, including unrestricted access to all services above, as well as:
Some insurers also offer “Plus” policies (e.g. Silver Plus or Bronze Plus). These include all the minimum services for that tier, plus extra benefits like joint replacements or cataract surgery, a flexible “in-between” option if you want more cover without jumping to the next tier.
Under some policies, certain services may be restricted, meaning you’re only covered as a private patient in a public hospital. In these cases, you can usually choose your doctor, but not your hospital, and you may still face public system waiting lists.
Extras cover
Extras (or general treatment) cover helps pay for everyday health services that Medicare doesn’t include. What you’re covered for, and how much you can claim depends on your provider and level of cover. Extras policies may include:
In short, private health insurance gives you options, from hospital treatment and surgery to everyday wellbeing services, so you can access care that fits your life, budget, and health goals.
The private health insurance rebate is a government initiative that helps make private health cover more affordable for Australians. It’s a percentage discount that the government contributes toward the cost of your private health insurance premiums – whether you have hospital cover, extras cover, or a combined policy
The amount of rebate you receive depends on your:
The rebate is designed to encourage more people to take out private health insurance and ease pressure on the public health system.
You can choose how you receive it:
The Australian Government reviews rebate levels each year, so the exact percentage may change over time.
If you’re not sure which rebate tier you fall into, your health insurer or the Australian Taxation Office (ATO) can help you check your eligibility and current rates.
The difference between what Medicare covers and what private health insurance covers depends on the type of service you’re looking at.
Hospital cover
Medicare pays 75% of the Medicare Benefits Schedule (MBS) fee for medical services if you’re treated as a private patient in a public hospital. The remaining costs may be covered by your health insurer, depending on your policy and level of cover.
Your private hospital cover can include:
Having hospital cover also means you can often choose your doctor, your hospital, and even your treatment time, giving you greater flexibility and potentially avoiding public hospital waiting lists (after serving any applicable waiting periods).
Extras cover
Medicare’s benefits for everyday health services are limited. That’s where extras cover can make a big difference.
Medicare doesn’t cover things like:
When it comes to prescription medicines, Medicare only helps pay for drugs listed on the Pharmaceutical Benefits Scheme (PBS). If your medication isn’t on the PBS, Medicare won’t contribute, but your private health insurance might, depending on your extras cover and the type of medication prescribed.
In short, private health insurance fills the gaps left by Medicare, giving you more choice, faster access to care, and cover for services that support your overall health and wellbeing.
Lifetime Health Cover (LHC) loading is a government initiative designed to encourage Australians to take out private hospital cover earlier in life and keep it long term.
If you don’t take out hospital cover before 1 July following your 31st birthday, you may have to pay an additional loading on top of your premium when you eventually join.
Here’s how it works:
Once you’ve held continuous hospital cover for 10 years, the loading is removed, provided you maintain your policy without long gaps.
There are some exceptions and grace periods. For example:
In short, Lifetime Health Cover loading rewards consistency, the earlier you join and the longer you stay covered, the less you’ll pay overtime.
No – Medicare does not cover ambulance services.
Instead, ambulance cover is managed by each state and territory, meaning what you’re entitled to (and how you’re billed) depends on where you live and your personal circumstances.
ACT
Residents who hold a Health Care Concession Card or a Full Aged Pensioner Concession Card are entitled to free emergency ambulance services. If you don’t hold a concession, you’ll need to arrange ambulance cover through a private health fund.
New South Wales (NSW)
If you hold a Health Care Concession Card, Pensioner Concession Card, or Commonwealth Seniors Health Card, you’re entitled to some free ambulance transport services. Others can take out ambulance cover through their private health fund.
Northern Territory (NT)
Holders of a Health Care Card or NT Centrelink Pensioner Concession Card receive free ambulance transport. All other residents can purchase cover through a private health fund or the state ambulance service.
Queensland (QLD)
Ambulance services are fully covered by the Queensland Government for all residents – no separate insurance required.
South Australia (SA)
Residents can purchase ambulance cover through a private health fund or directly from the state ambulance service.
Tasmania (TAS)
Ambulance costs for Tasmanian residents are generally covered by the state government.
Victoria (VIC)
Residents who hold a Pensioner Concession Card or a Health Care Card are entitled to free, clinically necessary ambulance transport. Other residents can purchase cover through a private health fund or the state ambulance service.
Western Australia (WA)
Residents holding a Pensioner Concession Card are eligible for free medically necessary ambulance transport. If you’re not eligible, you can purchase cover through a private health fund or the state ambulance service.
All of Australia
Holders of a Veteran Gold Card or Veteran White Card may be eligible for free emergency ambulance transport to the nearest clinical facility. Some non-emergency transport may also be covered, depending on the Department of Veterans’ Affairs guidelines.
Travelling interstate
Ambulance cover doesn’t always transfer across state lines. For example, Queensland and Tasmanian residents who receive free ambulance services in their home state may not be covered when travelling in Victoria or elsewhere.
Before travelling interstate, it’s best to check with your state ambulance service, concession card provider, or health fund to make sure you’re covered in an emergency.
For more information visit our Ambulance Cover guide or contact your state Ambulance Service.
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Konkrd’s website, mobile app and associated channels (“Platform”) is an informational tool only and uses advanced AI technology to provide you with product comparisons and recommendations. Our Platform displays information from third party providers so while we strive to keep our information up to date, you should always check this information with the provider.
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