This report outlines the state of private health insurance in Australia, trends, private health insurer contracts, paying for medical care and premiums. The report shows a sector in urgent need of reform, with consumers abandoning gold-tier policies and questioning the value of other policies, all while insurers experience huge profits.  

The report is designed to help consumers choose the right cover, noting that the most important features of a health insurance product will differ for each individual or family.

Since 2020, more Australians have been purchasing private health insurance, and today more Australians hold hospital treatment cover than ever before. But a closer look tells a different story: fewer policies now offer top-level coverage, exclusions are at record levels, and the overall value of private health insurance is eroding.

Key findings

• Every year since 2008, the growth of private health insurance premiums has outstripped inflation, health sector inflation, average weekly earnings and the indexation of the Medicare Benefits Schedule (MBS).
• Between 2008 and 2024, premiums climbed more than 100%, while MBS indexation increased by less than 20%.
• Over the six years to June 2025, insurers increased benefits paid for in-hospital medical treatment by 18% – a modest rise compared with sector profits, which grew by nearly 50% over the same period.
• In 2024‒25, insurers returned 84% of premiums to consumers as benefits – well below the 2019 level of 88%.