Health Insurance Going Up April 2026: How Much More You'll Pay & How to Save

From 1 April 2026, private health insurance premiums across Australia will increase by an industry-wide average of 4.41%. This is the annual adjustment approved by the federal Minister for Health, and it applies to both hospital and extras cover.

However, that 4.41% figure is just the average — individual funds vary significantly. Some smaller funds are pushing through increases of up to 5.98%, while a handful of larger funds have kept their rises closer to 3.5%. For a family paying $400 per month, a 4.41% increase means an extra $17.64 per month or roughly $212 per year.

Singles on a $150/month policy will see costs jump by about $6.62 per month. The increases apply regardless of whether you've hospital-only, extras-only, or combined cover. Importantly, you don't need to accept the increase on your current policy — you've the right to switch funds or downgrade your cover at any time without serving new waiting periods for equivalent or lower cover levels.

The practical side: Health insurance premiums in Australia have risen every single year for decades, consistently outpacing both inflation and wage growth. Several structural factors drive this.

First, Australia's population is ageing, meaning more policyholders are in higher-claiming age brackets. Insurers use community rating, so younger and healthier members effectively subsidise older and sicker ones — and as the ratio shifts, everyone pays more. Second, the cost of medical technology, pharmaceuticals, and hospital services continues to climb.

New treatments and devices deliver better outcomes but come with higher price tags. Third, gap payments have exploded — even with insurance, Australians face growing out-of-pocket costs because many specialists charge well above the Medicare Benefits Schedule fee. Insurers are also paying more for prostheses and medical devices, costs that are ultimately passed to policyholders.

Finally, the proportion of younger Australians holding cover has been declining, shrinking the risk pool and pushing per-member costs higher. The government's Lifetime Health Cover loading and Medicare Levy Surcharge are designed to counteract this trend, but participation rates among under-40s remain stubbornly low.

The single most effective way to fight premium increases is to shop around. Under Australian law, no insurer can refuse you cover or charge you more based on your age, health status, or claims history — this is the community rating principle.

What actually happens: That means switching is genuinely risk-free. Start with the government's official comparison site at privatehealth.gov.au, which lets you compare every policy from every fund on a like-for-like basis. You can filter by cover type, state, excess level, and specific inclusions.

For a more guided experience, comparison services like iSelect, Compare the Market, and Canstar also aggregate policies, though they may not show every fund. When comparing, focus on the clinical categories that matter to you — don't pay for inclusions you will never use. Check the fund's gap cover arrangements with your preferred hospitals and specialists.

Also check whether the fund offers multi-policy discounts, direct debit discounts, or corporate rates through your employer. You can switch funds any day of the year, and your new fund must recognise waiting periods you've already served.

If switching funds doesn't save enough, consider downgrading your cover tier. Since April 2019, all hospital policies in Australia have been classified into Gold, Silver, Bronze, and Basic tiers.

Gold covers everything including heart surgery, joint replacements, and pregnancy. Silver covers most hospital treatments but excludes some elective procedures. Bronze is more limited but still covers essentials like emergency ambulance and accident-related hospital admissions.

Here's the thing. Basic covers only a narrow set of treatments. Dropping from Gold to Silver can save 20-30% on premiums while still retaining cover for most common hospitalisations. Another powerful lever is your excess — increasing your excess from $250 to $750 can reduce premiums by $300-$600 per year, and you only pay the excess if you actually go to hospital.

For young, healthy individuals who rarely claim on hospital cover, a high-excess Bronze or Silver policy paired with a mid-range extras policy often delivers the best value. Review your claims history over the past two to three years to see which inclusions you actually used before making changes.

The Australian Government Private Health Insurance Rebate reduces the cost of your premiums based on your age and income. For the 2025-26 financial year, singles earning under $97,000 (or families under $194,000) receive the highest rebate: 24.608% if under 65, 28.710% if aged 65-69, and 32.812% if aged 70 or over.

As your income rises, the rebate reduces through three tiers until it phases out entirely for singles earning over $151,000 (families over $302,000). Most people claim the rebate as a direct reduction to their premiums — your fund applies the discount automatically if you provide your income details. Alternatively, you can pay full premiums and claim the rebate as a tax offset when you lodge your return.

The rebate is adjusted on 1 April each year and applies to both hospital and extras cover. If your income changes mid-year, make sure to update your details with your fund to avoid an unexpected tax bill. Use our Tax Calculator to see how the rebate affects your overall tax position.

Let's break this down. Whether private health insurance is worth it depends on three factors: your income, your health needs, and your risk tolerance. If you earn over $97,000 as a single (or $194,000 as a family), dropping hospital cover triggers the Medicare Levy Surcharge of 1-1.5% of your taxable income — often costing more than a basic hospital policy.

For a single on $120,000, the MLS alone would cost $1,200-$1,800 per year, while a basic hospital policy with a $750 excess might cost $1,100-$1,500 after the rebate. In that scenario, holding cover is cheaper than paying the surcharge, even if you never claim. For those earning under $97,000, the calculus shifts — you face no MLS penalty, so the question becomes whether the out-of-pocket protection justifies the premiums.

Consider what Medicare doesn't cover: private hospital rooms, choice of surgeon, shorter wait times for elective surgery, dental, optical, and physiotherapy. Run the numbers for your specific situation using our Budget Planner to see where health insurance fits in your overall spending. That's the key takeaway.