CHOICE health insurance analysis reveals some West Aussies could face $100 more monthly for top coverage

Health funds are hiking prices higher than ever, new consumer analysis has revealed, with one fund’s top policy set to slug West Australians who need health cover the most almost $100 extra each month. Top-tier policies — which often include coverage for specialty services such as psychiatry, pregnancy, cataracts and joint replacements — offered by major insurance companies are set to rise at the highest rates. It is another blow on the horizon for families dealing with bigger supermarket bills, huge price spikes at the petrol bowser, and looming interest rate rises. From April 1, four of the five biggest insurers will hit members with more than double the average 4.41 per cent premium hike endorsed by Federal Health Minister Mark Butler last month, which in itself is the largest average rise since 2017. HCF’s Gold policy will rise by a whopping 25 per cent - more than five times the government-approved premium. It means an extra $95.04 tacked onto some HCF customers’ bills each month, without discounts or rebates applied. Consumer peak body CHOICE analysed the incoming top-tier policies of HCF and Australia’s other “big five” insurers — Bupa, HBF, NIB, and Medibank. Bupa had the next highest average at 12.01 per cent more for top coverage, meaning its WA members could be charged another $39.70 each month. NIB’s Qantas insurance offering was only less at an average 10.14 per cent increase, while Medibank wasn’t far behind at 9.92 per cent, costing customers an extra $32.19 and $30.20 per month, respectively. Of the big five, only HBF is inflating premiums at a rate lower than double the government-approved 4.41 per cent, coming in at 7.89 per cent, which would still be $26.28 more every month. CHOICE health insurance expert Mark Blades said the 4.41 per cent figure is “of very little use to consumers”, as it’s not reflective of the true price rises many Australians will face — especially those with Gold-level insurance. “Top-level Gold cover is designed for the many Australians who have specific high-level needs . . . Often these are the people who can least afford higher premiums,” he said. Those top-tier policies usually cover things like psychiatric services, pregnancy, cataracts and joint replacements. “Our research has found that there is a huge difference between the increases consumers will face, depending on the level of policy they hold,” Mr Blades said. “The average increase to premiums of 4.41 per cent is just that — an average.” A look back at historical price hikes also revealed the price of Gold cover across the five major funds has risen an average 71.1 per cent in five years. It therefore comes as no surprise that many Australians are dropping top-tier coverage. In 2020, 39 per cent had comprehensive cover compared to 28 per cent by the end of 2025. Australian Private Hospitals Association chief executive Brett Heffernan said the Government “has a responsibility to ensure that consumers are not ripped off and hospital costs are covered in full for the treatments they provide”. Private Healthcare Australia chief executive Rachel David defended the steep increases, attributing it to the high cost of delivering complex care. “These treatments are becoming more expensive to deliver each year, driven by rising hospital costs, advances in medical technology, and an ageing population that often requires more complex and longer periods of care and rehabilitation,” Dr David said. She said PHA is calling for a review of the existing tier framework to improve flexibility and affordability. “Without reform, comprehensive cover will continue to become less affordable, and fewer Australians will be able to access the highest level of choice in their healthcare,” Dr David said.