![The top health insurance companies in Australia by market share [2025]](https://fairhealthcare.com.au/wp-content/uploads/2024/10/Aaron-Profile-Pic.webp)
Key Takeaways
- Medibank, Bupa, HCF, nib and HBF dominate the Australian private health insurance market.
- Not-for-profit health funds still offer plenty of strong competition to the larger insurers, and they can also give you better value and customer satisfaction.
- Portability laws mean you can switch health insurance without re-serving waiting periods for a similar or lower level of cover.
Intro
Choosing the right health insurer can be tough if you’re struggling to pick between dozens of options. Maybe you’re looking for better value or broader cover, or perhaps you’re feeling defeated with the amount of out-of-pocket costs you have to manage. Whatever the reason, getting to grips with all the Australian private health funds out there is the first step to finding the best value.
Here’s a look at the top health insurance companies by market share, the types of membership they offer, their business structures and – most importantly – how you can get the most bang for your buck.
Australian health insurers by market share [2025]
Here’s the latest market breakdown:
| Rank | Health fund | Market share | Membership type | Structure |
|---|---|---|---|---|
| 1 | Medibank (including AHM) | 27.1% | Open | For profit |
| 2 | Bupa | 24.9% | Open | For profit |
| 3 | HCF | 12.5% | Open | Not for profit |
| 4 | nib | 9.6% | Open | For profit |
| 5 | HBF | 7.7% | Open | Not for profit |
| 6 | Teachers Health | 2.6% | Restricted | Not for profit |
| 7 | GMHBA (includes Frank) | 2.2% | Open | Not for profit |
| 8 | Australian Unity | 2.2% | Open | For profit |
| 9 | Defence Health | 2.0% | Restricted | Not for profit |
| 10 | CBHS Health Fund | 1.5% | Restricted | Not for profit |
| 11 | Westfund | 0.9% | Open | Not for profit |
| 12 | Health Partners | 0.7% | Open | Not for profit |
| 13 | Latrobe | 0.7% | Open | Not for profit |
| 14 | HIF | 0.7% | Open | Not for profit |
| 15 | TUH | 0.6% | Restricted | Not for profit |
| 16 | St Luke’s | 0.6% | Open | Not for profit |
| 17 | Doctors’ Health Fund | 0.5% | Restricted | For profit |
| 18 | Police Health | 0.5% | Restricted | Not for profit |
| 19 | Peoplecare | 0.5% | Open | Not for profit |
| 20 | QCH | 0.4% | Open (regional) | For profit |
| 21 | Navy Health | 0.4% | Restricted | Not for profit |
| 22 | AIA Health | 0.4% | Open | For profit |
| 23 | Mildura District Health Fund (MDHF) | 0.3% | Open | Not for profit |
| 24 | Phoenix Health | 0.2% | Open | Not for profit |
| 25 | CDH | 0.1% | Open | Not for profit |
| 26 | Onemedifund | 0.1% | Open | Not for profit |
| 27 | ACA | 0.1% | Restricted | Not for profit |
| 28 | CBHS Corporate | 0.1% | Open (corporate) | Not for profit |
| 29 | HCI | 0.1% | Open | Not for profit |
Breaking down membership types
You’ll come across a couple of different types of memberships with our health insurers. The first – open membership funds – are health funds that are available to all Australians who meet residency requirements. Some of the biggest examples include Medibank, Bupa, HCF and GMHBA.
On the other hand, restricted membership funds are limited to people connected to certain industries or organisations. Think:
- Teachers Health is open to workers in the education sector.
- Defence Health is for those with army-related employment ties.
- Police Health covers current and former police officers and their families.
If you’re eligible, some restricted funds can deliver excellent value because of their smaller membership base and not-for-profit structures.
Business structures
Speaking of structures, here’s a quick look at for-profit versus not-for-profit models:
- For-profit health funds: Companies like Medibank, Bupa and nib operate to send a portion of their profits back to shareholders.
- Not-for-profit health funds: HCF, HBF, Teachers Health and others reinvest any surplus profits back into member benefits and services.
Statistically, many not-for-profit funds tend to have higher benefits paid versus premiums collected. They are also seen as being able to deliver better customer satisfaction, and they might even provide better-value extras and hospital cover.
Portability
Don’t re-serve waiting periods when you switch to a new health fund or policy
“John was immediately covered for a hip replacement in private hospital because he had already served his waiting periods for joint replacements on his old policy”
Why size doesn’t always equal value
While Medibank and Bupa are household names, size doesn’t always correlate with member satisfaction or value.
Smaller funds like Teachers Health, Defence Health, and Westfund consistently score well in independent customer satisfaction surveys. They often provide competitive pricing, better extras payouts, and strong hospital agreements with private hospitals.
Our best piece of advice?
Always compare the benefits – don’t just rely on brand recognition along.
Portability: Switching health funds without losing waiting periods
A critical rule built into the Private Health Insurance Act 2007 is portability. It means that when you switch health funds:
- You do not have to re-serve waiting periods for benefits you already held.
- You can upgrade your cover and only serve waiting periods on the upgraded portion.
Here’s a simple example: John switches health funds but has already served his waiting periods for joint replacement surgery. In this case, he’s immediately covered when he switches.
Portability is all about making sure everyday Australians are protected while also encouraging greater competition between funds.
Why you should regularly compare health insurance
Health funds introduce new products and tweak their existing ones every few years. If you’ve been on the same policy for more than two years, chances are:
- Your premiums have gone up.
- Your benefits haven’t kept pace with inflation for medical costs.
- Newer, better-value products are on the market (which you’re unaware of).
Bottom line? Comparing your health insurance every once in a while means you’ll never end up overpaying for cover or be underinsured.
Conclusion
At Fair Health Care Alliance, we’ll help you line-by-line compare your current policy with better options – all with expert, unbiased advice.
Ready to get a personalised health insurance comparison? Contact the team at Fair Health Care Alliance today and let us help you pay less – while getting more.
FAQ's
Medibank, including its AHM brand, holds the largest market share at 27.1% as of 2025.
Restricted funds are only available to certain groups, like teachers, defence personnel, or police employees and their families.
No. Thanks to portability rules, you don’t have to re-serve waiting periods for benefits you’re already covered for.
Not always, but many not-for-profit funds offer higher benefit payouts and strong customer satisfaction.
