Health insurance premiums rose 4.41% — are you still on the right cover?

April 2026 brought the biggest average premium increase in almost a decade. The range across funds runs from under 2% to nearly 6% — and if you're on a Gold policy, your increase may be far higher than the headline figure suggests.

What happened on 1 April 2026?

Every year, private health insurers in Australia apply to the Federal Government for approval to increase their premiums. The Minister for Health reviews each submission and approves the final rates. On 1 April 2026, the approved increases took effect — with the industry weighted average sitting at 4.41%.

According to the Department of Health, this is the highest average increase since 2017. The primary driver is the rising cost of hospital services, which increased by approximately 5% in the prior financial year — a figure that includes surgical costs, prostheses, and increased utilisation across the system as Australians caught up on deferred procedures post-COVID.

For the average policyholder, the 4.41% increase translates to roughly $330 more per year in premiums. But that average masks a wide spread depending on which fund you're with and what tier of cover you hold.

Fund-by-fund breakdown

The approved increases varied significantly across funds. Here are the approved weighted average increases for 2026 (source: Department of Health):

Source: Australian Government Department of Health and Aged Care, 2026 premium approvals. Figures are weighted averages across all policies per fund — individual policies may vary.

Gold policies: the hidden sting

The 4.41% headline figure significantly understates the impact for Gold policyholders. Across the largest funds, Gold policies increased by an average of 13.3% in 2026 — more than three times the industry average. By contrast, Basic, Bronze and Silver policies increased by an average of just 2.6% to 3.3%.

This reflects the surging cost of services covered under Gold — primarily obstetrics, joint replacements, and cardiac procedures — which have seen demand spike as the population ages and post-COVID backlogs are worked through.

If you're on a Gold policy and paying for services you don't use, this is the year to review whether you actually need that level of cover.

Who is most affected?

Premium increases hit hardest when you're paying more than you need to for cover you're not fully using. The most common scenarios:

• Long-term policyholders who haven't reviewed their cover in 3+ years — fund loyalty rarely results in better pricing
• Gold policyholders who took out comprehensive cover pre-COVID and no longer need it
• Higher-income earners paying the Medicare Levy Surcharge (MLS) who chose the cheapest policy to avoid it — that base policy may now be overpriced compared to newer alternatives
• NIB and Medibank customers — both funds are above the industry average at 5.47% and 5.10% respectively

Does the government rebate help?

The Australian Government Private Health Insurance Rebate reduces the cost of your premium based on your income and age. Most Australians earning under $97,000 as a single (or $194,000 as a family) qualify for at least some rebate. The rebate is applied directly to your premium, so you only pay the reduced amount.

The rebate percentage is adjusted annually based on the Consumer Price Index — but it has not kept pace with premium increases in recent years, meaning the out-of-pocket cost continues to rise in real terms for most policyholders.

What should you do?

The single most effective action is a comparison. By law, health funds must charge you exactly the same premium whether you go through a comparison service or buy direct. That means there is no cost to comparing — only potential savings. A comparison takes about 20 minutes and could identify equivalent cover at a meaningfully lower price.

Key questions to ask when reviewing your cover:

• Am I using the extras I'm paying for (dental, optical, physio)?
• Do I actually need Gold cover, or would Silver or Bronze be sufficient?
• Is my current fund above or below the industry average increase?
• Am I receiving the correct government rebate?
• Could I get the same hospital tier from another fund at a lower base rate?

Switching funds is straightforward and protected by law — you cannot lose any waiting periods for services you have already served, and there is typically no gap or exit fee for switching.