The average gold hospital policy has risen by 13% for individuals following the April price hikes, almost three times the government-approved average increase of 4.41%, Canstar analysis shows.
For an individual, this translates into an annual increase of $493.
Silver hospital policies rose by an average of 4.9% for individuals, while bronze hospital policies rose by the least at just 2.2%.
Canstar’s analysis of pre- and post-1 April data shows the higher-tier policies rose by the most, as was the case in previous years.
Change in average annual hospital insurance premiums - individual | |||
|---|---|---|---|
Hospital tier | Mar-26 | Apr-26 | Change |
Basic | $1,060 | $1,097 | +$37 (+3.5%) |
Bronze | $1,346 | $1,375 | +$29 (+2.2%) |
Silver | $1,854 | $1,944 | +$90 (+4.9%) |
Gold | $3,790 | $4,283 | +$493 (+13.0%) |
Source: Canstar. Based on hospital insurance policies on Canstar’s database, excluding ‘plus’ tiers. Gov rebate for avg income of 16.192% in Mar-26 and 16.079% in Apr-26 applied. Averages based on state averages, weighted by % of hospital insured persons (APRA Dec 25).
The health insurance loyalty tax you shouldn’t be paying this year
Sticking with the same fund can come at a cost.
Canstar research shows there is a 22% gap between the average and the lowest-priced gold hospital policies for an individual, a potential saving of $951 a year. For those who switch, this saving could more than offset April’s 13% increase for a typical gold hospital policy.
In fact, across all hospital tiers, switching from an average-priced policy to a lower-cost equivalent could help to offset this year’s average price increases.
Note: The lower figure is an average based on the lowest-priced policy available in each state and territory. The savings will vary depending on a person’s location.
Potential annual savings by switching hospital insurance policies - individual | |||
|---|---|---|---|
Hospital tier | Average | Minimum | Difference |
Basic | $1,097 | $993 | -$104 (-9.5%) |
Bronze | $1,375 | $1,228 | -$147 (-10.7%) |
Silver | $1,944 | $1,695 | -$249 (-12.8%) |
Gold | $4,283 | $3,332 | -$951 (-22.2%) |
Source: Canstar. Based on new customer hospital insurance policies on Canstar’s database for April 2026, excluding ‘plus’ tiers, with the gov rebate for avg income of 16.079% applied. Averages based on state averages, weighted by % of hospital insured persons (APRA Dec 25). The minimum figures are averages based on the lowest-priced policy available in each state and territory. The savings will vary depending on a person’s location. Consumers should check waiting periods and the Private Health Information Statement before deciding to switch.
Is health insurance still worth it?
This year’s price hikes could push some Australians to downgrade their cover. However, many are likely to continue to pay for health insurance to avoid the Medicare Levy Surcharge.
That’s the extra fee the government adds to your tax bill each year if you earn over a certain amount (currently over $101,000 for individuals and $202,000 for families) and don't have adequate private hospital cover.
Medicare Levy Surcharge rates - individual | ||
|---|---|---|
Current income | Income from 1 July | |
No surcharge | ≤$101k | ≤$105k |
1% of income | over $101k - $118k | over $105k - $123k |
1.25% of income | over $118k- $158k | over $123k - $164k |
1.50% of income | ≥$158k | ≥$164k |
Source: Privatehealth.gov.au. Note: based on an individual. The income brackets for couples/families will vary.
Canstar analysis shows someone earning the average full-time income of $106,950 and paying the Medicare Levy Surcharge at the lowest rate of 1% would pay an estimated $1,070 for the surcharge (assuming this is their annual taxable income).
Alternatively, the lowest-priced basic hospital policy is, on average across the states, $993 for the next 12 months – $77 cheaper than the surcharge.
Medicare Levy Surcharge vs lowest-cost hospital cover (annual) | ||
|---|---|---|
Income | Surcharge - next financial yr | Lowest-priced policy |
$106,950 | $1,070 | $993 |
Source: Canstar. Based on the Medicare Levy Surcharge rate of 1% compared to the lowest priced policy on Canstar’s database, which is an average based on the lowest-priced policy available in each state and territory. The lowest price will vary depending on a person’s location.
It's time to run the numbers and compare your options
Canstar’s data insights director, Sally Tindall, says, “These April increases are another reminder that the government-approved average rise is just that – an average, not a cap.”
“Plenty of people with Gold hospital policies are now left wondering why the cost of their policy has gone through the roof.
“The reality is, gold policies cover more procedures, particularly for treatments that are impacting our ageing population.
“A 13 per cent increase to one of the biggest insurance bills people pay, will leave some people wondering whether it’s worth it.
“What Canstar’s research shows is that premiums can vary wildly for the same level of cover, a little-known fact that could potentially see people pay less without having to drop to a lower level of insurance.
“Anyone switching to the same level of hospital cover can also take comfort in the fact that they won’t need to re-serve waiting periods when moving across. The new fund will manage the paperwork so you can potentially switch today and claim tomorrow.
“For those questioning whether private health insurance is still worth it, it’s important to run the numbers and compare your options.
“Do the maths on what your Medicare Levy Surcharge might be for the next financial year if you drop your cover and compare it to the cost of hospital policies on offer.
“You might find a basic policy costs less than the surcharge. It’s also worth shopping around, though, as a competitively-priced bronze or silver policy could not only help you avoid the surcharge, but also provide cover for treatments you may otherwise end up needing to pay for yourself.”
