Canstar's 2026 Health Insurance Awards
About the Health Insurance Awards
Every year, we assess the Australian private health insurance market to find the funds offering outstanding value. We look at hospital cover, extras cover, and combined hospital and extras cover across every state, every family type, and four lifestages, because good value depends entirely on who you are and your circumstances. A policy that works well for a healthy 28-year-old single is not necessarily right for a couple planning a pregnancy or a retiree weighing up joint replacement cover. We assess the total cost of holding and using a policy: premiums, excess, co-payments, rebates and discounts, out-of-pocket costs, alongside the features and coverage that come with it. This year we assessed over 41,000 product combinations from 30 providers. These are the funds that came out on top.
Learn more about our Award process in our methodology.
2026 Winners
National
Hospital
Extras
Packages
Numbers crunched
The market this year
More Australians have private health insurance than ever, but cost-of-living pressures are changing how people hold it. Switching between funds is up, more people are downgrading to cheaper tiers, and comparison activity is the highest in years. When we assessed this year's products, that showed up clearly. For younger, healthier Australians, the competition at the Bronze and Silver Plus level is fierce — there's genuinely not a lot separating the leading products. Where our assessment found real differences in value was for more comprehensive policies — older Australians who need cover for joint replacements and cataracts, and people planning a pregnancy. Those are the profiles where the fund makes the most difference, and where the biggest changes are happening.
Gold hospital cover continues to contract, with several funds removing or restricting their standalone Gold products this year. Pregnancy is where this matters most. It's increasingly hard to buy standalone pregnancy cover because the product economics are challenging — providers likely don't want people to take out cover planning to get pregnant, claim heavily around the birth, and leave. Funds are responding by moving pregnancy into packages, and our results reflect that shift. Some of the most competitive pregnancy outcomes we found this year come from package-only products that don't exist as standalone. If you're planning a pregnancy, packages may offer more competitive options than standalone hospital cover.
About the Winners
Bupa — National Award, Extras State Awards: NSW, QLD, SA, TAS & VIC
Bupa picked up a National Award for the fifth year in a row, and has won extras again in the same five states as last year. Their Freedom 60 and Freedom 60 Boost products pay 60% of whatever the provider charges, up to a combined annual limit. That percentage-back structure is central to their extras performance — when the cost of going to the dentist or the optometrist goes up, Bupa member rebates go up with it. On a fixed-dollar policy, the rebate stays the same and the extra cost comes out of your pocket. Providers in Bupa's Members First network, one of the largest in the market, cap their fees, so members pay less at the point of service. Extras is where Bupa leads, and because that strength carries through into packages, which is how most Australians hold their cover, it underpins their national position.
GMHBA — National Award, Packages State Award: SA
GMHBA, a not-for-profit, member-owned fund based in Geelong, has retained the National Award. It's one of the only funds in the market to waive the excess on day surgery admissions on its hospital cover. Where other funds charge $250-$500 per admission, GMHBA members pay nothing. For older Australians who may be more likely to need day procedures, that could offer meaningful savings.
In extras, GMHBA's SmartCare range gives you a single flexible annual limit to use across any included services — all on dental, all on physio, or split however you need. Customers can get 100% back on preventive dental, and 60% on everything else. When combined as a package, GMHBA adds optical cover and lets any unused annual limit roll over to the following year.
HBF — National Award, Extras State Awards: WA & NT, Packages State Awards: WA & NT
HBF has been a strong performer in extras for several years, and has now received a National Award for the first time. Their extras range features percentage-back structures and combined annual limits so you're not locked into set amounts for each service, and the amount you get back increases as costs rise. Their Flex 50 is one of the standouts: 50% back on treatments, an $800 per-person combined limit, and a separate $200 optical limit at 100%. The combined limit isn't tied to specific services — you decide where it goes based on what you actually need in a given year.
This year, we saw HBF strengthen their hospital cover. Premiums moved well below the market across the range — several Bronze and Silver products saw no increase at all, and their Silver Hospital Plus increases came in lower than comparable products. HBF also introduced Essential Silver Hospital, adding a third Silver Plus option at a lower price point, helpful if you want more comprehensive cover than Bronze but don't need to pay for Gold.
HCF — National Award, Packages State Award: TAS
HCF has retained the National Award for the 11th year in a row, and the Tasmania packages state award this year. HCF's extras products perform strongly in every state, anchored by their nationwide gap-free provider network across dental and optical. Members visiting a participating provider pay nothing out of pocket at the point of service. This year HCF also introduced new hospital products including Hospital Bronze and Hospital Basic Plus, expanding their range at the more affordable end. HCF doesn't offer standalone hospital policies with pregnancy cover. However, it is offered in their My Family Silver Plus packages, which perform strongly in our Awards, with HCF winning TAS this year.
Medibank — National Award, Hospital State Awards: NSW, VIC, SA, WA, TAS & NT
Medibank has retained the National Award and won six of seven state awards for hospital cover, remaining one of the strongest on the market with the breadth and depth of their hospital range. Their Silver Plus products — Core, Support, Secure, and Advanced — give people four different price points to hold Silver Plus cover, each with different inclusions. In our Mature profiles, where hospital admissions carry the most weight, Medibank's Silver Plus products consistently deliver competitive net costs across the admission scenarios we model. Their Bronze Plus suite is similarly competitive, expanding the range at the more affordable end.
For extras, Medibank's policies generally pay percentage back rebates for providers in their network and fixed-dollar amounts for those that aren't, so the network can make a meaningful difference to what you get back.
Phoenix Health Fund — Packages State Awards: NSW, VIC & QLD
Phoenix has picked up state awards for packaged Hospital & Extras in NSW, VIC, and QLD. Phoenix is a not-for-profit, member-owned fund based in Newcastle, and their strong performance for packages comes from unlocking competitive extras products when bundled with hospital cover. Extras like Healthy Flex Extras 50 and Value Extras 60 are available exclusively as part of a package, offering 100% back on up to two preventive dental check-ups per person per year, flexible limits you can allocate across services as you need, and relatively few restrictive sub-limits. Their hospital products are also competitive in their own right, ranking among the top three for standalone hospital cover in all three states. Combined with relatively low year-on-year premium increases on their hospital products, the packages deliver strong out-of-pocket value across the profiles we assessed.
Queensland Country Health Fund — Hospital State Award: QLD
New recipient Queensland Country Health Fund has won the hospital award in QLD this year. QCH's hospital products are competitively priced from their Bronze options through to Signature Hospital, a newer product that covers heart and vascular services without requiring people to pay for pregnancy or joint replacement cover they may not need. Their three-tier excess options also give customers the flexibility to balance premiums and excess. Now part of the HBF group, QCH continues to focus on Queensland and the Northern Territory. It also won Canstar's Most Satisfied Customers award for health insurance in 2026, so QCH is offering a strong member experience as well as outstanding value.
How we chose the winners
Scored across the full customer journey
Health insurance is one of the most complicated and dynamic markets we assess. Our awards take into account standalone hospital cover, standalone extras cover, and packaged cover across seven states and territories, twelve consumer profiles, and four lifestages:
- Young: less than 36 years of age
- Established: 36 to 59 years of age
- Mature: 60 years of age and above
- Pregnancy: any age
Each policy receives a Price Score and a Feature Score, with price carrying 50-70% of the total weight depending on the lifestage.
For hospital, we model eight admission scenarios — from no admission at all through to a 14-night stay — combining premiums, excess, co-payments, age-based discounts, and the government rebate into a single net cost. That number represents what you actually pay to hold and use the policy across a range of realistic scenarios. Features assessed include clinical cover inclusions, hospital agreement networks, medical gap cover, complaints data, and service channels.
For extras, we use ten hypothetical claim personas to calculate what you would pay out of pocket across three tiers of coverage. The cost of those claims is based on standard item costs, many of which increased this year. Where a fund has a preferred provider network, we blend the standard cost with network cost based on actual utilisation by consumers. If 60% of fund members use a network dentist, we'd price 60% of dental claims at the membership rate. Large, frequently-used networks carry a meaningful advantage in the calculation.
For packages, we combine the hospital and extras approaches. Health funds can offer extras products or hospital products that are specifically designed for packages that aren't available standalone, and some of this year's strongest results come from funds that have built their entire strategy around that.
The national award weights each fund's state and territory performance by population and the performance in each subcategory by how people actually hold cover. Since the majority of Australians hold packages, packages carry the most weight. A fund that performs well in hospitals but not in extras will find it difficult to win nationally by design, because most people are buying both.
This year we also integrated complaints data from the Private Health Insurance Ombudsman into the feature score. We measure total complaints relative to market share and the proportion that required formal investigation. This data helps capture how a fund handles claims, billing, and member enquiries.
Who we looked at
We assess eligible private health insurance policies across:
- Queensland
- New South Wales & ACT
- Victoria
- Tasmania
- South Australia
- Western Australia
- Northern Territory
To be considered for a state or territory award, a health fund must have a meaningful presence in that market. This means it must either hold at least 0.4% of the state or territory market share, or have at least 10% of its policyholders in that state or territory. To be eligible for a National Award, funds had to meet these requirements in every state and territory.
Policies must be available to new customers through all channels, and listed on the Private Health Insurance Ombudsman database. This excludes closed funds and corporate-only funds, as most people typically cannot access them.
Hospital policies must cover treatment as a private patient in a private hospital and exempt the policyholder from the Medicare Levy Surcharge. They also need the minimum cover required by the profiles they're assessed in — a policy can't be assessed in our Pregnancy profiles unless it covers pregnancy and birth. For extras, we assess three tiers of increasing coverage; policies not eligible for the first tier aren't assessed.
These criteria are designed to ensure we're comparing health insurance products genuinely available to consumers that provide a meaningful level of cover, while maintaining a consistent basis for comparing funds across the market.
What to keep in mind
Check what's right for you. Our awards are designed to recognise health funds that are consistently strong performers across a wide range of needs, circumstances, and realistic usage scenarios considered (we assess 420 different profiles to determine our national winners). When you're choosing health insurance, it's important to compare policies, premiums, coverage and out-of-pocket costs based on your own needs and circumstances. A policy that offers outstanding value for one person may not be the right fit for another.
Percentage-back vs fixed-dollar extras. Some policies pay you a percentage of the charge, so if your policy pays 60% and a root canal costs $550, you get $330 back. Others pay a fixed dollar amount - say $150 or $200 - regardless of what the service actually costs. Percentage-back policies typically carry a higher premium, but the rebate scales as costs rise. Fixed-dollar policies are often cheaper to hold, but the gap between the rebate and the cost grows over time. Last year the standard cost of a root canal in our assessment was $446. This year it's $550, so on a 60% policy your rebate would go from $268 to $330 automatically.
Extras policies are complex. Hospital policies are regulated in what they include at each tier, so comparing them is relatively straightforward. Extras are different — funds have much more freedom in how they structure benefits, limits, and inclusions. These are some of the most difficult policies to compare, and the way they're designed can be counterintuitive.
A policy that includes services you don't think you'll use isn't necessarily a waste of money. If it has a combined annual limit, you're not paying for those specific services, you're paying for a pool of money you can use however you need. All on dental. All on physio. Split across whatever comes up. That flexibility might mean better value than a policy that looks cheaper but locks you into fixed limits on each service.
What this award is and isn't
What it is:
- A like-for-like comparison: All eligible health funds and products are assessed using the same methodology, with hospital, extras and packaged cover assessed across states and territories, consumer profiles and lifestages.
- A comprehensive assessment: The results consider both the cost of holding and using a policy and the features and coverage it provides. This includes premiums, excesses, co-payments, rebates, discounts and out-of-pocket costs, alongside factors such as clinical cover, hospital networks, medical gap cover, preferred provider networks, complaints, service channels and more.
- A recognition of consistent performance. Winners offered outstanding value across a broad range of profiles and scenarios. This is not a list of the cheapest policies, and no single award winner will be the best fit for everyone.
What it isn't:
- Personal financial or health insurance advice: The awards are based on general assessment criteria and consumer profiles. They do not take your individual circumstances, health needs, objectives or budget into account. The winners may not have the right policy for you.
- A guarantee of future value: Health insurance premiums, benefits, coverage, provider networks and other policy features can change. The awards reflect the products and information assessed for the 2026 awards period and are not a guarantee of future performance or value.
- A list of every health insurance product available: We assess eligible providers and products, but not every fund or product in the Australian market will necessarily be included. Eligibility and assessment criteria apply.
FAQs
Who decides the winners for Canstar's Star Ratings and Awards?
Canstar's expert researchers review the overall value offered by a provider for its products in a financial services category. We consider metrics such as price and costs against features and functionality, with all of the competitors in a category compared using Canstar's unique research methodology. The products or providers recognised as winners are those that offer the highest overall value proposition.
What other awards does Canstar give?
In addition to Canstar's Star Ratings that appear in our comparison tables, Canstar gives Outstanding Value Awards that identify providers with high-performing products. Separately, Canstar's Customer Satisfaction Awards reveal how content customers are with a particular financial institution or insurance provider.
What are Canstar's Outstanding Value Awards?
Canstar recognises financial institutions with annual Awards for outstanding value across a wide range of product categories. These Awards are given to the providers whose products are the strongest overall performers in our Star Ratings over the award period.
What are Canstar's Customer Satisfaction Awards?
Canstar's Customer Satisfaction Awards are for providers, recognising institutions with the most satisfied customers overall based on consumer surveys.
How does Canstar work out award-winning brands and providers?
Canstar compares over a thousand brands and products across multiple finance and household services categories, including banking, insurances, superannuation as well as energy and mobile. Each of Canstar's Star Ratings and Awards uses a unique methodology that is brought together by our expert Research team, with products analysed based on price and features. You can find out more about how Canstar's value-based rating system works.
Who do I contact for a media enquiry about Canstar's Star Ratings?
For media enquiries, commentary or analysis about Canstar's Star Ratings and Awards, including our Outstanding Value Awards or Customer Satisfaction Awards, please contact our Corporate Affairs team.