Private Health Insurance New South Wales

Thinking about taking out private health insurance? It doesn’t have to feel like an overwhelming task. Yes, there are lots of different providers and tiers to choose from, but we’ve got all the information you need to find great value private health insurance in New South Wales for you.

Why compare health insurance in NSW?

Comparing health insurance policies online means you can find a plan that suits your needs and budget. Whether you're after hospital cover, extras or a combined policy, there are a number of things you’ll need to consider in order to find the right provider. Plus, you don’t want to end up overpaying for unnecessary services or missing out on benefits you would regularly use.

So, what are the biggest benefits of doing a quick online comparison?

• Cost savings: Compare Club customers have saved an average of $300 annually by switching policies.

• Cover to suit your lifestyle: Find plans that match with your current healthcare needs, whether that includes dental and optical, or more comprehensive hospital cover for surgery and age-related procedures.

• Avoid hidden costs: Check that your preferred policies include must-haves like ambulance cover and minimal gap fees.

What types of cover can you get in NSW?

Hospital cover

Available in Basic, Bronze, Silver, and Gold tiers. As the name suggests, Gold-tier policies give you the most comprehensive level of cover, including for maternity services and joint replacements.

Extras cover

Cover you for out-of-hospital services like dental, optical, physiotherapy and alternative therapies.

Combined cover

Bundles hospital and extras cover into one policy, which is highly convenient and potentially even better value.

Ambulance-only cover

Essential in NSW, as Medicare doesn’t cover emergency ambulance fees. Costs start at $351 for a non-emergency callout, up to a maximum charge of $7,299 – whether it’s a road ambulance, fixed wing or helicopter.

How long do you have to wait for elective surgery in NSW?

Public hospitals in NSW have experienced significant delays for elective surgeries, partly due to the COVID-19 pandemic:

• In 2020-21, around 90% of public patients were admitted within 339 days for elective surgery.

• However in 2023-24, 6.4% of patients waited longer than a full year to be admitted for elective surgery.

• Private health insurance means you’ll enjoy much shorter wait times by attending a private hospital, particularly for non-urgent procedures, compared to those reliant on the public healthcare system.

Regional resident? Here’s what to consider about private health cover in NSW

Living outside of Sydney or major metropolitan areas can adversely impact your ability to access healthcare services. Here’s what to consider:

• Hospital agreements: Make sure your health fund has agreements with hospitals in your local area to ensure you can get the most from your cover.

• Extras providers: Confirm your policy includes local practitioners for dental and optical services within its network.

Rebates for NSW residents

Private health insurance rebates are available based on income and age. If you’re under 65, for example, you could be eligible for:

• 24.608% rebate for singles earning up to $97,000 or couples/families earning up to $194,000.

• 16.405% rebate for singles earning between $97,001–$113,000 or couples/families earning $194,001–$226,000.

• 8.202% rebate for singles earning between $113,001–151,000 or couples/families earning $226,001–$302,000.

The rebate gets even higher for seniors (up to 32.812%), so check out the ATO’s latest information on income thresholds and rates for the private health insurance rebate.

Who are the major health funds in NSW?

The largest health insurers in NSW by market share include:

• Bupa (24.7%): Internationally operated but widely trusted in Australia.

• Medibank (23.1%): A well-established national provider headquartered in Melbourne.

• HCF (19.7%): Australia's largest not-for-profit health insurer that has excellent member benefits.

• nib (13.7%): Increasingly popular in recent years and headquartered in Newcastle.

In terms of smaller and regional insurers, both Westfund (Lithgow) and Hunter Health Insurance (Cessnock) are popular options among rural and regional residents in NSW. Funds like these tend to have specific agreements with local hospitals and specialists, which could be exactly what you are looking for.

What are Australia's top performing help funds?

So, you've potentially found a great health policy at a great price that fits your specific needs.

But you want to make sure you're also getting good customer service.

Here are the health funds that received the least complaints nationwide.

• HBF (received just 4.0% of complaints versus their 7.3% market share)

• Medibank (22.8% of complaints versus 26.9% market share)

• Bupa (21.5% of complaints, versus 25.4% market share)

• Defence Health (2.1% of complaints versus 1.8% market share)

• nib (8.1% of complaints versus 9.2% market share)

Frequently Asked Questions

Is health insurance worth it in NSW?

Yes, because appropriate private health insurance will give you faster hospital care for non-emergency services and procedures, your choice of doctors and specialists, the ability to get treated in a private hospital, as well as cover for services not included under Medicare.

Can private health insurance be part of my salary in NSW?

Some employers do offer salary packaging for health insurance premiums, which means employees can pay using their pre-tax income.

Sources

*Based on 136,746 customers between 1 Jan 2018 - 23 December 2022.

**Commonwealth Ombudsman, [2020 State of the Health Funds Report], March 2021

**NSW Ambulance, [Accounts and Fees], March 2021

****Australian Institute of Health and Welfare, [Elective Surgery], March 2021

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Chris Stanley is the sales & operations manager of health insurance at Compare Club. With extensive experience and expertise, Chris is a trusted leader known for his deep understanding of health insurance markets, policies, and coverage options. As the sales & operations manager of health insurance, Chris leads a team of dedicated professionals committed to helping individuals and families make informed decisions about their health insurance needs.

Meet our health insurance expert, Chris Stanley

Chris's top health insurance tips

• 1

  Australia’s public health system is world-class, but wait times for public hospitals can be long, inconvenient - and leave you living in constant pain while you wait.

• 2

  An appropriate private health insurance policy can speed up your surgery, relieving your pain sooner.

• 3

  Family health cover means your children are covered under the same policy as you.

• 4

  Many health insurance policies come with a 12-month waiting period for pregnancy-related cover, so it’s a good idea to get a family policy organized well before starting your family. This means your child will be covered from birth until at least their early twenties (depending on which health fund you select).