If you’ve opened your latest private health insurance bill and felt your blood pressure spike, you’re not alone.
Recent analysis has revealed that the cost of private hospital cover in Australia—especially for those with top-tier Gold policies—has risen well beyond expectations.
And for many over-50s who rely on comprehensive cover for peace of mind, these hikes are hitting particularly hard.
Gold-tier cover: The real price of ‘peace of mind’
While the government announced an average premium increase of 3.73 per cent from 1 April, the reality for many policyholders is far more sobering.
Recent findings show that individual Gold-tier policies jumped by a staggering 13.8 per cent on average. That’s an extra $442 a year for singles.
For families, the pain is even sharper—average Gold-tier family premiums have climbed to $7,207, up $858 since March.
These figures highlight a growing gap between the official averages and what is actually happening in the market.
Insurers have significant discretion in how they apply increases, and it is clear that those with the most comprehensive cover are shouldering the heaviest burden.
Not all tiers are created equal
If you’re on a Bronze or Silver policy, you may have dodged the worst of the increases.
Adjustments in these categories ranged from a relatively modest 1.5 per cent to 5.2 per cent. In fact, some Basic-tier policies even saw a slight decline.
But for those who want the security of Gold-tier cover—often necessary for senior Australians or those with complex health needs—the cost is rising at a rate that is hard to ignore.
Location, location, location: Where you live matters
It is not just your level of cover that determines your premium. The same analysis found significant differences depending on where you live.
Victorians and Queenslanders are paying some of the highest average Gold-tier premiums, while those in the Northern Territory and Western Australia are getting a better deal.
These regional variations come down to a mix of market competition, the cost of delivering services, and the pricing strategies of individual insurers.
Are you getting value for money?
With premiums climbing, it is natural to wonder if you are actually getting your money’s worth.
According to a separate study by Money.com.au, Australians with hospital cover make an average of just two claims per year.
In fact, 51 per cent of respondents reported one or two claims annually, and about a third said they had never used their policy at all.
Unsurprisingly, senior Australians are more likely to use their cover. Baby Boomers led the pack, with 68 per cent making one or two claims a year.
Younger generations were less likely to claim, and more likely to have never used their policy.
When it comes to extras cover—such as dental, physio and optometry—singles are the least likely to claim frequently, with 40 per cent reporting just one or two claims per year.
Couples and families, on the other hand, tend to get more value from their extras.
Confused by the system? You’re not alone
In 2020, the government introduced a four-tier system (Basic, Bronze, Silver, Gold) to make private hospital insurance easier to understand.
But has it worked? Not really, according to the latest surveys.
More than half of respondents said they only partially understood the new model, and 13 per cent found it just as confusing as before.
How to fight back: Shop around and save
The good news? You don’t have to take these price hikes lying down.
The same research from Canstar shows there are significant savings to be had if you’re willing to switch insurers.
Individuals on Gold policies could save up to $1,296 a year by moving to a lower-priced option with the same level of cover.
For families, the potential savings are even greater—up to $2,493 annually.
It pays to compare policies, check what you are actually using, and consider whether you need all the bells and whistles.
Sometimes, a lower-tier policy or a different insurer can offer the same benefits for much less.
Have you been hit by a health cover hike?
It’s becoming more important than ever to keep an eye on your private health insurance costs—especially if you’re on a Gold-tier policy.
If you’re not getting the value you expect, it might be time to take action.
Have you reviewed your health cover lately? Did you notice a big jump in your premium—or find ways to save by switching providers? Share your story in the comments section below. Your experience could help fellow readers make more informed decisions.
Also read: Private health insurance premiums climb: 3.73% hike kicks in this April