Members Health Fund Alliance, the peak body for Australia’s not-for-profit and member owned health funds, today welcomed the latest quarterly private health insurance statistics released by the Australian Prudential Regulation Authority (APRA).
The figures further demonstrate the value Australians place on private health insurance and the significant benefits it offers.
“The data suggests disruption caused to hospital operations by COVID-19 is firmly behind us. Private hospitals revenue has increased sharply during the quarter with the percentage of premiums paid in hospital benefits rebounding back to a payout ratio of 88.4%.” Members Health CEO, Matthew Koce said.
Private health insurers have underpinned the financial viability of providers, with hospital revenue for quarter 1 financial year 2026 having increased by 8.5% year on year to $3.4 billion.
Increased hospital payouts have occurred at the same time as the number of Australians with private health hospital cover grew by 102,922 people over the latest quarter, to reach a new record high of more than 12.6 million Australians.
Those with extras cover, for services such as dental, optical, physiotherapy and ambulance, increased by a massive 107,394 to more than 15.3 million.
“That a growing 55% of all Australians choose to be part of a health insurance fund points to the value being delivered,” said Mr Koce.
“Waits for care in the public system can extend into the years. By growing private health participation, people can bypass those very long queues for care while also freeing up public resources for those most in need.”
“Health funds are delivering more in benefits to members, with over $26.3 billion benefits paid over the last 12 months to help cover important hospital and extras care.”
“It is particularly pleasing to see payments to help members cover the cost of extras services like dental, optical, physio, chiro, psych, acupuncture, remedial massage, podiatry, speech therapy, dietitian services and hearing aids increased by $434 million or 6.7% for the 12 months to September 2025.”
During just the September 2025 quarter, health insurers paid out $1,672.88 million in extras benefits including:
• Dental $947.90 million
• Optical $213.74 million
• Physiotherapy $130.48 million
• Chiropractic $78.04 million.
“Despite record payouts by health insurers, I remain very concerned that some Australians are not making the most of their extras cover for preventative health checks.” Mr Koce said.
Many people do not realise that most health insurers reset their extras limits on 1 January each year, so now is the last chance to book an appointment with a dentist or optometrist for a check-up.
“It takes less than 2 minutes to see what services and limits you can use, these routine health check ups may t save you thousands in the long term,” Mr Koce said.
“No one likes the idea of spending their well-earned break in a busy hospital emergency department with a dodgy back, making an emergency dental appointment for a toothache or getting headaches because your glasses need to be replaced.
“Yet every summer holidays, we know our hard-working doctors and nurses treat people who present with preventable aliments, adding pressure to our already overburden hospital system.”
Mr Koce said as the year winds down, many people may be feeling burnt out. Focusing on your health is one of the best ways to invest in yourself and start the new year feeling refreshed.
Australians considering taking up or changing private health insurers should consider joining a Members Health fund that is committed to putting people first before profit while providing the best possible value and care.
A full list of Members Health funds can be found at: www.membershealth.com.au/our-funds
Members Health is the peak industry body for an alliance of more than 20 health funds that are not-for-profit or part of a member-owned group, regional or community based. They all share the common ethic of putting their members’ health before profit. Our funds represent the interests of more than 5.4 million Australians.
Media Contact
Brenton Baldwin
Brenton.Baldwin@membershealth.com.au
0409 517 176