Putting members’ health before profit

More Australians join health insurers for peace of mind

Members Health’s exclusive analysis of the latest APRA private health insurance data shows that over the past year to June 2022, participation in private health insurance continued to grow.

“This is the eighth quarter of continuous growth, with the number of Australians taking out hospital treatment cover increasing by over 230,000 during the year”, said Matthew Koce, CEO of Members Health Fund Alliance, the peak body representing the 26 member owned and not profit health funds.

“It is particularly pleasing that the alliance of Members Health funds continued to outpace the rest, growing more than one and half times faster than the industry average.”

‘‘The latest set of numbers are a demonstration of the confidence Australians have in private health insurance and in the not for profit and member owned health funds we represent.”

“Public hospital wait times are stretching out into the years, reinforcing the enormous value and peace of mind that comes from fast access to high quality care and doctor of choice in the private healthcare system.”

“Living with pain and waiting up to two years to receive a joint replacement, tonsillectomy, a cataract removal or ligament repair has an awful impact on a person’s wellbeing.”

“Waiting for surgery means that the other important things in our lives are often delayed: such as getting to work or spending quality time with the family.”

“Private health insurance offers a way for someone to improve their health and receive treatment much sooner than in the public system.”

Importantly having private health cover also helps to take pressure of overstretched public hospitals by freeing up beds for those that need them the most.

Mr Koce said Members Health funds are leaders in value and customer service for their members.

“As a group Members Health funds operate on narrower profit margins and don’t have to satisfy shareholders or overseas investors. That means any profits generated goes back to the members through quality health cover and better health benefits.”

Australia’s unique mixed health system means that people have the choice to belong to a private health insurance fund and there are some questions to consider depending on your circumstances:


As a group the alliance of Members Health funds return more of the premium dollar back in benefits and deliver better service. They don’t have to serve shareholders and overseas investors so they are entirely focused on maximising value to their members. Members Health has consistently achieved policyholder growth well ahead of the industry average and now covers over 5 million lives.


To encourage people to take out health insurance at an early age, the Australian Government introduced rules for Lifetime Health Cover (LHC). The LHC loading is an extra fee charged on top of your hospital cover premium. If you are over 30 years of age when you first take out hospital cover, the fee is calculated at a rate of two per cent for every year over 30. If you wait until you are 65 to take out cover it could go as high as 70 per cent.[1]


The Private Health Insurance Rebate helps you cover the cost of health insurance premiums. The rebate is means tested, so what you receive depends on your income and your family situation. Low-income earners receive the maximum rebate, while those on higher incomes receive a smaller percentage of their insurance premiums.

If you’re looking to join a health fund, check whether they include the appropriate rebate. The level of rebate available to you will depend on your age and your income.

Check the table below:


If you earn over a certain amount of money and you have not taken out private hospital cover, you may be required to pay the Medicare Levy Surcharge (MLS). The MLS was introduced with the aim of reducing Medicare costs by encouraging those who could afford it to take out private health insurance.


Waiting periods will exist in some instances, these are in place to prevent new health insurance purchasers from making an immediate claim.

[1] The loading lasts for 10 years and there are some exemptions for returning expats, new migrants and defence force personnel.

 Members Health is the peak industry body for an alliance of 26 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 million Australians.

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Media enquires: Matt Harris 0479 135 464