Members Health Fund Alliance, the national 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) for the December 2025 quarter.
The latest statistics show that more Australians are choosing to take out and make use of their private health insurance cover.
The latest APRA data shows the number of Australians with private health hospital cover increased by 54,262 people over the latest quarter, ensuring overall participation continues to grow beyond 15.3 million Australians, highlighting the ongoing value Australians place on being able to access timely, high quality health care.
The number of Australians with extras cover grew by 60,236 over the latest quarter, with more Australians now using their private health cover to help pay for essential services such as dental, optical and physiotherapy care.
This increase demonstrates that more Australians are taking proactive steps to manage their health and stay well.
Health funds are continuing to deliver substantial value, having paid more than $5.3 billion in hospital treatment benefits over the quarter, a 2.89% increase compared to the previous quarter. This includes more than $3.9 billion paid to private hospitals for services such as accommodation and nursing.
Over the full year, health insurers paid out a staggering $26.9 billion in benefits.
Similarly, health funds paid out $1.8 billion in extras benefits over the same period, a substantial increase of 7.7% compared to the previous quarter, including strong uptake in the major categories of:
- Dental $989.93 million
- Optical $327.24 million
- Physiotherapy $117.83 million
- Chiropractic $68.36 million.
The substantial growth in extras benefits paid in the latest quarter is strong evidence that consumers were heeding Members Health’s call to Use or Lose their Extras before the end of the calendar year.
Members Health CEO Matthew Koce said the results demonstrate both the vitality of the sector and the superior value offered by member-owned funds.
“The growth in participation shows that even in a tight economy, Australians prioritise the security of private health insurance,” Mr. Koce said.
“Members Health funds are dedicated to putting people before profit, ensuring more of every premium dollar goes directly toward care.”
“The surge in benefits paid this quarter shows just how much Australians rely on their private health insurance,” Mr Koce said.
“Members Health funds are stepping up to support members to maintain their health and access the care they need, when they need it — especially at a time when costs across the healthcare system continue to rise.”
While participation is rising, Mr. Koce also noted that affordability remains the primary concern for households.
“Members Health funds continue to stand apart by keeping premium increases well below the industry average. Our average premium change for 2026 is 3.62%, comfortably below CPI and significantly lower than the 5.12% average applied by the ‘Big 3’ for-profit insurers.”
“We achieve this by operating on lean net margins of just 2.6%, compared to around 7% among major for-profit funds. While for-profit entities must deliver for overseas investors and shareholders, Members Health funds operate solely for members,” Mr. Koce explained.
Australians reviewing their private health cover now and considering a switch are encouraged to look to Members Health funds, all of which share the same commitment to putting members first and reinvesting funds back into better care and better value.
A full list of Members Health funds is available 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 ethos of putting their members’ health before profit. Our funds represent the interests of more than 5.3 million Australians.
Media Contact
brenton.baldwin@membershealth.com.au
0409 517 176