Last Updated on 12 February 2020

Health Insurance: QLD

Although Medicare pays for some health services for Australians, more than half of the population opts to purchase some type of private health coverage. In total, approximately 55 percent of the population has general coverage and 10.7 million Americans have private hospital coverage, which means that around 47 percent of the population chooses to buy additional health protection in case they require hospital services.

When considering both hospital and general cover policies. 12.6 million total Australians are covered. There are 34 major insurers offering policies to these insured Australians, but there are some substantial differences between insurance markets across different states. If you live in Queensland, it is helpful to have an understanding of your insurance market and of how it compares to others across the country.

Who are the biggest insurers in Queensland?

There are 22 insurance providers in Queensland who have open membership funds, and there are additional restricted membership funds as well. Of these insurers, some have a significantly larger market share than others. For example:

  • Medibank has 34.7 percent of the market share in Queensland.
  • BUPA has 33.2 percent of the market share.

The other small providers within Queensland all have less than one percent of the market share. This does not mean these small providers should not be considered. You need to look at many factors when shopping for coverage, and should compare prices and coverage details from insurers of all sizes.

How does the cost of health insurance in Queensland compare?

Average premium costs can vary significantly in different parts of Australia. In QLD, the average cost of family cover in 2015 was $4039 without obstetrics and $4345 without it.

While families in Queensland do not have the opportunity to move to a different state just to lower their average health insurance premium costs, they can shop around to try to find policies with the best value.

How does ambulance cover vary?

Taking an ambulance to the hospital may be life-saving if you suffer a medical emergency, but you must understand how costs are paid, as there are substantial differences between states. In Queensland, ambulance coverage is provided by the QLD government. Queensland residents nation-wide may take advantage of state-funded coverage, so there are no concerns about ensuring your private health policy pays for ambulance cover. This is not the case in all locations throughout Australia, so if you move from QLD and must obtain new health coverage, you should be certain to determine if an emergency ambulance ride will be paid for by your new policy.

How profitable are insurers in Queensland?

130603-Competition-in-the-Australian-PHI-market-RP1-1In Queensland, insurers have a gross profit margin of 10.6 percent for hospital treatment and 20 percent for general treatment. This is substantially lower than in Northern Territory, where the gross profit margin for hospital treatment is 26 percent and the gross profit margin or general treatment is 30.5 percent. Profit is built into the for-profit health insurance market, but should be reasonable so consumers do not overpay to enrich insurance companies.

Shop around carefully as you look for coverage for you and your family to ensure you get a reasonable premium cost and a policy that provides the type of coverage you need to secure your health and have peace of mind that a medical emergency won’t cause you financial harm.

Disclaimer: The above information is correct and current at the time of publication.


Still have questions? Let's talk!

Confused? Not sure if this applies to your situation? Phone us on 1300 163 402 for some free, no obligation advice.


Or want to compare policies now?