Methodology

Every policy on this site comes from the Private Health Open Listing (PHOL) — the Australian Government’s official directory of currently-available health insurance products, published by the Department of Health and Aged Care via data.gov.au under Creative Commons Attribution 4.0. We refresh it periodically; the date stamp at the foot of every page is the version we served you.

(A note on names: the Private Health Insurance Ombudsman (PHIO) is a separate agency that handles consumer complaints and operates privatehealth.gov.au. We don’t use the PHIO complaints data — we use the product directory only. They’re sometimes confused; they shouldn’t be.)

We don’t take affiliate fees, kickbacks or referral commissions from any fund listed. We are not a broker. We don’t hold an Australian Financial Services Licence; this is a calculator, not advice.

For every policy that matches your eligibility (state, cover type, household, fund access), the calculator works out two numbers over the time horizon you choose:

• ·Premiums paid. The published monthly premium, multiplied through your horizon, with the government rebate applied (if you claim it, at the tier your age and income put you in).
• ·Benefits returned. For each service you’ve told us you expect to use, the calculator walks the policy’s benefit schedule and caps: per-visit rebate, annual limit, shared sub-limits, and waiting periods. It pays you back up to the policy’s rules, no further.

The headline answer (“you’re $X ahead”) is simply benefits minus premiums. The ranking is by that net number, best first.

The Australian Government rebate is income-tested and age-banded. For every eligible Australian resident, the calculator derives the right rate from the household income and oldest-person age you enter, then applies it to every premium in the answer. Tier 3 earners get 0% — the rebate phases out above $158,000 (singles) or $316,000 (families).

These are the rates the calculator currently applies (ATO schedule for 1 April 2026 – 31 March 2027):

Family thresholds increase by $1,500 for each dependent child after the first. Single-parent households use family thresholds (ATO treatment). The ATO updates these rates on 1 April each year; we refresh the table when they do.

A calculator that pretended to model everything would be more confident than it should be. We hold ourselves to the estimates we’re sure about and call out the rest:

• ·Major dental and orthodontic work. Lifetime limits, complex sub-limits and per-tooth caps vary too much for a per-visit estimate. We surface these as risks rather than guessing the rebate.
• ·Hospital cover. This is an Extras-only tool. If you’re weighing hospital, that’s a separate decision (and the Medicare Levy Surcharge often drives it).
• ·Provider network discounts. Many funds pay more at their preferred providers. We use the policy’s published “100% back” or set-benefit schedule; your actual benefit may be higher at a network clinic.
• ·Loyalty bonuses. Annual limits that grow with years of membership aren’t projected; we use year-one limits unless the policy publishes the full ladder.
• ·Promotions and waived waiting periods. Insurers periodically waive waits during switching campaigns. We don’t model these because they aren’t in the published data; check the fund’s current offer.

The ranked list shows policies that match your eligibility, sorted by their net outcome for the usage you entered. The top of the list isn’t the “best” policy in general; it’s the best one for the inputs you gave. Change the inputs (more dental, fewer physio visits, a longer horizon) and the ranking changes.

A negative net outcome isn’t a bug. For many people, Extras cover doesn’t pay for itself. We’ll tell you so, with the actual numbers.

Anything that materially affects the answer (a waiting period blocking a service, an annual limit you’ll hit early, a sub-limit that caps a category below the headline number) is surfaced in the expanded per-policy detail. That’s the working you’d ask a broker to show you.

Treat the answer as a well-informed starting point, not the final word. Before you switch or sign anything, confirm the specific product, premium and limits with the insurer directly. Our job is to narrow your field; theirs is to sell you the contract.