Published September 3, 2026
A 2026 Cost Guide to What You’ll Actually Pay and How to Pay Less
Most couples don’t really ask whether they need health insurance. They ask how much it’s going to cost them. Fair question. Combined hospital and extras cover for a couple in Australia averages somewhere around $5,500 a year, though the real number moves a lot depending on your tier, your excess and a couple of dates on the calendar you probably don’t know matter yet. This is less about whether to get cover and more about how not to overpay for it.
What actually drives the price you pay
Hospital cover for a couple typically runs somewhere between $2,100 and $7,100 a year depending on which of the four standard tiers you pick, plus extras on top, which average around $1,380 a year combined. Where you land in that range comes down to five things. Your age when you first took out cover. Your combined income. Your excess. Your hospital tier. And how much of your extras cover you actually use rather than just pay for.
The cheapest way to avoid a tax you don’t need to pay
If your combined income sits above a set threshold and you don’t hold appropriate private hospital cover, you pay the Medicare Levy Surcharge on top of the usual 2 percent Medicare levy. It’s assessed on your combined income as a couple or de facto pair, not each person separately.
| Household income | 2025-26 | 2026-27 | Surcharge rate |
|---|---|---|---|
| Base tier (no surcharge) | $202,000 or less | $210,000 or less | 0% |
| Tier 1 | $202,001 to $236,000 | $210,001 to $246,000 | 1.0% |
| Tier 2 | $236,001 to $316,000 | $246,001 to $328,000 | 1.25% |
| Tier 3 | $316,001 and above | $328,001 and above | 1.5% |
The cheapest fix if you’re above the threshold isn’t always Gold cover. A Basic policy that meets the requirement, meaning a hospital excess of $750 or less if you’re single or $1,500 or less as a couple, can cost less each year than the surcharge itself. Extras only policies don’t count here no matter how good they are, because the ATO only looks at hospital cover for this test.
The loading that quietly taxes procrastination
Wait past 1 July following your 31st birthday to take out hospital cover and insurers can add a 2 percent loading to your premium for every year you were over 30, up to a cap of 70 percent. It sits on your policy for a decade before it drops off.
Say your combined hospital premium sits around $3,500 a year. A 10 percent loading, roughly what you’d pick up joining at 35, adds about $350 to that bill every year for ten years. That’s close to $3,500 in loading alone before it disappears, for cover you could have had at the same base price by joining earlier.
On a joint policy the loading is usually averaged across both partners, so if one of you joined early it softens the hit for the other. It doesn’t erase it though, which is the whole point of joining sooner rather than later.
Does a joint policy actually save you money?
Less than people assume. A joint couples policy is mostly about convenience, one premium, one renewal date, one login, rather than a guaranteed discount. Some funds do price joint cover a little cheaper than two matching singles policies added together. Others charge exactly the same either way. It varies enough between funds that it’s worth asking for both quotes rather than assuming the joint option is automatically cheaper.
Picking a tier without paying for cover you won’t use
All hospital policies fall into one of four standard tiers, and the jump from one to the next is where a lot of the cost difference sits.
| Tier | What it coversh | Where the cost trap is |
|---|---|---|
| Basic | Rehab, psychiatric care and palliative care only | Cheapest option, but check the fine print, not every Basic policy clears the MLS test |
| Bronze | Common surgery categories: joints, ENT, gynaecology, digestive and skin | Solid value if you’re generally healthy, but cataracts and joint replacement are usually excluded |
| Silver | Adds heart, vascular and lung or chest treatment | Pregnancy is still usually optional here, easy to assume it’s included when it isn’t |
| Gold | Everything, including pregnancy, birth, IVF, joint replacement, cataracts and dialysis | The most expensive tier, worth it only if you’ll actually use what it adds |
Paying for Gold when you won’t use its extras for years is the single most common way couples overspend on hospital cover. Paying for Basic when you’re planning a family within the next year or two is the opposite mistake, since pregnancy cover is only guaranteed at Gold and carries a 12 month wait no matter which fund you choose.
Extras that earn back their premium, and ones that don’t
Extras cover isn’t linked to income or the surcharge, so the only question that matters is whether you’ll claim back more than you pay in premiums. For most couples the inclusions that pay for themselves are dental, optical and physiotherapy, plus mental health support like psychology sessions, which more funds are expanding cover for.
- Dental, especially if either of you needs orthodontic work down the track
- Optical, worthwhile if your prescription changes most years
- Physio and remedial massage if either of you plays sport or has a physical job
- Mental health support, an inclusion worth checking for even if you don’t think you’ll use it yet
If you’re paying for extras like acupuncture or a health club rebate and never claiming them, that premium is quietly funding nothing. Check your claims history once a year and drop what you don’t use.
Let the government cover part of it
The rebate reduces what you actually pay, either as a lower premium upfront or as a credit at tax time, and it uses the same income tiers as the surcharge.
| Household income tier | Rebate (under 65, from 1 July 2026) |
|---|---|
| Base tier (up to $210,000) | 24.118% |
| Tier 1 ($210,001 to $246,000) | 16.079% |
| Tier 2 ($246,001 to $328,000) | 8.038% |
| Tier 3 ($328,001 and above) | 0% |
Take it as a reduced premium rather than waiting for tax time if cash flow matters more to you month to month. Either way the dollar value ends up the same.
When switching actually saves you money
Premiums rise across the industry most years, usually from 1 April, and the approved average increase for 2026 was 4.41 percent. That alone is worth an annual check on whether you’re still on the best value version of your cover, not necessarily a brand new fund entirely.
If you do switch, ask your current fund for a clearance certificate before you cancel. It records your join date, your Lifetime Health Cover age of entry and which waiting periods you’ve already served, so your new fund can’t treat you as a first time member and reset the clock. Moving to an equivalent or lower level of cover generally keeps your served waiting periods intact. Upgrading to something new, like adding pregnancy cover you didn’t have before, still means serving that waiting period fresh.
The other detail that costs people money without them noticing. Leave more than a month or two between cancelling your old policy and starting a new one and some funds will treat you as having a gap in cover, which can undo the protection your clearance certificate was meant to give you. Line up the start date before you cancel the old one.
Frequently asked questions
How much does health insurance actually cost for a couple in Australia?
Combined hospital and extras cover averages around $5,500 a year, though the real figure ranges from about $3,500 to well over $8,000 depending on your tier, excess and how much extras cover you add. Basic hospital only cover sits at the cheaper end, Gold with extras at the top.
What's the cheapest way to avoid the Medicare Levy Surcharge?
A Basic hospital policy with an excess of $1,500 or less as a couple, since that's usually enough to meet the appropriate cover test without paying for extras you don't need. Just confirm the specific policy is MLS compliant before you buy, since not every Basic policy automatically qualifies.
Does dropping extras cover actually save much?
Sometimes yes, sometimes no. Extras premiums are relatively small compared to hospital cover, so dropping them only makes sense if you're genuinely not claiming enough to cover what you pay. Check a year of claims history before cancelling rather than guessing.
Is it worth downgrading hospital cover to save money?
Only if you won't need what you're giving up. Downgrading from Gold to Silver saves money immediately but drops guaranteed pregnancy cover, so it's a bad move if starting a family is on the medium term horizon. For a couple with no plans in that direction, Bronze or Silver is often enough.
How much can switching funds actually save?
It depends on the fund and your current tier, but the bigger risk than missing out on savings is losing continuity by mistake, restarting a waiting period or paying a Lifetime Health Cover loading again because a clearance certificate wasn't sorted first. Compare like for like cover levels, not just the price on the page.
Do young couples get any kind of discount?
Not usually a specific young couples discount, but joining before Lifetime Health Cover loading applies is effectively the biggest discount available, since it avoids a cost that follows you around for a decade once it's added.
Comparing all of this fund by fund is the boring part. At Compare Today you can compare health insurance, energy and broadband in one place, so checking whether you’re still on the best value cover takes minutes instead of a Saturday afternoon.
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