Around 20% of Australian families avoid using their private hospital health insurance covers due to high out-of-pocket costs according to a survey conducted by Money.com.au.
The survey revealed that in comparison to 20% families, 17% of couples and 15% of singles reported avoided using their private health insurance cover.
Only 43% of the policyholder families proceeded with a health claim while 44% of singles and 64% of couples filed health insurance claims.
The report said this trend is likely due to families’ greater exposure to more major claims including childbirth and childhood-related procedures, leading to higher accumulated gap fees.
The survey, conducted in March 2025 with a nationally representative sample of 1,000 Australians, also showed that 20% of singles avoided hospital claims due to uncertainty over what their policy covered, compared to 12% of families and 9% of couples.
Money.com.au general manager health insurance Chris Whitelaw said whilst families face greater financial exposure, many may be unaware of ways to reduce costs, such as using no-gap providers or agreement hospitals.
Money.com.au said as of September 2024, more than 15m Australian people were covered by some form of private health insurance covers. Extras health insurance policies (covering non-hospital treatments) are more popular than hospital policies.
Around 12.3m are covered by a combined hospital and extras policy, which is roughly the same number of people covered by a hospital policy. Around 2.7m people have extras only cover, which does not cover treatments that are also covered by Medicare.