HBF health insurance: the smallest 2026 rise, and what it costs you elsewhere

HBF Health Limited is a not-for-profit mutual headquartered in Perth. PrivateHealth.gov.au states it operates in all states and territories. Its 2026 premium increase was the smallest of the seven largest funds by a wide margin, which is the first thing most people hear about it. This page sets out what that actually means, and what the government’s other published figures show.

Plain Cover does not score or rank funds. The Plain Cover methodology does not yet set scoring weights, so no rating appears here.

What a 2.15% rise does and does not tell you

HBF announced an average premium increase of 2.15% effective 1 April 2026, on 16 February 2026, and states it was the lowest average increase among Australia’s five largest health funds for the second year running. The Department of Health, Disability and Ageing approved an industry average change of 4.41% for the same date. Outside the seven largest funds, GMHBA announced 1.98%.

A small increase is not the same as a small premium. The increase is applied to whatever the policy already cost, so a fund with a higher starting premium and a 2.15% rise can still cost more than a fund with a lower starting premium and a 5.47% rise. The increase tells you the direction of travel, not the destination.

The second thing it does not tell you is how much comes back. HBF returns 82.2% of contributions as benefits, below the 84.5% industry figure and the second lowest of the seven funds here. A fund can hold increases down by paying out less, and the published figures show both halves of that.

What HBF cover costs in 2026-27

The table converts each fund’s announced 2026 change into dollars a year on the same A$2,400 a year policy. The policy is a stated example, not an HBF quote.

On the stated example HBF’s rise costs A$51.60 a year against A$131.28 for the largest rise in the table, a difference of A$79.68 a year for that one year. Each percentage is the fund’s own announced figure, published between 16 and 18 February 2026. Dollar figures are Plain Cover arithmetic. Last verified 19 September 2026.

How HBF performs on the government’s own figures

HBF has the highest retention and the highest share of hospital related charges covered of the seven funds here, and draws about half the complaints its market share would predict. It returns the second smallest share of contributions as benefits. PrivateHealth.gov.au does not state the period these figures cover. Read 19 September 2026.

HBF’s own figures, in its release of 16 February 2026, are a record $1.87 billion in claims paid, approximately 1.2 million members nationwide, and 92.7% of in-hospital medical services involving no out-of-pocket cost.

The complaints record, dated

The Commonwealth Ombudsman’s State of the Health Funds Report 2023-24, published March 2025, puts HBF at 2.2% of all private health insurance complaints on an 8.1% market share, and 3.2% of the complaints that were investigated.

That is the widest favourable gap of the five largest funds in that report. For comparison, Bupa drew 18.0% of complaints on a 25.4% share and 23.6% of investigated complaints. Across the industry the Ombudsman received 4,241 complaints in 2023-24, up 23.7% on the year before.

What you actually pay after the rebate

The Australian Government Rebate is set by income, not by fund, so it is identical whichever of these seven you hold. From 1 April 2026 a single under 65 earning A$105,000 or less gets 24.118% back. On the A$2,400 example that is A$578.83, leaving A$1,821.17. It does not apply to any Lifetime Health Cover loading.

The Medicare Levy Surcharge works the same way: 1% above A$105,000 for a single in 2026-27, rising to 1.25% and 1.5%. In 2025-26 those thresholds were A$101,000, A$118,000 and A$158,000. The Medicare Levy Surcharge in 2026-27 has the full table, and the rebate guide has every age band.

Does HBF cover ambulance, and what is left out?

HBF bundles unlimited urgent ambulance by road into its hospital and extras covers. Its Basic Hospital Plus and Silver Hospital Plus summaries both carry the line “Unlimited urgent ambulance by road”, and Silver Hospital Plus adds that “HBF will cover the cost for urgent ambulance transport by road only for circumstances classified as emergency or urgent”.

Two things HBF does not cover, and both are unusual.

Air ambulance is excluded outright. HBF’s Urgent Ambulance product document states “HBF does not cover air or water ambulance services”. HCF covers air, land and sea. Medibank covers air with pre-approval.

Non-urgent transport is not in the bundled benefit. It is sold separately as Ambulance Care, from A$0.50 a week, covering transport from home to hospital and between hospitals.

The waiting period is 7 days, against 1 day at Medibank, nib and Bupa, and 24 hours at HCF. It is the longest of the seven, and it is the one to know if cover is being taken out in a hurry. Outside the seven, Health Partners’ 2026 policy statements set 2 months.

Queensland and Tasmania residents cannot buy HBF Urgent Ambulance because their state schemes cover them. HBF notes the Queensland scheme covers residents nationwide while the Tasmanian scheme covers them within Tasmania. Read 20 September 2026. Our ambulance guide sets out the state schemes, state by state.

How to claim with HBF, and how long it takes

HBF publishes the clearest claim timetable of the seven funds.

Last verified 20 September 2026. For comparison, HCF publishes 7 working days and Bupa 5 business days, while Medibank and nib publish no figure at all.

There are five ways to claim: the HBF App, the myHBF online account, in branch, by mail, or on the spot, which HBF describes as “Swipe or tap your member card at a participating provider terminal to receive your benefit instantly” using a HICAPS terminal.

HBF’s provider network is called Member Plus, singular, and it changes the bill twice over: the provider’s fee is capped by agreement, and the benefit percentage is higher inside the network. On HBF’s own worked example for an oral examination in Western Australia, a Member Plus dentist leaves A$15 out of pocket against A$32.50 outside the network, a difference of A$17.50 on one visit.

The excess is charged once per person per calendar year, not per admission, across A$0, A$250, A$500 and A$750 options.

Who tends to weigh up HBF, and against what

People in this situation typically weigh up the smallest increase and the strongest service figures against the smaller share of contributions returned as benefits. HBF keeps more members than any of the other six, covers the highest share of hospital related charges, draws about half the complaints its size predicts, and raised premiums by less than half the industry average.

Against that, it pays out 82.2% of contributions as benefits where HCF pays 87.8%, a gap of 5.6 percentage points, or about A$134 a year on the A$2,400 example. The two large mutuals sit at opposite ends of that trade-off: HCF returns more per dollar, HBF holds increases down and keeps members longer.

Neither figure decides the question for a given person. They are the published record, and they are the part of it that can be checked.