lifetime health cover letter australia

• Health insurance
• Overseas students (OSHC)
• Overseas visitors (OVHC)
• Understanding Hospital & Extras cover
• Lifetime health cover
• Member benefits
• Travel insurance
• NDIS services
• Find a Provider
• Healthy Living
• Health Management Programs
• HealthCheck
• The Check Up: wellness articles

Healthcare in Australia

Government initiatives, medicare and the public system, view healthcare in australia steps, lifetime health cover.

Lifetime Health Cover (LHC) is a Government initiative aimed at encouraging people to take out private hospital cover earlier in life, and maintain it. If you don’t take out private hospital cover before 1 July after you turn 31, you’ll pay a 2% loading on top of your normal hospital premium for each year you don’t have hospital cover (up to a maximum of 70%). The loading applies for 10 years of continuous hospital cover. For every year you put off signing up for hospital cover, another 2% will be added. So if you wait until you’re 40, you’ll pay 20% more than someone on the same cover who joined when they were 31.

Avoid LHC with a hospital cover that suits you.

How to avoid the lifetime health cover loading.

Join any nib Hospital cover before 1 July following your 31st birthday. As long as you keep your private hospital cover, you can avoid paying the 2% annual loading. Lifetime Health Cover loading only applies to the hospital portion of your premiums on a combined cover and does not apply to Extras cover or Ambulance only cover.

Frequently asked questions

Q: who does the lhc apply to.

A: LHC will apply if you are 31 or over and:

Don’t have private hospital cover before 1 July following your 31st birthday

Have periods totalling more than 1,094 days without private hospital cover

Migrated to Australia and don't take out private hospital cover within 12 months of being registered for full Medicare benefits

Have been travelling overseas and don't take out private hospital cover within 12 months from the day you returned to Australia

Q: How does LHC loading affect couples and families?

A: If you and your partner have been without private hospital cover for different lengths of time, your LHC loading is calculated by averaging out the two. For example, if you’re paying a 40% loading and your partner has a 10% loading, that will be averaged out to 25% on a couple or family policy.

Q: What if my birthday falls in the second half of the year?

A: Once you turn 31, you have until the following 1 July to purchase hospital cover before the 2% loading applies. So if you turned 31 in October for example, you’ll have until 1 July the following year to join before the loading catches up with you.

Q: When do I stop paying the LHC loading?

A: If you take out private hospital cover after 1 July following your 31st birthday and Lifetime Health Cover loading is applied to your health cover when you join, you will need to pay this loading for 10 consecutive years before it ceases to apply.

Once the 10 year mark is reached on your policy, a letter will be sent out confirming your new premium amount. Anyone else on the policy who is eligible for this removal will also be contacted at this time. If you don't hear from us, and feel you are eligible for the premium reduction, please contact us .

Q: What if I am switching between health funds?

A: To avoid using up any of the 1,094 permitted days (one day short of three years) you can be without hospital cover during your lifetime, we recommend you keep your cover with your old fund until the date you transfer to us. We make switching easy, we’ll even handle the break-up call for you. For more information, see our switching page.

If you already have an LHC loading, it will move with you.

Q: What if I suspend my cover?

A: Suspending your policy won't affect your LHC status. While you won't be able to claim on services provided in this time and you won't be paying your premiums for the duration of the suspension, you'll still be classed as maintaining your cover. See Suspend or Resume Your Policy or contact us for more information.

Q: What if I am going overseas?

A: If you're going to be out of Australia for 2 months to 24 months, you can apply to suspend your health cover. If your request is approved, your LHC loading level will not be affected and, if you take out travel insurance , you'll avoid waiting periods for pre-existing hospital conditions when you return to Australia.

If you anticipate being out of the country for at least a year and decide to cancel your health insurance, the only time that will count towards your 1094 permitted days will be any periods of 90 days or more you spend in Australia, per visit. If you're in the country for less than 90 days, you'll still be counted as being overseas and won't affect your level of loading.

Q: What if I’m a new migrant to Australia?

A: You'll have until either 1 July following your 31st birthday or until the one-year anniversary of your full Medicare registration (whichever is the later) to get private hospital insurance and avoid an LHC loading.

If you're over 31 and you'll be overseas on your Medicare anniversary (if you registered with Medicare on or after 1 July 2009) you won't be affected by the loading, provided you take out private hospital cover within 12 months of your return to Australia.

If you don't have private hospital cover by this new anniversary, you’ll have an LHC loading of 2% added to your hospital cover premium for each year you are aged over 30 when you take out private health insurance.

Q: What is certified age of entry?

A: When you purchase health insurance for the first time, you are given a ‘certified age of entry’ (CAE) so that we can determine what your premium is and if you need to pay any LHC. The CAE is based on the age you are when you first take out Hospital cover.

If you purchase Hospital cover before 1 July following your 31st birthday, you’ll be given a CAE of 30 and won’t have to pay any LHC. If you were to get Hospital cover after your 31st birthday, your CAE is your age you were on 1 July before you were covered.

For example, Kate turns 39 on 6 March 2019, and purchases Hospital cover for the first time on 10 June 2019. On the 1 July before Kate first purchased Hospital cover she was aged 38, so her lifetime health cover age is 38. Her loading will be 16%, which is a 2% loading for each year she is aged over 30 without having Hospital cover.

More information

Contact us , or visit the department of Health and Ageing website at www.health.gov.au .

Continue to the next page

Related articles.

Lifetime Health Cover: I've turned 31 this year, what does that mean for private health insurance?

Switching private health insurance funds? Here’s what you need to know

Should I take out health insurance while I’m young?

What is Lifetime Health Cover?

Lifetime Health Cover (LHC) is an Australian Government initiative designed to encourage people to get their hospital cover early and keep it up.

How does Lifetime Health Cover work?

Once you turn 31, a 2% loading is added to your hospital cover premium for every year you’re without hospital cover. This is called the Lifetime Health Cover (LHC) loading.

To avoid this loading, you can take out hospital cover by July 1st following your 31st birthday, which is called your base day.

For example, if you wait until 35 to get hospital cover, your loading will be 10%. So, a $100 monthly hospital premium would become $110 with the added loading.

If you’re on a combined cover, the LHC loading is only applied to the hospital portion of your premium.

On a couple or family cover? The loading is calculated by taking an average of the loadings applied to the adults on the hospital cover. So, if one person has 18% loading and their partner has no loading, or 0%, the loading applied is 9% overall.

Does Lifetime Health Cover loading apply to everyone?

Well, no. There are a few groups of people who are exempt from the LHC loading. Some veterans and members of the Australian Defence Force may avoid having LHC applied. People born on or before 1 July 1934 won’t have LHC applied.

To learn more about LHC exemptions, visit: www.privatehealth.gov.au .

If you think you might qualify for an LHC exemption, you can apply using the LHC Exemption form .

Download form

Why should I consider hospital cover with Medibank?

Getting hospital cover doesn’t just mean you could avoid paying LHC loading after turning 31. Hospital cover could give you peace of mind in your day-to-day and help if the unexpected happens.

Find out more about hospital cover with Medibank.

Can my LHC loading be removed?

Once you have an LHC loading, it can only be removed once you’ve paid the loading for 10 continuous years. After this time, the loading may be reapplied if you drop your hospital cover and then take up cover again.

What if I switch health funds?

When you move funds, your LHC loading goes with you. If you’re switching to Medibank from another fund, it’s a good idea to maintain your hospital cover up until the date that you transfer, to avoid using up any of your permitted days without cover unnecessarily.

Permitted days without hospital cover

If you have hospital cover on or after your base day, you are entitled to 1,094 days without hospital cover that won’t affect your LHC loading status.

What if I drop my hospital cover?

If you exceed your 1,094 permitted days without cover, you’ll probably have to pay an LHC loading once you take out hospital cover again. If you were already paying an LHC loading, the loading will be higher.

What if I’m going overseas?

If you’re away from Australia for more than one continuous year (including visits back to Australia less than 90 days at a time, as you’re still considered to be living overseas) these days may not count towards your 1,094 permitted days without hospital cover.

What if I suspend my hospital cover?

If your health fund agrees to suspend your membership, this period isn’t counted towards your 1,094 permitted days without hospital cover. If you have a loading, it’s not going to increase while your cover is suspended.

If you’re ready to talk about hospital cover, call our team on 132 331

Or visit us in store .

Useful resources 

What are the common hospital procedures for someone like you.

Our interactive tool reveals the common procedures, what you might pay out-of-pocket and how health insurance could help manage the costs.

How much extra tax could you pay without hospital cover?

Use the Medicare Levy Surcharge Calculator to find out if you're eligible, or discover how much extra tax you may be paying by not having Hospital cover for a full tax year. #

Understanding Health Insurance

Health insurance can be tricky to understand. To help, we have put some handy guides together to get you started.

Did you find this information useful?

Things you need to know

# Where annual income for Medicare Levy Surcharge purposes is over $97,000 as a single (or $194,000 as a couple/family).

Medibank Private Limited cannot advise on financial or tax matters. Any information provided to you is general in nature and does not take account of your individual circumstances. You should obtain your own independent financial advice.

For independent private health insurance advice, visit  privatehealth.gov.au .

Request a call back

Leave your details and a Medibank expert will be in touch to take you through your options. In providing your telephone number, you consent to Medibank contacting you about health insurance.

We'll have someone call you soon to help with any questions you have.

COVID-19 Health Assist - Expression of interest

Complete this form to express your interest in one of our programs. If you're eligible, a member of our team will call you within 2-3 business days.

What program are you interested in?

Sorry, only members with current Hospital cover are eligible to participate in these programs

Eligible Medibank members with Extras cover are able to access a range of telehealth services included on their cover - you can find out more here . Alternatively, if you would like to talk to one of our team about your cover, we're here on 132 331 .

Your membership details

Please provide your details so we can know how to contact you.

Your contact details

By clicking Submit, I understand that Medibank or its subsidiaries may contact me to discuss my eligibility for the Covid-19 Heath Assist program(s), and will disclose my personal information within the Medibank Group of companies and to third party service providers. Please see Medibank’s privacy policy for further information about how Medibank will handle my personal information, and how to contact Medibank: https://www.medibank.com.au/privacy/

Thank you for expressing your interest in one of our COVID-19 Health Assist programs.

If you are eligible, one of our health professionals will call you in 2-3 business days to discuss your situation and help to enrol you in the relevant program.

There is no cost to participate, however some referred services may incur an out of pocket cost.

What is the Lifetime Health Cover loading?

Once you turn 31, you’ve got until the following 1 july to buy private hospital cover and avoid paying the loading..

For every year you delay, you may have to pay an additional 2% on top of the cost of your private hospital cover.

How does Lifetime Health Cover loading work?

The Lifetime Health Cover loading was introduced by the Australian Government in July 2000 to encourage people to take out private hospital insurance at a younger age and maintain it over time.

Once you turn 31, you’ve got until the following 1 July to buy private hospital cover and avoid paying the loading.

For every year you delay, you may have to pay an additional 2% (up to a maximum of 70%) on top of the cost of your private hospital cover . The good news is that the loading doesn’t last a lifetime. Once you have held private hospital cover for 10 continuous years, the loading will be removed.

Does everyone have to pay?

The Lifetime Health Cover loading applies if you didn’t have private hospital cover

• on 1 July 2000, OR
• by 1 July following your 31st birthday, whichever is later

How does Lifetime Health Cover loading affect couples and families?

If you and your partner have been without cover for different lengths of time, your Lifetime Health Cover loading will be calculated by averaging out the two.

For example, if you’re paying a 4% loading, and your partner has a 10% loading, that will be averaged out to 7% on a couple or family policy.

What happens when you switch to a new health fund?

The old fund will provide your new health fund with a transfer certificate. This certificate has information about your previous cover including your Lifetime Health Cover loading plus details about any waiting periods you’ve already completed, so that these can be applied to your new cover.

That means that your Lifetime Health Cover loading moves with you.

Switch to Australian Unity

Can you have gaps in hospital cover?

Can you suspend your private hospital cover, i'm going overseas for 1 year or more, how will this affect my lifetime health cover loading, for example, if your private hospital cover costs $1,000 per year, buy cover at age 31.

• 0% Lifetime Health Cover loading Once you turn 31, you’ve got until the following 1 July to buy private hospital cover
• $0 extra Lifetime Health Cover loading a year As long as you maintain your private hospital cover, you’ll avoid paying any Lifetime Health Cover loading
• $0 extra Lifetime Health Cover loading over 10 years Enjoy the benefits of private hospital cover without having to pay extra loading

Wait until you turn 50

• Up to 40% Lifetime Health Cover loading For every year you delay, you may have to pay an extra 2% for your private hospital cover
• About $400 extra Lifetime Health Cover loading a year The longer you delay, the more it can cost—up to a maximum of 70% loading
• About $4,000 over 10 years You can get the same level of cover, it can just cost you more for the first 10 years

Get a quick quote now

Still got questions.

Find the answers to your questions below, or to find out more about how the Lifetime Health Cover loading affects your health insurance premium or if you’d like us to request a transfer certificate from your previous health fund, call us on 13 29 39. You can also visit the Private Health website or ATO website . If you have specific tax-related questions, contact your registered tax agent.

We're here for you

Upgrade to Microsoft Edge to get the full experience

Our new website isn't supported in Internet Explorer. For the best experience, upgrade to Edge , Chrome or Firefox .

Lifetime Health Cover

What is lifetime health cover.

Lifetime Health Cover (LHC) was introduced to encourage younger people to take out hospital cover earlier in life and to maintain that cover. LHC works by applying a financial penalty to those who choose to take out hospital cover after they turn 31 in the form of a two per cent loading for each year their age exceeds 30 when they do choose to join.

LHC applies to everyone who takes out hospital cover after July 1 following their 31st birthday (this day is sometimes referred to as your LHC base day).

For example, if you take out hospital cover at age 40 you will pay 20% more (2% for each year over the age of 30 x 10) than someone who first took out the same hospital cover at age 30.

Example scenario one:

Sally is 37 and has decided to take out a hospital policy with Westfund. Sally has not previously held private hospital cover. Her base premium is $1000 per annum. Sally must also pay a LHC loading of 14% (2% x 7 years), bringing her premium to $1140 per annum*.

If you’re on a couple or family policy, your loading is calculated as an average between the individual loading of the two adults. For example, if one person has 20% loading and the other person has 0% loading, the loading applied to the couples’ policy is 10%.

NOTE: Extras cover, Overseas Visitors Health Cover, and international forms of insurance are not considered to be hospital cover for Lifetime Health Cover purposes.

Example scenario two:

Bruce and Jennifer are 36 and 35 respectively and are taking out a family hospital policy with Westfund. Neither have previously held private hospital cover. Bruce’s LHC loading is 12% (2% x 6 years) and Jennifer’s is 10% (2% x 5 years) meaning a combined total of 22%. This loading will be halved, bringing their collective LHC loading to 11%. Their base premium is $5000 per annum; with LHC loading applied, their premium then becomes $5550 per annum*.

*Costs are for illustrative purposes only and do not reflect the pricing of any specific Westfund Health Insurance product.

Common questions

The maximum LHC loading is 70%.

If you were born on or before 1 July 1934, you are exempt from LHC.

Once you have paid an LHC loading on your private hospital insurance for 10 continuous years, the loading is removed.

Your loading will then remain at 0% as long as you retain your hospital cover; or, if you cancel your cover after the loading is removed, as long as you do not exceed your permitted days without hospital cover.

If you have taken up hospital cover on or after your Lifetime Health Cover base day, then you can access the following ‘permitted days without hospital cover’ during which you don’t have an active hospital policy, but your loading does not increase. For most people, your base day is the later of 1 July 2000 or the 1 July after your 31st birthday.

• Gaps in cover – to cover small gaps, such as switching from one fund to another, you are able to be without hospital cover for periods totalling 1094 days (i.e. three years less one day) during your lifetime, without affecting your loading. This is known as ‘Days of Absence’. If you use up your Days of Absence – that is, you have a total gap period of 1095 days – you will pay a loading on rejoining private hospital cover. The loading is an additional 2% on top of any previous loading and will increase by 2% for every year after the 1094 days without cover.
• Suspension of membership – if you suspend your hospital cover for a short period (for example, to travel overseas for a holiday), this period of suspension isn’t counted towards your 1094 days of absence. 
• Going overseas – if you cancel your hospital insurance after your Lifetime Health Cover base day in order to go overseas for at least one continuous year, the days you spend outside of Australia aren’t counted towards the 1094 Days of Absence. You are able to return to Australia for periods of up to 90 consecutive days, per visit, and are still considered to be overseas. Any periods of 90 days or more which you spend in Australia will be deducted from the 1094 Days of Absence.

Information sourced from: privatehealth.gov.au

No, LHC relates to private hospital cover only.

A dependant person with a disability is treated as an adult for the purposes of Lifetime Health Cover (LHC). If they are covered by hospital cover on their LHC base day they will avoid paying a LHC loading. If a dependant person with a disability joins their family hospital cover for the first time after their LHC base day, a loading of 2% will apply for every year they are aged over 30, based on their age on the 1 July prior to joining.

Example 1:   Lucy turned 31 in January 2019, so her LHC base day is 1 July 2019. In November 2021 at the age of 33, Lucy joins her family’s hospital cover as a dependant person with a disability. As Lucy had no hospital cover on her LHC base day Lucy’s LHC loading is 6%. Lucy is the only adult on the policy that has a LHC loading. The average LHC loading on the family cover is 2%. If a person has their own singles hospital policy with a loading, then transfers to a family or single parent policy as a dependant person with a disability, they will carry their loading with them.

Example 2:   Archie takes out a singles hospital cover for himself in February 2018 at the age of 32. His LHC loading is 4%. In December 2021, Archie transfers to his mother’s single parent hospital cover as a dependant person with a disability. Archie’s individual loading is 4% and his mother has a loading of 0%. The average LHC loading on the single parent cover is 2%. Archie will be eligible to have his loading removed after he has maintained a hospital cover for ten continuous years.

Lifetime Health Cover

Think of the Lifetime Health Cover system as a way of spreading the load between the young and healthy and older Australians.

Under Lifetime Health Cover, people who take out private hospital cover before they turn 31 years old pay less for it than people who wait until they are older. That is only fair. Otherwise they would end up subsidising people who join at a later age.

So, if you are around 30 years old, and you do not have private health insurance hospital cover, you should seriously consider taking it out now. Because after 1st July following your 31st birthday, you will pay 2% more for every year you wait.

You can save money on health insurance if you take it out sooner rather than later!

If you’re privately insured before June 30 of the year you turn 31 you will be on the lowest premium rate for life. From the age of 30 you will have to pay an extra 2% for every year you remain uninsured – so if you wait until you’re 40 to take out private health insurance you’ll pay an extra 20% and if you wait until you’re 45 you’ll pay an extra 30%.

Lifetime Health Cover (LHC)

LHC applies to everyone born after 1 July 1934 and it sets your premium rating for life when you first take out private health insurance hospital cover. If you do not have hospital cover on the 1st of July following your 31st birthday and then decide to take out hospital cover later in life, you will pay a 2% loading on top of your premium for every year you are aged over 30.

For example, if you take out hospital cover at age 40 you will pay 20% more than someone who first took out hospital cover at age 30. The maximum loading is 70%.

Once you have paid a LHC loading on your private hospital insurance for 10 continuous years, the loading is removed as long as you retain your hospital cover.

That’s a fair reward for those members who have shown a long term commitment to the private health system!

Lifetime Health Cover… Read More>>>

Have you recently become a permanent Australian resident?

It's time to look at your cover options

description Related articles

• How to make an extras claim online
• Want to know where to find your limits?

Congratulations! We're happy you've decided to stay in Australia. It's important to make sure you're on the right level of cover for Australian residents now you've got access to Medicare.

How to change your cover.

We've got great-value policies for whatever life stage you're at, so get in touch with us today and we'll help you find the best policy. You can also get a quote online .

Get in touch with us.

Useful information.

As a permanent resident, the way you're covered will change with your new health insurance policy. Outpatient medical services, such as going to the General Practitioner (GP), visiting a specialist, or getting a blood test, can only be covered through Medicare.

The way we pay for inpatient procedures is also different. When you're admitted to hospital for a procedure that's included in your level of cover and that you've served waiting periods for, we'll pay the hospital fees and we’ll work with Medicare to cover your doctor’s costs, up to the Medicare Benefit Schedule (MBS) fee.

Having private health insurance as an Australian resident means you may avoid lengthy hospital waiting lists and you also get to choose the specialist who'll be treating you.

There are lots of great benefits of staying with Bupa .

Why stay with Bupa?

Because you can get more from your cover.

Find out how to reduce your out of pocket costs and make the most of your extras cover .

Because there’s a cover for every life stage

Whether your family is growing or the nest is emptying, your health needs will change over time. We have a wide range of products for all life stages, so you can make sure you’re getting cover that's right for you .

Because you can access exclusive discounts and offers

Because you can access exclusive discounts and offers Loyalty should be rewarded. Access an exclusive range of member-only discounts and offers from Life Rewards . It’s our little way of saying thank you for staying with Bupa.

Medicare Levy Surcharge (MLS)

If you’re a high income earner and you don’t have private hospital insurance, you may be liable to pay the Medicare Levy Surcharge .

Lifetime Health Cover (LHC) loading

Over 31 and taking out private health insurance after a break in cover may mean that Lifetime Health Cover loading will apply. Read more about LHC .

Important things to consider

If you're over 31 when you become eligible for Medicare, you then have 12 months to take up private hospital cover before Lifetime Health Cover (LHC) loading applies. After this time, an extra 2% is added to your premium for each year you're over the age of 30 to a maximum of 70%. LHC stays on your policy for 10 years. We'll need a copy of your Medicare Eligibility Letter to confirm your Medicare eligibility date.

If you're under 31 when you become a permanent resident, you'll have until the 30 th June following your 31 st birthday to take out private hospital cover to avoid incurring LHC loading. There's also the age-based discount (ABD) available on private hospital cover if you're between 18 and 29 when you take it out. This can save you up to 10% on your premiums until you turn 41!

Taking out private hospital cover may exempt you from needing to pay the Medicare Levy Surcharge (MLS) if you're a high-income earner. Please contact us to discuss your needs further.

Quick answers to common questions

How do i get my medicare eligibility letter expand_more expand_less.

You’ll need to contact Medicare to request a copy.

Will I have to serve waiting periods again? expand_more expand_less

We'll recognise all waiting periods you've already served when you change your cover. Any new services or benefits that you weren't covered for before will have waiting periods.

Can I change my cover in myBupa? expand_more expand_less

You won't be able to change from an overseas visitors cover to a resident cover in myBupa, but we're very happy to help you make the change.

Can I still use myBupa once I change my cover? expand_more expand_less

Absolutely! You won't even need to register again.

• Join CHOICE

Lifetime health cover for migrants

You'll pay a price if you take out health insurance too late..

Fact-checked

Checked for accuracy by our qualified fact-checkers and verifiers. Find out more about fact-checking at CHOICE .

Figuring out whether or not you need private health insurance if you're an Australian living in Australia is tricky enough.

If you're a migrant or an Australian returning from overseas it gets even trickier. You may end up paying a lot more than you otherwise would if you don't understand the rules.

On this page:

Lifetime Health Cover for migrants

How it works, lhc for overseas residents and citizens, how does the lhc affect migrants to australia, who's responsible for making migrants aware of lhc loading, how to appeal, how to lodge an lhc-related complaint, the lifetime health cover loading.

The first thing to understand is that the Australian government really wants you to take out private health insurance to ease the burden on the public healthcare system, and that's fair enough.

It's why the government imposes a penalty on Australian citizens or permanent residents who don't take out private health insurance by the start of the financial year following their 31st birthday.

The penalty is called Lifetime Health Cover (LHC) loading , and it adds a two percent surcharge on top of your premium for every year you don't have private health insurance starting on 1 July after you turn 31.

LHC only applies to hospital cover; you're not required to take out extras cover (for things like dentistry and physio) to avoid LHC loading.

If and when you do get hospital private health insurance, the loading continues for 10 years.

The surcharge has a 70% cap, so if you delay getting private health insurance until age 66, for instance, almost half of your premium will be an LHC surcharge. As an example:

• For couples taking out cover in their mid-sixties and facing an annual premium of $3400, the total once you add in LHC loading would balloon out to $5780 a year. (Though you're exempt from LHC loading if you were born before 1 July 1934.)

Well before your mature years, however, an LHC surcharge can cost you many thousands of dollars in premiums you wouldn't have had to pay if you'd bought a private health insurance policy when the government wanted you to.

With the cost of private health insurance continuing to rise significantly even without LHC loading, such a financial penalty appears to have proven a pretty effective deterrent to people putting off private health insurance for too long if they plan to take it out at all.

The LHC protocol is pretty straightforward for Australian citizens, but what about migrants who arrived in Australia well after age 31 and didn't get the message about the costs of LHC loading and the deadline that applies to migrants?

Is it fair to charge LHC loading for years that a migrant did not yet live in Australia and therefore were not a burden on the Australian healthcare system? Whether it's fair or not, that's how it works.

We asked the Department of Health about this discrepancy, but a spokesperson simply reiterated the policy, saying "for migrants, the LHC loading of 2% for each year is applied regardless of whether or not they lived in Australia when they were aged 30 or over". 

It seems even less fair when you consider the migrant may well have had private health insurance in the country they came from.

LHC for migrants

• Migrants to Australia who are over 31 when they arrive have 365 days from Medicare registration to take out private health insurance and avoid LHC loading. If you miss the 365-day deadline, your 'base day' – when the 2% loading would begin – will be 1 July after your 31st birthday, regardless of where you were living at the time.
• If you migrate and turn 31 while living in Australia as a permanent resident or citizen, you have until 1 July following your 31st birthday or one year after Medicare registration to take out private health insurance and avoid LHC loading, whichever event comes second. In this case, your 'base day' is whichever of these dates applies to your situation.
• If you're a migrant who is overseas on 1 July following your 31st birthday and you registered with Medicare on or after 1 July 2009, you have 365 days after returning to Australia to take out private health insurance and avoid LHC loading.
• Australian citizens and permanent residents who were overseas on 1 July following a 31st birthday in Australia that fell after 1 July 2000 have 365 days after returning to Australia to take out private health insurance and avoid LHC loading. You can be in Australia for up to 90 days per visit before the 365-day countdown begins, though the 90 days will count toward that limit if you stay longer.
• Australian citizens and permanent residents who were overseas and over the age of 31 on 1 July 2000 have 1094 days to take out private health insurance once they return to Australia without incurring the LHC loading. The 1094 is a lifetime limit. You can return to Australia while living overseas for up to 90 days at a time without affecting the limit, but anything over 90 days counts against the 1094 total.

But bear in mind that health funds can make mistakes, either through incompetence or negligence. One Australian woman who was living overseas when LHC loading was first introduced in July 2000 recently contacted CHOICE about her LHC loading issue and ending up getting a $6200 refund from her insurer due to an incorrectly applied loading. 

If you migrate from one of the 11 countries that has reciprocal healthcare agreements with Australia, your 365-day countdown to take out private health insurance and avoid LHC loading after age 31 starts when you're granted full Medicare eligibility.

There are other ins and outs and exemptions to LHC loading. Go to the Private Health Insurance Ombudsman website to find out more.

Consider this real-life case study

• Our case study moved to Australia at age 45 and took out private health insurance (PHI) with HCF two weeks past the 365-day deadline to avoid LHC loading. He had not heard of the LHC levy, nor had his Australian wife. It was a coincidence that he was so close to the deadline. LHC information is communicated to migrants by the Department of Health and the Department of Human Services, but it's easy to miss the memo in the barrage of other migrant paperwork.
• Because our case study missed the deadline, HCF applied a 32% LHC loading. It meant that a 2% surcharge was added for every year after age 31 that this person did not have Australian private health insurance. The kicker is that this person did not migrate to Australia until age 45, so in effect he was penalised for accessing the Australian healthcare system without private health insurance for the 14 years between ages 31 and 45 – years when he did not live in Australia and could not have accessed the Australian healthcare system. Then another 2% loading was added for each year he was a resident of Australia without private health insurance, even though he was only about two weeks into his second year. During the years between ages 31 and 45 he had PHI in his own country.
• Our case study appealed to HCF regarding his situation to no avail, though his Australian wife (who had 1094 days, not 365, to take out private health insurance upon returning to Australia without incurring an LHC loading) was reimbursed $2188.55 after providing an International Movement Record .  

How much has our case study paid in LHC loading to date? Had he not caught wind of the LHC issue and requested the rebate from HCF, it would have been $5422.50 as of January 2017.

Factoring in his wife's rebate and $121.45 in LHC loading on his latest monthly premium payment, he has paid $3355.40 so far. His 10-year LHC period ends in July 2017.

According to the Department of Health spokesperson, the Department of Human Services sends migrants information about private health insurance and LHC loading along with their Medicare cards, and the Department of Health sends new migrants info about LHC in May each year.

A spokeswoman for the Department of Immigration told us "new migrants have access to a range of information about health and social services in Australia via links on the Department's website ," adding that "questions about how the Lifetime Health Cover loading is applied should be directed to the Department of Health".

Though the insurer made no such enquiries with our case study, the Private Health Insurance Ombudsman told CHOICE that health insurers should ask new customers about their immigration and citizenship status and how it might apply to LHC loading.

"It would be expected that health insurers should make appropriate enquiries at the time of joining to ensure the correct LHC loading is applied," a spokesperson said. "Where the incorrect loading has been applied, the insurer may be obliged to retrospectively correct this."

It's worth pointing out that the revenue generated by LHC loading stays with the private health funds instead of going to the health department to help offset the burden placed on the healthcare system by people without private health insurance, which would seem to make sense. 

against an LHC loading

If you're a migrant or returning citizen and think LHC loading has been inaccurately applied to your private health insurance premium, you'll need two documents to make your case.

• International Movement Record – Indicates when you first arrived in Australia as a permanent resident or returning citizen. You will need to request this from the Department of Immigration and Border Protection. Our case study received his in a few days.
• Medicare Eligibility Letter – Indicates when you first became eligible for Medicare benefits and, for migrants, is used to establish your "base day", or the day when the 365-day countdown to obtain private health insurance and avoid an LHC loading begins. Our case study had to visit a Centrelink/Medicare office to obtain this letter.

The Private Health Insurance Ombudsman requires you to try to resolve any dispute through the health insurance provider's complaints process first.

If that doesn't work out – or you think the insurer is taking too long to deal with the complaint – contact the PHIO on 1300 362 072, 9am-5pm Mon-Fri (AEST), or email [email protected].

Stock images:  Getty, unless otherwise stated.

Join the conversation

To share your thoughts or ask a question, visit the CHOICE Community forum.

How Health Insurance Works

Health insurers, compare policies, lifetime health cover calculators.

This website has two calculators to help you determine the lifetime health cover (LHC) loading payable on your hospital cover and whether you have paid a loading for at least ten years and no longer have to pay it.

Lifetime Health Cover Calculator

Ten Years Continuous Cover calculator

This website has two calculators to help you determine the lifetime health cover (LHC) loading payable on your hospital cover. 

This calculator is for people who want to know their Lifetime Health Cover (LHC) base day and their loading if they took out hospital cover today or confirm their current Lifetime Health Cover loading.

It is based on the provisions of the Private Health Insurance Act 2007 which commenced on 1 April 2007. If you had hospital cover on 31 March 2007 and that cover is continuing, your LHC loading, if any, is based on the previous legislation. Your health insurer can provide you with details of that pre-2007 loading.

Ten Years Continuous Cover Calculator

This calculator is for people who are currently paying for hospital cover with a Lifetime Health Cover (LHC) loading. It will help you determine if you have paid a loading on your hospital cover for at least ten years.

It is based on the provisions of the Private Health Insurance Act 2007 . Under that legislation, any loading you are required to pay ceases after ten continuous years, or where more than ten years have elapsed, after ten years only interrupted by certain periods overseas, or other permitted breaks.

Your questions answered.

Policies, contact details & performance.

Find policies that match your needs.

Search this site

Find out about Private Health Insurance.

Frequently asked questions.

Need more information? Contact us today.

Get the Reddit app

A dusty corner on the internet where you can chew the fat about Australia and Australians.

Could someone kindly explain Lifetime Health Cover (LHC) loading?

Am I just a moron, or did the ATO deliberately make his article difficult to understand ( https://www.ato.gov.au/Individuals/Medicare-levy/Private-health-insurance-rebate/Lifetime-health-cover/ )?

This explanation from a Health Insurer trying to sell me Insurance makes slightly more sense ( https://www.australianunity.com.au/health-insurance/explained/lhc ),

So every year I don't buy health insurance in the first tax year on July 1 after my 31st birthday, I have to pay a loading tax charge which accrues by 2% or some percentage every year? What happens if I get health insurance when I'm 35? Do I still have to pay the loading charge? Pardon my ignorance.

By continuing, you agree to our User Agreement and acknowledge that you understand the Privacy Policy .

Enter the 6-digit code from your authenticator app

You’ve set up two-factor authentication for this account.

Enter a 6-digit backup code

Create your username and password.

Reddit is anonymous, so your username is what you’ll go by here. Choose wisely—because once you get a name, you can’t change it.

Reset your password

Enter your email address or username and we’ll send you a link to reset your password

Check your inbox

An email with a link to reset your password was sent to the email address associated with your account

Choose a Reddit account to continue