If you take out hospital cover before you’re 31 you’ll enjoy lower premiums.
- The government encourages young people to get, and maintain, hospital cover
- Each year you wait after the age of 31 you’ll pay an extra 2% for your cover
- Maintain your cover for 10 years and any loading will be removed
The government’s Lifetime Health Cover (LHC) initiative rewards people who get private hospital cover when they’re young. To get the full benefit, you need to take out hospital insurance with an Australian registered health fund by 1 July following your 31st birthday.
If you take out cover after this time you’ll pay an extra 2% for each year you waited. So if you wait until you’re 40 you’ll pay 20% more than someone who got cover when they were 30. The maximum LHC loading is 70%.
If you get hospital cover later in life, and maintain it for 10 years, the loading will be removed.
You can be without hospital cover for up to 1094 days (three years less one day) over your lifetime, without affecting your loading. This is known as 'Days of Absence'. If you exceed this period you’ll pay a 2% loading if you rejoin. The loading will increase by 2% for every year after that without cover.
Suspending or cancelling your cover
If you ask your fund to suspend your hospital cover for a short period it won't affect your LHC loading, as you’re considered to be maintaining your cover.
If you cancel your hospital cover because you’re going overseas, the days you spend outside of Australia aren't counted towards your 'Days of Absence' as long as you stay overseas for at least one continuous year.
If you’re a new migrant to Australia, and are aged 31 or over, you won’t have to pay a LHC loading if you take out hospital cover within 12 months of registering for Medicare.
After this, you’ll have to pay a 2% loading for each year you’re aged over 30.
- If you were born on, or before, 1 July 1934, you're exempt from LHC
- If you’re an Australian citizen or permanent resident who was overseas on 1 July 2000, or are overseas on 1 July following your 31st birthday, you won’t pay LHC loading if you take out hospital cover by the first anniversary of the day you return to Australia. You can return to Australia for periods of up to 90 consecutive days, and are still considered to be overseas
- Time spent on Norfolk Island is classified as time spent overseas. This can have different effects depending on the dates you were resident on Norfolk Island
- If you’re a member of the Australian Defence Forces (ADF) your medical services are provided by the ADF, so you’re considered to have hospital cover. If you discharge from the ADF after 1 July following your 31st birthday, you have 1094 days to join a health fund and still pay the base rate premium. If you discharge from the ADF before 1 July following your 31st birthday, the normal rules apply
- If you hold a Department of Veterans' Affairs (DVA) Gold Card you’re considered to have hospital cover. If you've held a Gold Card at any time since 1 July 1999, and the card was subsequently withdrawn by the DVA, you may claim the period you held the card as a period with private health insurance
For more information on LHC go to the Department of Health.
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