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Lifetime Health Cover

Lifetime Health Cover (LHC) is a Government initiative designed to encourage people to take out hospital insurance earlier in life and to maintain their cover. If you take out hospital cover earlier in life and maintain your hospital cover, you will pay lower premiums throughout your life compared to someone who joins when they’re older. To avoid paying a LHC loading, you need to take out a private health insurance hospital policy by the 1st of July following your 31st birthday. For each year you delay, you will pay 2% more for your premium, up to a maximum of 70%.

 

Changes from 1 July 2013

The Government has introduced legislation that from the 1 July 2013, the Australian Government Rebate on Private Health Insurance will no longer apply to the LHC loading. This means that you will receive a lower rebate than you had been receiving prior to 1 July 2013.

For example:

  Before
1 July 2013
After
1 July 2013
Hospital cover base premium +$200 +$200
plus 50% LHC loading +$100 +$100
less 30% rebate -$90
(on base + LHC)
-$60
(on base only)
You pay $210  $240

 

Who pays LHC?

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%.

To cover small gaps, such as switching from one insurer to another, you are able to be without private cover for periods totalling 1094 days (ie three years less one day) during your lifetime, without affecting your loading. If you have a gap of 1095 days you will pay a 2% loading. For every 365 days without cover after that, your loading will increase by 2%. If you apply to your health insurer to suspend your cover for a short period, and it agrees, this period of suspension does not affect your LHC loading (you are considered to be maintaining your cover).

If you are unsure how much of your period of absence you have used, you can contact your health insurer and they can inform you. Alternatively, you can refer to the annual statement that your health insurer sends you detailing your LHC status.

If you take out private hospital insurance and then cancel your insurance to go overseas, the days you spend outside of Australia aren’t counted towards your 1094 period of absence, provided you stay overseas for at least one continuous year.

As a new migrant to Australia, if you are aged 31 or over, you will not have to pay a Lifetime Health Cover loading if you take out private health insurance within 12 months of being registered for Medicare. After this time you will have to pay 2% more for each year you are aged over 30 when you take out private health insurance.

 

Who is exempt from LHC?

If you were born on or before 1 July 1934, you are exempt from LHC. You can join a health insurer at any time in the future and pay the same premium as someone who takes out cover at age 30.

 

For how long do I have to pay the loading?

Once you have paid a LHC loading on your private health insurance for 10 continuous years, the loading is removed as long as you retain your hospital cover. Some other special circumstances apply, which are described below.

 

What about special circumstances?

If you are an Australian citizen or permanent resident who turns 31 after 1 January 2000, and you are overseas on the 1st of July following your 31st birthday, you will not pay a Lifetime Health Cover loading if you purchase hospital cover by the first anniversary of the day you return to Australia. You are able to 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 and this can have different effects depending on the actual dates you were resident on Norfolk Island.

If you are a member of the Australian Defence Forces (ADF) your medical services are provided by the ADF, so you are considered to have hospital cover. If you discharge from the ADF after the 1st of July following your 31st birthday, you have 1094 days to join a health insurer and still pay the base rate premium (this is the same 1094 period of absence allowed to people with private hospital cover, as discussed above in ‘Who pays LHC’). If you discharge from the ADF before the 1st of July following your 31st birthday, then the normal rules apply.

If you hold a Department of Veterans’ Affairs (DVA) Gold Card you are considered to have hospital cover. If you have 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.

 

More Information

For more information regarding Lifetime Health Cover please go to privatehealth.gov.au or call Navy Health on 1300 306 289.

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