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When it comes to health insurance and taxes, there’s plenty of confusing jargon thrown around (er, there’s a difference between the Medicare Levy Surcharge and the Medicare Levy?).

That’s why we’ve put together this guide; to make it all simples.


Over 31 years old?

You may be affected by the Lifetime Health Cover (LHC) loading


Single and earn over $90k? Combined income of over $180k?

You may be affected by the Medicare Levy Surcharge (MLS)


Want to save on your premium?

You may be eligible for an Australian Government Rebate


Do you earn more than the income thresholds? You may need to pay the Medicare Levy Surcharge.

The Medicare Levy Surcharge (MLS) is an additional levy designed to encourage higher income earners without hospital cover to take out a policy. Ultimately, the MLS is designed to help reduce the burden on our public hospitals.

If you don’t have hospital cover and you a) earn over $90k a year and you’re single, or b) have a partner or family with a combined income over $180,000 a year, you accumulate the Medicare Levy Surcharge (MLS) every day you don’t have cover (unless you fall into one of the exemption categories).

In total, you’re charged between 1% and 1.5% of your taxable income each year, depending on exactly how much you earn, which is payable at tax time.

How could the Medicare Levy Surcharge (MLS) affect your hip pocket?

Let’s say:

  • you earn $95,000 per financial year
  • you’re single
  • you’re not exempt from MLS; and
  • you don’t have hospital cover for the full tax year.

In this case, your total MLS could be charged at one per cent of your taxable income.

This means you may need to pay $950 at tax time.

Our table below outlines how the MLS may impact you this tax time.

Medicare Levy Surcharge – Income Thresholds
SinglesUnder $90,000
($0 payable)
$90,001 – $105,000
(~$900 – $1,050 payable)
$105,001 – $140,000
($1,312.51 – $1,750 payable)
(~$2,100+ payable)
Families^Under $180,000
($0 payable)
$180,001 – $210,000
(~$1,800 – $2,100 payable)
$210,001 – $280,000
($2,625 – $3,500 payable)
(~$4,200+ payable)
Retrieved from Privatehealth.gov.au | Information current at 24/6/2020. Dollar amounts payable are rounded up.
^For families with children, thresholds increase by $1,500 for each child after the first.
Families include couples, de facto couples, and single parents.


Can you avoid the MLS?

Not unless you’re earning under the income threshold when MLS starts applying, have a hospital policy or you fall into one of the exemption categories.

Worried about whether having health insurance can impact your tax return? Remember, having cover goes far beyond avoiding possible levies at the end of the financial year.

As such, it’s important you carefully choose a competitive cover option that:

  • provides cover towards treatment you need
  • may help you receive treatment faster for injuries or illnesses than if you were treated as a public patient[1]
  • offers you the choice of doctor*
  • allows you to enjoy the privacy of your own room*
  • covers the cost of ambulance services (except in Queensland and Tasmania, where the state governments cover these costs).

*Subject to availability.                                      

Our comparison service makes it easy to find a policy that offers this reassurance – and more – at a great price.

How is the Medicare Levy different to the MLS?

The Medicare Levy is a tax many Aussies pay. One point of difference between MLS and the Medicare Levy is that you’re still charged the Medicare Levy, even if you hold hospital cover (so long as you’re not exempt from the levy).

The Medicare Levy partly funds Medicare, which provides all Aussies access to free or subsidised healthcare.

How could the Medicare Levy affect you this tax time?

The Australian Taxation Office (ATO) says the Medicare Levy is charged two per cent of your taxable income.[2]

The levy is included in the total tax withheld from your employer.

When won’t you need to pay the levy?

The ATO says you may be exempt from the levy if your taxable income is equal or less than the following thresholds for 2018-19:[3]

  • $22,398
  • $35,418 for those eligible for the seniors and pensioners tax offset.

You’re only required to pay part of the Medicare Levy if your taxable income is between:

  • $22,398 and $27,997
  • $35,418 and $44,272 for those eligible for seniors and pensioners tax offset.

You may also be exempt if you’re a foreign resident, aren’t eligible to receive Medicare benefits, or meet specific medical requirements.

Are you 31 years or older? Beware Lifetime Health Cover Loading.

What is Lifetime Health Cover (LHC) loading?

Lifetime Health Cover (LHC) loading is an Australian Government initiative designed to encourage Aussies to take out and maintain private hospital cover earlier in life.

The more Aussies who are treated privately, the less pressure there is on our public healthcare system.

How does LHC loading affect you?

If you don’t take out private health insurance by 1 July following your 31st birthday, you’ll start accruing LHC loading on your hospital insurance premium.

LHC loading accrues at two per cent of your hospital insurance premium for each year you’re over 30 and don’t have hospital cover. Loading is capped at 70%.

Please note: You’ll only be impacted by this loading if you take out private health insurance, as you’ll need to pay a higher premium.

Once you hold cover for 10 continuous years, any LHC loading you’ve accrued is no longer applicable.


So, let’s say you’re 32 years old and are taking out a private hospital policy. When you pay your policy premiums, you’ll pay an extra four per cent.

Or, let’s say you’re 40 years old and are taking out a policy for the first time. You’ll need to pay an extra 20% on top of your hospital policy premiums. If you’re paying, say, $2,000 annually on a policy, you’d be paying an extra $400 on LHC loading.

Couple in their 30's enjoying a walk

What can you do to avoid LHC loading?

If you’ve been considering health insurance, now might be the time to review policy options before another year goes by and your loading increases by another two per cent.

If you want to take out a couples hospital policy, any applicable LHC loading will be averaged between you and your partner.

For example, if your partner has 6% LHC loading applicable and you have 2% loading applicable, you’d be charged 4% loading on your couples policy.

When won’t you need to pay LHC?

  1. If you were overseas on 1 July following your 31st birthday

LHC loading won’t start accruing if you weren’t in Australia on 1 July following your 31st birthday. However, you typically need to purchase cover within a year of arriving back in Australia to prevent LHC loading from starting to accrue.

Furthermore, loading will not increase if you:

  • have already taken out hospital cover;
  • are over the age of 31; and
  • cancel or suspend your cover to go overseas for more than 12 months. You’ll still be considered as ‘overseas’ if your visits back to Australia don’t exceed 90 days.If your visit back to Australia does exceed the 90-day period, your ‘Days of Absence’ will accumulate for every day past the 90-day period.

‘Days of Absence’ refers to the number of days you can take a break from your private hospital cover before LHC loading will start accruing. So, if you have cancelled your policy and you are over 31, you will have a total period of 1,094 days in your lifetime before the loading kicks back in.

Similar to Australians who travel overseas, new migrants over 31 will also be given 12 months to purchase a policy from the time they become eligible for Medicare.

  1. Australian Defence Force members who are discharged after 1 July following their 31stbirthdays

Since coverage is provided for the Australian Defence Force while serving, members are technically seen as having private insurance. People in this position have the ‘Days of Absence’ period to register their private health policy without a loading being applied.

  1. Any person who acquired a Department of Veterans’ Affairs Gold Card after 1 July 1999

These cardholders are already determined to have a form of private health insurance, which will be taken into consideration if they are looking to take out a private cover.

  1. Any person born on or before 1 July 1934

Those who fit this category are exempt from paying the loading.

Do you qualify for the health insurance rebate?

The Private Health Insurance Government Rebate is a rebate paid by the government to help you afford your health insurance policy.

This support encourages you to keep cover and ultimately lighten the load on the public healthcare system.

This rebate may be applicable to hospital, extras or combined policies. Either you can claim this rebate through your tax return, or you could benefit from it in the form of reduced policy premiums.

How could the rebate help you?

The rebate amount depends on your relationship/family status, your annual taxable income and your age.

We’ve outlined the rebate percentages below, which may be applied to your health insurance premium depending on the category you fall into:

Income ThresholdsBase TierTier 1Tier 2Tier 3
Under $90,000
Under $180,000
$90,001 – 105,000
$180,001 – $210,000
$105,01 – $140,000
$210,001 – $280,000
Under 6525.059%16.706%8.352%0.00%
70 and over33.413%25.059%16.706%0.00%
Retrieved from PrivateHealth.gov.au | Information current at 24/05/2019
^For families with children, thresholds increase by $1,500 for each child after the first.
Families include couples, de facto couples, and single parents. The rebate level is based on the oldest person covered by health insurance.

The rebate percentages are adjusted every year on 1 April. Learn more about the Australian Government rebate.

Why switch health insurance before the end of financial year?

The question remains: why go to the effort of taking out or switching health insurance at this time of the year?

For some, it’s entirely possible the health insurance policy you’re currently enjoying is the best available. If that’s true, and none of the below points apply to you, stay with your current fund!

Before you make your decision, though, consider the following:

  • a new product or health fund may have entered the market during the year. Such policies may offer better value than your existing policy – you won’t know until you look;
  • your circumstances may have changed. For example, perhaps you’re considering starting a family, or you’re eager to finally fix your teeth with a set of braces;
  • waiting periods don’t apply when you move to lesser or the same level of cover, although be careful when upgrading to higher levels of cover as you will often need to serve a waiting period; and
  • the paperwork is handled for you. When you use our service, we deal with all the paperwork. In addition, waiting periods you’ve already sat through will carry over, your LHC status remains unchanged, and any eligible rebates continue to apply.

How you can shop smarter, not harder for cover

Our free comparison tool makes it easy to see how policies from some of Australia’s to9p health insurers stack up.

Once you enter your details, we’ll present you with a range of quotes based on this information. Our comparison service clearly indicates whether a policy is Gold, Silver, Bronze or Basic (as well as any ‘Plus/+’ policies).

After you’ve found the policy that provides cover for services and treatment you need, you can continue through our journey and make your own purchase – best of all, purchasing through our service won’t cost you anything extra than buying direct from the insurer. That’s our Best Price Promise.

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[1] Australian Institute of Health and Welfare (AIHW): Admitted patient care. 2017-18. Australian hospital statistics.
[2] Australian Taxation Office: Medicare Levy. Last modified: 24 August 2018.
[3] Australian Taxation Office: Medicare levy reduction for low-income earners. Last modified 29 June 2018.

So, what are you waiting for?

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