Private health insurance and tax time
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Expert tips on private health insurance and tax time
Our health insurance expert, Steven Spicer, has some tips on how health insurance can help you save during tax time.
Steven Spicer
Executive General Manager – Health, Life & Energy
Hold hospital cover for the entire financial year to avoid the Medicare Levy Surcharge
If your income exceeds the Medicare Levy Surcharge (MLS) threshold and you don’t hold an eligible private hospital insurance policy for the entire financial year, you’ll incur the MLS for each day that you did not hold the active policy.
Be careful taking out health insurance for tax purposes
It can be tempting just to get ‘the basics’ to avoid the MLS, but this won’t provide you much actual cover should you need healthcare services. To ensure you don’t find yourself underinsured, consider any previous hospital admissions and your family’s medical history when looking at different levels of cover.
Keep your excess at $750 or below
If you’re taking out hospital cover for MLS purposes, make sure your excess doesn’t exceed $750 for singles or $1,500 for couples/families. This is the maximum permitted excess for private hospital insurance to avoid the MLS.
Include your spouse and any dependents on the policy
For MLS purposes, all members of your family, including your spouse (married or de facto) and dependents, must be included on your policy or hold their own eligible hospital insurance policy. Only covering the high-income earner will not prevent the MLS from accruing.
Is private health insurance tax-deductible?
No, you can’t get a tax deduction on your private health insurance premiums, although there are some other ways you can save at tax time.
The Australian Government rebate on private health insurance will either refund a percentage of your private health cover premiums at tax time or apply a premium reduction throughout the year. Your rebate entitlement will depend on your family income and the age of the oldest person on your policy.
If you’re a high-income earner, you can also save by taking out hospital cover to avoid the Medicare Levy Surcharge at tax time.
Lifetime Health Cover (LHC) loading
LHC loading is an Australian Government initiative designed to encourage Australians to take out and maintain private patient hospital cover earlier in life. The more people 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 if you choose to take out a policy in the future.
LHC loading accrues at 2% of your base hospital insurance premium for each year you’re over 30 and don’t have hospital cover. Loading is capped at 70%.
You’ll only be impacted by this loading if you take out private hospital insurance after 1 July, following your 31st birthday. If you take out cover for the first time after this date, the LHC is added to your base hospital premium if applicable.
Once you hold hospital cover for 10 continuous years, any LHC loading you’ve accrued is no longer applicable.
Example of LHC
Let’s say you take out a private hospital policy for the first time at 32 years old. When you pay your policy premiums, you’ll pay an extra 4% on your premium each year you hold the policy.
Or let’s say you’re 40 years old and are taking out a policy for the first time; this means you’ll need to pay an extra 20% on top of your hospital policy premiums each year. For example, if you’re paying $2,000 annually on a policy, you’d also be paying an extra $400 in LHC loading each year.
What can you do to avoid Lifetime Health Cover (LHC) loading?
To avoid any Lifetime Health Cover (LHC) loading, purchase an eligible hospital cover policy before 1 July following your 31st birthday.
If you’ve been considering health insurance, now might be the time to review policy options before your loading increases by another 2%.
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?
Being under the age of 31 or taking out and maintaining a private hospital insurance policy before 1 July following your 31st birthday are situations where you won’t have to pay the LHC. Here are a few other exemptions that could apply to you.
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 returning to Australia to prevent LHC loading from accruing. You will also need to provide your new health fund with your International Movement Record.
Loading will also not increase if you 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 aged 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 aged over 31 years will also be given 12 months to purchase a policy from the time they become eligible for Medicare. These customers will be required to provide their Medicare Eligibility Letter to their health fund.
Australian Defence Force members who are discharged after 1 July following their 31st birthday
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. When taking out a hospital insurance policy, they will be required to provide their health fund with a copy of their discharge letter confirming their dates of service.
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’re looking to take out a private cover.
Any person born on or before 1 July 1934
Those who fit this category are exempt from paying the loading.
Medicare Levy Surcharge
The Medicare Levy Surcharge is a government incentive for higher-income earners without hospital cover to take out a policy. Ultimately, the MLS is designed to help reduce the burden on public hospitals.
If you don’t have an appropriate level of hospital cover and have an annual income of more than $105,000 a year as a single, or a family income of more than $210,000, you accumulate the MLS every day you don’t have hospital cover (unless you fall into one of the exemption categories).
In total, you would be charged from 1% to 1.5% of your taxable income each year, depending on how much you earn, which is paid when you complete your annual income tax return.
It’s important to note that the Australian Taxation Office (ATO) calculates your income for the MLS differently than your standard taxable income. Your income for MLS purposes is your regular taxable income (not including any assessable First Home Super Saver released amount) plus any reportable fringe benefits and super contributions, minus your net property and investment losses.1 See the ATO website or speak to your accountant or a tax agent for more details.
How could the Medicare Levy Surcharge (MLS) affect you?
The Medicare Levy Surcharge can increase the amount of tax you pay by 1%-1.5%.
Let’s say:
- you earn $110,000 per financial year
- you’re single
- you’re not exempt from the MLS
- you don’t have hospital cover for the full tax year.
In this case, your total MLS would be charged at 1% of your taxable income.
This means you may need to pay $1,100 at tax time.
Our table below outlines how the MLS may impact you this tax time.
| Medicare Levy Surcharge – Income Tiers (all ages) | ||||
|---|---|---|---|---|
| Surcharge rate | 0% | 1% | 1.25% | 1.5% |
| Single income thresholds |
$105,000 or less ($0 payable) |
$105,001 – $123,000 (~$1,050 – $1,230 payable) |
$123,001 – $164,000 (~$1,537 – $2,050 payable) |
$164,001+ ($2,460+ payable) |
| Family income thresholds^ |
$210,000 or less ($0 payable) |
$210,001 – $246,000 (~$2,100 – $2,460 payable) |
$246,001 – $328,000 ($3,075 – $4,100 payable) |
$328,001+ (~$4,920+ payable) |
|
Retrieved from Australian Taxation Office | Information current from 1 July 2026. 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. |
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Can you avoid the Medicare Levy Surcharge (MLS)?
Not unless you’re earning under the income threshold, have an eligible hospital policy (or combined hospital and extras cover), or you fall into one of the exemption categories.
Worried about whether your health insurance can impact your tax return? Remember, having hospital cover goes far beyond its ability to avoid the Medicare Levy Surcharge. While it can be tempting to take out the lowest level of hospital cover to avoid the MLS, private hospital cover can offer some great benefits that you might want to take advantage of.
Look for a cover option that:
- Provides cover towards treatments and medical services you need.
- Can help you avoid public waiting lists for injuries or illnesses through treatment in a private hospital.
- Offers you a choice of doctor.*
- Allows you to enjoy the privacy of your own room.*
- Pays a benefit towards the cost of ambulance services in your state (if required).
*Subject to availability.
Our free comparison service makes it easy to look for a policy that offers all this and more.
Medicare Levy
How is the Medicare Levy different to the MLS?
The Medicare Levy is a tax that applies to almost all Australian taxpayers, whereas the Medicare Levy Surcharge is an additional tax that applies to higher-income earners without private hospital cover. The main 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 the public health system, Medicare, which provides all Australians with 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 as 2% 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 Medicare Levy?
You are exempt from the levy if you’re not eligible for Medicare, earn less than the minimum income thresholds, or meet specific medical requirements.
You’re exempt from paying the levy if you’re single and your taxable income is equal to or less than the following thresholds for 2026-27:3
- $28,011 a year
- $44,268 a year 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:
- $28,011 and $35,013 a year
- $44,268 and $55,335 a year 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.
Australian Government Rebate
The Australian Government Rebate (AGR) is an income-tested contribution that reduces your health insurance premiums. This rebate applies to hospital, extras and ambulance policies from registered health insurers.
Do you qualify for the health insurance rebate?
You will qualify for the health insurance rebate if you’re eligible for Medicare, have an eligible health insurance policy and have a taxable income of $164,000 or less as a single or $328,000 or less as a family.
The government’s private health insurance rebate is a benefit 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 apply to hospital, extras or combined policies. You can either claim this rebate through your tax return or in the form of reduced policy premiums.
How could the private health rebate help you?
The Australian Government Rebate can help lower the cost of your health insurance. The rebate amount you’re eligible for is determined by your relationship or 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 tiers | Base tier | Tier one | Tier two | Tier three |
|---|---|---|---|---|
| Single income | Under $105,000 | $105,001 – $123,000 | $123,001 – $164,000 | Over $164,001 |
| Family income | Under $210,000 | $210,001 – $246,000 | $246,001 – $328,000 | Over $328,001 |
| Rebate amount | ||||
| Under 65 | 24.118% | 16.079% | 8.038% | 0% |
| 65-69 | 28.139% | 20.098% | 12.058% | 0% |
| Over 70 | 32.158% | 24.118% | 16.079% | 0% |
|
Source: privatehealth.gov.au. Current from 1 July 2026 Single parents and couples are included in the family tiers. The income thresholds for families with dependent children are increased by $1,500 for each child after the first. |
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The rebate percentages are subject to change every year on 1 April. Learn more about the Australian Government rebate.
Why switch health insurance before the end of the financial year?
Switching funds provides a chance for you to save money and allows you to purchase a policy that better suits your current needs.
For some, the health insurance policy you’re currently on may be the best option for your needs. If that’s true and none of the points below applies to you, stay with your current fund.
Before you decide to switch, consider the following:
- A new product or health fund may be available. Such policies may offer better value than your existing policy, and 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 have to be re-served when you move from an active policy to a policy with lesser or the same of cover, you will only need to serve a waiting period for any upgrades to your policy.
- The paperwork is handled for you. When you use our service, we take care of the application for you. This provides your new health fund with all the information they will need to set up your policy and request a clearance certificate from your previous fund. If you’re not switching like-for-like cover, you may still need to cancel any remaining cover with your previous fund yourself.
Meet our health insurance expert, Steven Spicer
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.
Want to know more about health insurance?
1 PrivateHealth.gov.au Medicare levy surcharge income, thresholds and rates. Accessed June 2026.
2 Australian Taxation Office: Medicare Levy. Accessed June 2026.
3 Australian Taxation Office: Medicare levy reduction for low-income earners. Accessed June 2026.
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