Lifetime Health Cover
Lifetime Health Cover (LHC) is a Government initiative that started on 1 July 2000. It was designed to encourage people to take out hospital cover earlier in life and encourage them to maintain it.
If you purchase hospital cover earlier in life, and keep it, you will avoid paying an extra amount called 'LHC loading'. The usual deadline to purchase hospital cover without a loading is the 1 July following your 31st birthday, though some exceptions may apply if you are a new migrant or you are an Australian who has been living overseas.
moreLifetime Health Cover (LHC) is a Government initiative that started on 1 July 2000. It was designed to encourage people to take out hospital cover earlier in life and encourage them to maintain it.
If you purchase hospital cover earlier in life, and keep it, you will avoid paying an extra amount called 'LHC loading'.
In some cases you may be exempt from LHC loading or fit into a special circumstances category.
If you are joining or transferring between insurers, or if you fit into one of the new migrant or special circumstances categories, you will need to establish your LHC loading by supplying supporting documents.
LHC loadings only apply to hospital cover.
Only private hospital cover with Australian registered private health insurers is considered to be complying hospital cover for the purpose of Lifetime Health Cover. General treatment (extras) cover, Overseas Visitors Health Cover, Overseas Student Health Cover, and international forms of insurance are not considered to be hospital cover for Lifetime Health Cover purposes.
Who pays LHC loading?
You can avoid paying LHC loading if you take out hospital cover with an Australian registered health insurer before your Lifetime Health Cover base day and you maintain your hospital cover.
If you do not have hospital cover on your Lifetime Health Cover base day and then decide to take out hospital cover later in life, you will pay a 2% loading on top of your hospital premium for every year you are aged over 30, based on your age on the 1 July prior to joining.
The maximum LHC loading that anyone can pay is 70%. Increased premiums due to LHC loading stop after 10 years of continuous hospital cover.
You can use the Lifetime Health Cover calculators to find out if you need to pay the LHC loading.
If you are on a couple or family policy, your loading is calculated as an average between the individual loading of the two adults.
For example, Noor and Lukas start a new hospital policy for couples. Lukas is 41 years old and has never held hospital cover. His individual LHC loading is 22% (2% per year x 11 years over age 30). Noor has held hospital cover continuously since she was 28 years old. Her individual LHC loading is 0%. The LHC loading on their couples’ cover is 11% (the average of 22% and 0%).
When is my LHC base day?
In most cases, your Lifetime Health Cover base day is the later of 1 July 2000 or the 1 July following your 31st birthday.
Some special circumstances may apply if you are a new migrant or an Australian who has been living overseas.
For example, Shona and Rajeev both turned 40 in April 2019. Their Lifetime Health Cover base day is 1 July 2010. Rajeev has continuously held hospital cover since March 2009 and so he does not pay LHC loading. Shona took out hospital cover for the first time in May 2019. Shona pays 18% LHC loading (2% per year x 9 years over age 30, as of 1 July 2018) on top of her normal hospital premium.
Who is exempt from LHC?
If you were born on or before 1 July 1934, you are exempt from LHC.
Permitted days without hospital cover
If you have held hospital cover on or after your Lifetime Health Cover (LHC) base day, then you can access the following 'permitted days without hospital cover'. During these periods, you do not have an active hospital policy, but your loading does not increase.
- Gaps in cover and Days of Absence- to cover gaps, such as switching from one insurer to another, you can be without hospital cover for a total of 1094 days (i.e. three years less one day) during your lifetime, without affecting your LHC 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 or more days - you will pay a LHC loading on rejoining 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 apply to your health insurer to suspend your hospital cover for a short period (for example, to travel overseas for a holiday), and the insurer agrees, this period of suspension is not counted towards your 1094 Days of Absence. Suspension terms and conditions vary from insurer to insurer, so check with your insurer as to whether you can suspend your policy.
- Going overseas - if you cancel your hospital insurance after your Lifetime Health Cover base day to go overseas for at least one continuous year, the days you spend outside of Australia are not counted towards the 1094 Days of Absence. You can return to Australia for periods of up to 90 consecutive days, per visit, and be considered to be overseas. Any periods of 90 days or more which you spend in Australia during this time will be deducted from the 1094 Days of Absence.
Example of gaps in cover
Marit’s date of birth is 12 February 1976. She took out hospital cover on 30 August 2008. On that date Marit was 32 years old so she paid 4% LHC loading on her premium (2% per year x 2 years over age 30). Marit’s priorities changed and she cancelled her cover on 15 March 2011. Marit rejoined hospital cover on 16 February 2014 (1069 Days of Absence). She paid the same 4% LHC loading on her premium because she had not exhausted her 1094 days of absence.
Example of permitted days without hospital cover while going overseas
Wei’s date of birth is 18 April 1971. He took out hospital cover on 29 June 2001 with 0% LHC loading. Wei accepted a work posting in Canada and cancelled his hospital cover on 8 February 2004. He visited his family in Australia once a year for 25 days while working overseas. Wei permanently returned to live in Australia on 15 November 2012 (0 Days of Absence for hospital cover purposes).
Wei rejoined hospital cover on 4 December 2015 (1114 Days of Absence). Wei paid 2% LHC loading on his hospital cover because he exceeded the allowable 1094 Days of Absence.
Removal of LHC loading after 10 years
If you have a LHC loading on your hospital premium, it is removed once you have held LHC loading on your hospital cover for 10 continuous years. Your loading will then remain at 0% as long as you retain your hospital cover. If you cancel your cover after the loading is removed, you may become liable to pay a LHC loading again if you take out another hospital cover.
If you complete 10 years of continuous hospital cover, your LHC loading will be reduced to 0%.
Can I have a break in my cover?
You can break up your 10 years of continuous cover with any of the permitted days without hospital cover. However, the breaks in cover do not count towards the 10 years.
For example, Kaia’s date of birth is 7 March 1972. She took out hospital cover on 17 November 2005 with 6% LHC loading (2% per year x 3 years over age 30). Kaia cancelled her hospital cover to go overseas on 24 January 2015 (3355 days or 9 years, 2 months and 7 days of continuous cover). Kaia did not return to Australia for more than 90 consecutive days until her permanent return on 24 January 2017.
Kaia rejoined hospital cover on 26 March 2017 and paid her original 6% LHC loading for another 10 months (297 days). On 17 January 2018 Kaia’s LHC loading was removed from her hospital cover premium.
What if I use up my Days of Absence?
If you cancel your hospital cover and use up all your permitted days without hospital cover (i.e. exhaust the full 1094 Days of Absence), then the continuity of your 10 year period of cover is broken and you will incur a new LHC loading if you rejoin later.
The new LHC loading will be your previous loading back, plus any further loading that has since accrued (i.e. 2% for each further year beyond the permitted periods without hospital cover). You will have to start your 10 years of continuous cover from the date of rejoining.
New migrants to Australia
If you are a new migrant to Australia, then your LHC base day is the later of
- the 1 July following your 31st birthday; or
- the first anniversary of your full Medicare registration.
Your 'full Medicare registration' refers to the date you registered for interim or full Medicare benefits (usually a blue or green Medicare card). Reciprocal Medicare does not count for LHC purposes.
You can confirm your full Medicare registration date by requesting a letter from Medicare - contact Medicare (Services Australia) or visit your local Medicare branch.
If you miss your Lifetime Health Cover base day, you will have to pay a loading. The loading is calculated as 2% for each year you are aged over 30 when you take out hospital cover.
An example: Sonja was registered for full Medicare benefits (green Medicare card) on 20 April 2013. Sonja had her 31st birthday on 8 January 2014. Sonja’s Lifetime Health Cover (LHC) base day is 1 July 2014 because this is the 1 July following her 31st birthday. Sonja purchased private hospital cover on 2 October 2018. On that date Sonja was 36 years old so she has to pay 12% LHC loading [(36 years old – 30 year cut-off) x 2%].
New migrant and overseas on base day, if your base day is after 30 June 2010
The following applies if you are:
- a new migrant;
- overseas on your Lifetime Health Cover base day; and
- you registered with Medicare on or after 1 July 2009.
If all these apply to you, then you will not have to pay a Lifetime Health Cover loading if you purchase hospital cover within 12 months of your first return to Australia for a period of 90 days or more. The anniversary of your first return to Australia of 90 days or more becomes your new Lifetime Health Cover base day.
An example: Deepak registered for full Medicare benefits (green Medicare card) on 21 August 2009. His date of birth is 12 December 1976. Deepak’s Lifetime Health Cover (LHC) base day was 21 August 2010 because this is the first anniversary of his full Medicare registration and he was over 31 years old. He left Australia on 23 December 2009 to work in France for 6 years. Deepak visited his brother in Australia twice a year, for a maximum of three weeks per visit. He permanently returned to live in Australia on 22 December 2015.
Deepak contacted Medicare to request a letter stating his Medicare Registration date. He requested an International Movement Record from the Department of Home Affairs. He purchased hospital cover on 2 November 2016. Deepak supplied the Medicare letter and movement record to his health insurer. His new LHC base day is 22 December 2016 (the first anniversary of his return to Australia). Deepak does not need to pay LHC loading because he purchased hospital cover before his new LHC base day.
LHC for a dependant person with a disability
The normal LHC rules apply to a dependent person with a Disability. Dependents who hold a hospital cover on their Lifetime Health Cover base day will avoid paying LHC loading. If a dependent person with a disability joins a hospital cover for the first time after their LHC base day, loading will apply at 2% for every year they are aged over 30, based on their age on the 1 July prior to joining.
Where loading applies to at least one adult on a family or single parent hospital policy, the loading will be averaged between the total number of adults on the policy.
An example: Lucy turned 31 in January 2019, so her Lifetime Health Cover base day is 1 July 2019. In November 2021 at the age of 33, Lucy joins her parents’ family hospital cover as a dependent with a disability. Lucy’s individual loading is 6%. Lucy is the only adult on the policy that has loading applied. As there are 3 adults on the family policy, the loading will be averaged between the 3 adults. The LHC loading on the family cover is 2% (the average of 6% and 0% and 0%).
If a dependent has their own single person hospital policy with a loading, then transfers to a family or single parent policy as a dependent with a disability, they will carry their loading with them, and the loading will be averaged between the total number of adults on the policy.
An example: Archie takes out a single 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 dependent with a disability. Archie’s individual loading is 4% and his mother has a loading of 0%. The loading will be averaged between the 2 adults on the policy. The LHC loading on the single parent cover is 2% (the average of 4% and 0%). Archie will be eligible to have his loading removed after he has held a hospital cover for 10 continuous years.
Special circumstances
Overseas on the 1 July following your 31st birthday
If you are
- an Australian citizen or permanent resident, and
- you were overseas on the 1 July following your 31st birthday, and
- your 31st birthday falls after 1 July 2000, and
- you return to Australia, and
- you purchase hospital cover by the first anniversary of the day of your return to Australia,
You can return to Australia for periods of up to 90 consecutive days, per visit, and are still considered to be overseas. So your 'return' is your first period of 90 days or more in Australia.
If you purchase hospital cover after the end of the first anniversary of the date of your return to Australia, LHC loading will be applied based on your age at the date of joining.
An example: Phuong is an Australian citizen and her date of birth is 5 April 1983. She left Australia on 26 June 2014 (before 1 July following her 31st birthday) to live in Ecuador for 2 years. Phuong visited her parents in Australia five times, for no more than 40 days per visit. She permanently returned to live in Australia on 25 June 2016. Her new LHC base day is 25 June 2017. Phuong purchased hospital cover on 12 October 2018. On that date Phuong was 35 years old so she has to pay 10% LHC loading (2% per year x 5 years over age 30).
Over 31 and overseas on 1 July 2000
If on 1 July 2000 you were:
- aged 31 or over; and
- an Australian citizen or permanent resident; and
- overseas,
While you are overseas, no LHC loading accumulates. You can visit Australia for visits of up to 90 days and still be considered to be overseas. When you are in Australia (i.e. any visits of 90 days or more) you have 1094 Days of Absence to purchase hospital cover without paying a LHC loading.
The 1094 Days of Absence is a lifetime limit and cannot be renewed; if in future you have any breaks in your cover while living in Australia, the time spent without cover will also be deducted from this period. If you use up your Days of Absence - that is, you have a total gap period of 1095 or more days - you will pay a 2% LHC loading on rejoining hospital cover. The loading will increase by 2% for every year after that without cover.
An example: Haruki is a permanent resident of Australia and his date of birth is 19 March 1964. Haruki moved to Sweden for work on 21 May 2000. He did not return to Australia for more than 90 consecutive days until his permanent return on 7 September 2012. He had 1094 Days of Absence (6 September 2015) to purchase hospital cover to avoid LHC loading. Haruki did not take out hospital cover until 14 December 2018 and therefore paid 8% LHC loading (2% per year x 4 years after the end of the 1094 Days of Absence).
Australian Defence Forces (ADF)
If you are a member of the Australian Defence Forces (ADF) on continuous full-time service and your medical services are provided by or through the ADF, you are considered to have hospital cover. The same is true for your adult dependents if medical services are provided by or through the ADF.
From 1 July 2000 onwards, if you discharge from the ADF after the 1 July following your 31st birthday, you have 1094 Days of Absence to join a health insurer and still pay the base rate premium. If you discharge from the ADF before the 1 July following your 31st birthday, then the normal LHC rules apply.
An example: Megan served continuously and full-time with the ADF for twelve years until her discharge on 14 October 2017. Her date of birth is 4 February 1985. She had 1094 Days of Absence (14 October 2020) to purchase hospital cover to avoid LHC loading. Megan took out hospital cover on 7 March 2019 without paying LHC loading (509 Days of Absence).
Department of Veterans' Affairs (DVA)
If you hold a Department of Veterans' Affairs (DVA) Gold Card you are considered to have hospital cover. The cardholder may be a veteran or the widow/widower and/or dependant of a veteran. You need to be listed on the card. 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 hospital cover. Anyone holding a 'white' or 'orange' card is not considered to have hospital cover. More information regarding the DVA card entitlements can be found at the DVA website.
An example: Patrick held a DVA Gold Card until it was withdrawn by the DVA on 9 June 2017. He had 1094 Days of Absence (8 June 2020) to purchase hospital cover to avoid LHC loading. Patrick took out hospital cover on 25 May 2019 without paying LHC loading (715 Days of Absence).
Norfolk Island
Prior to 1 July 2016, time spent on Norfolk Island was classified as time spent overseas and this can have different effects depending on the actual dates you were resident on Norfolk Island. From 1 July 2016, this no longer applied and time spent on Norfolk Island is considered to be equivalent to time spent in Australia.
Norfolk Island residents who were aged over 31 at 1 July 2016 had until 30 June 2017 to purchase hospital cover without incurring a Lifetime Health Cover loading. If those residents did not take out hospital cover before 1 July 2017, the LHC loading is based on the age of the resident at their time of joining. Younger residents will have until their normal LHC base day or the 1 July following their 31st birthday to purchase hospital cover without incurring a LHC loading.
From 1 July 2016, residents of Norfolk Island became eligible for Medicare benefits and are therefore also able to purchase Australian private health insurance policies. Residents of Norfolk Island can purchase the same policies as residents of Queensland.
An example: Jennifer is a resident of Norfolk Island and her date of birth is 23 May 1975. She had until 30 June 2017 to take out hospital cover to avoid LHC loading. Jennifer did not purchase hospital cover until 28 July 2019 and therefore needs to pay 28% LHC loading (2% per year x 14 years over age 30).
Establishing your LHC loading
If you are transferring between private health insurers or joining as a new member, in some circumstances you may need to supply supporting documents to your new health insurer to have the correct loading applied. Depending on your circumstances, you may need to obtain one or more of the following:
Clearance Certificate
If you are transferring between private health insurers or rejoining hospital cover after a period of absence, you should obtain a Clearance Certificate from your previous health insurer and provide this to your new health insurer on or after joining. This will establish your previous LHC loading, if any; and if transferring between insurers, will also provide information about waiting periods you have already completed. Under the Private Health Insurance Act 2007, your previous insurer is required to provide you with a Clearance Certificate within 14 days. You can find contact details for all registered health insurers on this website.
Medicare registration date letter
If you are a new migrant to Australia aged over 31, then you normally have 12 months from the date of your Medicare registration for interim or full Medicare benefits (usually a blue or green Medicare card) to purchase hospital cover without a LHC loading.
If you join hospital cover within 12 months of Medicare registration, you will need to confirm the applicable date by requesting a letter from Medicare - contact Medicare (Services Australia) or visit your local Medicare branch. Supply the letter to your insurer on or after joining to have your LHC loading reassessed.
If you registered with Medicare on or after 1 July 2009 and you were overseas on the anniversary of your Medicare registration, then you should also obtain an International Movement Record - see below.
International Movement Record
You may need this document if you fit under one of the following cases and the corresponding timeframe:
| Your case | Your timeframe |
|---|---|
| You were an Australian permanent resident or citizen on the 1 July following your 31st birthday, the date fell after 1 July 2000, and you were overseas on that day. | You purchase hospital cover within 1 year of your return to Australia. Your 'return' is the first time you returned for 90 days or more. |
| You were an Australian permanent resident or citizen, who was aged over 31, and overseas on 1 July 2000. | You purchase hospital cover at any time after your return. |
| You were a new migrant when you registered with Medicare on or after on or after 1 July 2009, you were aged over 31, and you were overseas on the anniversary of your Medicare registration date | You purchase hospital cover within a year of your return. You should also obtain a Medicare Registration date letter. |
| You cancelled your hospital cover after the age of 31 and after 1 July 2000. You then went overseas for a period of at least 12 months. | You purchase hospital cover at any time after your return to Australia. Your 'return' is the first time you returned for 90 days or more. You should also obtain a Clearance Certificate. |
If you fall into one of these categories and you meet the timeframe, then to confirm your entry and exit dates from Australia you can request an International Movement Record from the Department of Home Affairs. The Request for international movement records application form is available on their website. When you have received the record from Home Affairs, supply it to your health insurer on or after joining to have your LHC loading reassessed.