Lifetime Health Cover (LHC) is a Government initiative that started on 1 July 2000. It was designed to encourage people to take out hospital insurance by the time they turn 30 and to maintain their cover. 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 insurance 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.more
Lifetime Health Cover (LHC) is a Government initiative that started on 1 July 2000. It was designed to encourage people to take out hospital insurance by the time they turn 30 and to maintain their cover.
If you purchase hospital cover earlier in life, and keep it, you will avoid paying an extra amount called 'LHC loading'.
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 private hospital 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.
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 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 the same age who has held hospital cover since age 30.
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, if one person has 20% loading and the other person has 0% loading, the loading applied to the couples' policy is 10%.
In most cases, your Lifetime Health Cover base day is the later of 1 July 2000 or the 1 July following your 31st birthday.
If you were born on or before 1 July 1934, you are exempt from LHC.
If you have taken up 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. You can only access these periods if you held hospital cover on or after your LHC base day.
If you have a LHC loading on your premium, it is removed once you have held LHC loading on your private 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 private hospital cover.
If you complete 10 years of continuous hospital cover, your LHC loading will be reduced to 0%.
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, if you pay your LHC loading for 9 years and then cancel your cover while living overseas for several years, you will still have to pay 1 more year of loading when you return to Australia and take out hospital cover again.
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.
If you are a new migrant to Australia, then your LHC base day is the later of
Your 'full Medicare registration' refers to you registered for interim or full Medicare benefits (usually a blue or green Medicare card). Reciprocal Medicare does not count for LHC purposes.
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 private hospital insurance.
An example: Sonja was registered for full Medicare benefits (green Medicare card) on 20 April 2013. Sonja had her 31st birthday on 8 November 2013. 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%].
The following applies if you are:
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 return to Australia becomes your new Lifetime Health Cover base day.
If you are an Australian citizen or permanent resident who is overseas on the 1 July following your 31st birthday, and your 31st birthday falls after 1 July 2000, 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, 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 insurance after the end of this one year grace period, LHC loading will be applied based on your age at the date of joining.
If on 1 July 2000 you were:
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 up to 1094 Days of Absence to purchase private 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 private hospital cover. The loading will increase by 2% for every year after that without cover.
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.
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 private health insurance. 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.
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 insurance 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 NSW.
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:
If you are transferring between private health insurers or rejoining private health insurance 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. You can find contact details for any health insurer on this website.
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 have joined or intend to join private hospital cover within 12 months of Medicare registration, you will need to confirm the applicable date by requesting a letter from Medicare - contact Medicare (Department of Human Services) 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.
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 intend to purchase or have purchased private 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 intend to purchase or have purchased private 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 intend to purchase or have purchased private 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 now intend to purchase or have purchased private 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 application form (Form 1359) can be downloaded from 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.