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 insurance earlier in life and to maintain their cover. If you purchase hospital cover earlier in life, and keep it, you will pay lower premiums compared to someone who joins when they are older. 

 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.

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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 earlier in life and to maintain their cover. 

If you purchase hospital cover earlier in life, and keep it, you will pay lower premiums compared to someone who joins when they are older. The extra amount is called 'LHC loading'.

In some cases you may be exempt 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, 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.

Who pays LHC?

If you do not have hospital cover with an Australian registered health insurer 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 who first took out hospital cover at age 30. The maximum loading is 70%. 

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%.

When is my LHC base day?

In most cases, your Lifetime Health Cover base day is the later of 1 July 2000 or the 1st of July following your 31st birthday.

Some special circumstances may apply if you are a new migrant or an Australian who has been living overseas.

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.

Permitted days without hospital cover

If you have taken up hospital cover on or after your Lifetime Health Cover 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. 

  • Gaps in cover and Days of Absence - to cover small gaps, such as switching from one insurer to another, you are able to be without hospital cover for periods totalling 1094 days (i.e. three years less one day) during your lifetime, without affecting your 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 days - you will pay a loading on rejoining private 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 in order 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 are able to return to Australia for periods of up to 90 consecutive days, per visit, and are still considered to be overseas. Any periods of 90 days or more which you spend in Australia will be deducted from the 1094 Days of Absence.

Removal of LHC loading after 10 years

If you have a LHC loading, it is removed once you have paid a LHC loading on your private hospital insurance 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 in the future.

If you complete 10 years of continuous hospital cover, your 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 above permitted days without hospital cover. However, the breaks in cover do not count towards the 10 years.

For example, if you pay your 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 on rejoining for the loading to be removed.

What if I use up my Days of Absence?

If you later drop your hospital insurance and use up all your permitted periods 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 loading again if you rejoin later. 

The 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. You have until that day to take out private hospital cover without incurring a Lifetime Health Cover loading.

'Full Medicare benefits' refers to your application for interim or full Medicare benefits (usually a blue or green Medicare card). Reciprocal Medicare does not count for LHC purposes. 

You can confirm the applicable date by requesting a letter from Medicare - contact Medicare (Department of Human Services) or visit your local Medicare branch.

If you miss your Lifetime Health Cover base day or delay purchasing private hospital cover for more than 12 months after registering, 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.

New migrant and overseas on base day, if your base day is after 1 July 2009

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 return to Australia becomes your new Lifetime Health Cover base day.

Special circumstances

Overseas on the 1st of July following your 31st birthday 

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 visit back of 90 days or more.

If you do not purchase hospital insurance during this one year grace period and purchase insurance later, then loading will be applied based on your age at the date of joining.

Over 31 and overseas on 1 July 2000

If you were an Australian citizen or permanent resident who was aged over 31 and overseas on 1 July 2000, then you are considered to have held hospital cover on your base day. This means you have access to the permitted days without hospital cover.

If you are overseas for at least 12 months, then no loading accumulates in that time, and you can be in 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 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 days - you will pay a 2% loading on rejoining private hospital cover. The loading will increase by 2% for every year after that without cover.

Australian Defence Forces (ADF) 

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.

From 1 July 2000 onwards, if you discharge from the ADF after the 1st of 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 1st of July following your 31st birthday, then the normal rules apply.

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 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.

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 are aged over 31 at 1 July 2016 had until 1 July 2017 to purchase insurance without incurring a Lifetime Health Cover loading; if purchasing from or after 1 July 2017, a loading will apply. Residents of Norfolk Island can purchase the same policies as residents of NSW.

From 1 July 2016, residents of Norfolk Island became eligible for Medicare benefits and are therefore also be able to purchase Australian private health insurance policies. Norfolk Island residents who were aged over 31 had a 12 month grace period, to 1 July 2017, to purchase insurance without incurring a Lifetime Health Cover loading; if purchasing from or after 1 July 2017, a loading will apply based on their age at the time of joining. (For younger residents, they will have until their normal LHC base day of the 1 July following their 31st birthday to purchase insurance without incurring a loading.)

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 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.

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 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 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 caseYour timeframe
You are an Australian permanent resident or citizen on the 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 are a new Australian migrant who was aged over 31, you registered with Medicare on or after 1 July 2009, and you were overseas on the anniversary of your Medicare registration dateYou intend to purchase or have purchased private hospital cover within a year of your return.

You should also obtain a Medicare Registration date letter as above.
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 as above.

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 online. 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.