What you should know

Health Insurance Rebate

Your health insurance costs less with the Federal Government health insurance rebate. It's available on any level of cover but to be eligible to receive it, everyone listed on your membership must be eligible for Medicare entitlements. Find out more about the rebate.

Lifetime Health Cover

People aged 31 and over who take out private hospital cover may be required to pay a higher premium depending on their age. The Lifetime Health Cover penalty does not apply to those born on or before July 1, 1934. More about Lifetime Health Cover.

Medicare Levy Surcharge

The Medicare Levy Surcharge was introduced on 1 July 1997 as a way of encouraging high income earners to take out private hospital cover, use the private hospital system and thereby reduce demand on the public system.

The surcharge is an additional 1% surcharge of taxable income imposed on high income earners who do not have an appropriate hospital cover with a Private Health Insurer. The Medicare Levy Surcharge is in addition to the normal 1.5% Medicare Levy.

’High income‘ is defined as:

  • A single person with an annual taxable income of over $50,000
  • A family or couple with a combined income of over $100,000. The family income threshold increases by $1,500 for each dependent child after the first

(Currently, there is a bill before Parliament to lift the above income thresholds)

You must also pay the surcharge if you are a ’prescribed person‘ which would have been determined by the Australian Taxation Office.

An ’appropriate‘ hospital cover is one with a ’low‘ excess - equal or less than $500pa for single policies or equal or less than $1000pa for families/couples. ahm covers do not have excesses (only co-payments) so all ahm hospital covers comply for the purpose of exempting policy holders from the Medicare Levy Surcharge.

(An ’excess‘ is a lump sum amount that you agree to pay if admitted to hospital and is also known as a ’front end deductible‘. A co-payment is an amount you agree to pay a set amount each time a service is provided. In ahm‘s case, the co-payment is applied for each day in hospital-limits apply).

Ancillary or Extras cover does not exempt a person from the surcharge.

You must hold the appropriate hospital cover for 365 days in the financial year to be exempt from the Medicare Levy Surcharge. If you suspend your cover for any reason throughout the year, you are deemed NOT to hold the appropriate insurance for that period of time and the Levy will be charged.

Find out how much you can save by having ahm health insurance using the Medicare Levy Surcharge Calculator.

You can call the Australian Taxation Office for more information on 132 861.

Back to top

Access Gap Cover

You can now have a hand in closing the gap on medical costs. If your doctor participates in Access Gap Cover, you will either have no out-of-pocket expenses or you will know exactly how much you will have to pay before your treatment begins.
More about Access Gap Cover.

Glossary & Rules

To help you understand your choice of cover, visit the ahm health insurance Glossary & Rules.

 

More information

Need to know more? Visit our Common Questions

Or visit the web site of the Australian Health Insurance Association - www.privatehealth.com.au

If you have any health insurance questions, please do not hesitate to call our friendly staff on 134 246.

Back to top