What you should know
Health Insurance Rebate
Your health insurance costs less with the Federal Government 30% rebate on private health insurance. 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 (MLS)
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 income for MLS purposes imposed on those earning over a certain amount who do not have an appropriate hospital cover with a Private Health Insurer to cover themselves and any dependants. The Medicare Levy Surcharge is in addition to the normal 1.5% Medicare Levy.
In 2011 – 2012 the income thresholds are:
- A single person with an annual income for MLS purposes of over $80,000
- A family or couple with a combined annual income for MLS purposes of over $160,000. The family income threshold increases by $1,500 for the second and each subsequent dependant child.
You must also pay the Surcharge if you are a prescribed person* with an income for MLS purpose over the threshold, and have any dependants who are not prescribed persons and who are not covered by an appropriate Hospital cover.
* Generally, you will know if you are a prescribed person. If you need more information on prescribed persons, call the Australian Taxation Office (ATO) Helpline on 13 28 61.
An ’appropriate‘ Hospital cover is one with an excess equal or less than $500pa for single policies or equal or less than $1000pa for families/couples. All ahm Hospital covers comply for the purpose of exempting members from the Medicare Levy Surcharge because they either have a co-payment (instead of an excess) or the excess is no more than the $500/$1000 limit.
(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 as a set amount each time a service is provided. In ahm‘s case, the co-payment is applied for each day in hospital, however policy 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.
For any further information, you can call the ATO on 132 861 or visit the ATO web site.
GapCover
ahm’s GapCover is designed to help remove or reduce out-of-pocket medical expenses so that you pay less or nothing at all for these services when you go to hospital.
Find out more about GapCover » .
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 Private Healthcare Australia - www.privatehealth.com.au
If you have any health insurance questions, please do not hesitate to call our friendly staff on 134 246.