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Lifetime health cover

LHC is a loading added to your hospital premium if you didn't have private hospital cover from the year you turn 31.

Last updated 29 June 2023

Lifetime health cover loading

Lifetime Health Cover (LHC) is a government initiative that encourages you to purchase and maintain private patient hospital cover earlier in life.

If you have not taken out and maintained private patient hospital cover from the year you turn 31 and then you decide to take it out later in life, you will pay a 2% LHC loading on top of your premium for every year you are aged over 30.

For example, if you take out private patient hospital cover when you are 40 years old, you could pay an extra 20% on the cost of this cover per year for 10 years. If you wait until you are 50 years old, you could pay 40% more per year for 10 years.

The maximum LHC loading that can be applied is 70%. Once you have paid LHC loading for 10 years of continuous cover, you will no longer have to pay this loading.

If you cancel your private patient hospital cover after paying for the LHC loading for 10 continuous years, you may become liable to pay the LHC loading again if you take out another private patient hospital cover later.

When you don't have to pay the LHC loading

You don't have to pay the LHC loading if any of the following apply to you:

• you are aged under 31 years old
• you hold an appropriate level of private patient hospital cover before you reach your LHC 'base day' – for many people, LHC base day is 1 July following their 31st birthday, but this can change depending on personal circumstances such as if you are overseas on this day
• you are a new migrant to Australia, and are aged 31 or over, and you had hospital cover within 12 months of being registered for full Medicare benefits
• you were born on or before 1 July 1934.

LHC loadings apply only to private patient hospital cover – they don't apply to general treatment cover (also known as ancillary or extras cover).

LHC and the private health insurance rebate

The government does not pay the private health insurance rebate on LHC loading component of a policy.

Example: No private health insurance rebate on LHC loading

On 1 July 2022, Rebecca pays a premium of $220 for two months of her private patient hospital cover. Due to Rebecca’s circumstances, her premium includes LHC loading of 10%. The premium eligible for the private health insurance rebate is $200 only, because the LHC loading of $20 does not qualify for this rebate.

Rebecca's income is $59,000 and she is eligible for the 24.608% rebate. She receives a rebate of $49, which is 24.608% of the $200 premium eligible for the rebate. Rebecca does not receive any rebate on the LHC loading of $20.

See Lifetime health cover External Link and Lifetime health cover calculator External Link for more information and to calculate your LHC.

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Lifetime health cover for migrants

You'll pay a price if you take out health insurance too late..

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Checked for accuracy by our qualified fact-checkers and verifiers. Find out more about fact-checking at CHOICE .

Figuring out whether or not you need private health insurance if you're an Australian living in Australia is tricky enough.

If you're a migrant or an Australian returning from overseas it gets even trickier. You may end up paying a lot more than you otherwise would if you don't understand the rules.

On this page:

Lifetime Health Cover for migrants

How it works, lhc for overseas residents and citizens, how does the lhc affect migrants to australia, who's responsible for making migrants aware of lhc loading, how to appeal, how to lodge an lhc-related complaint, the lifetime health cover loading.

The first thing to understand is that the Australian government really wants you to take out private health insurance to ease the burden on the public healthcare system, and that's fair enough.

It's why the government imposes a penalty on Australian citizens or permanent residents who don't take out private health insurance by the start of the financial year following their 31st birthday.

The penalty is called Lifetime Health Cover (LHC) loading , and it adds a two percent surcharge on top of your premium for every year you don't have private health insurance starting on 1 July after you turn 31.

LHC only applies to hospital cover; you're not required to take out extras cover (for things like dentistry and physio) to avoid LHC loading.

If and when you do get hospital private health insurance, the loading continues for 10 years.

The surcharge has a 70% cap, so if you delay getting private health insurance until age 66, for instance, almost half of your premium will be an LHC surcharge. As an example:

• For couples taking out cover in their mid-sixties and facing an annual premium of $3400, the total once you add in LHC loading would balloon out to $5780 a year. (Though you're exempt from LHC loading if you were born before 1 July 1934.)

Well before your mature years, however, an LHC surcharge can cost you many thousands of dollars in premiums you wouldn't have had to pay if you'd bought a private health insurance policy when the government wanted you to.

With the cost of private health insurance continuing to rise significantly even without LHC loading, such a financial penalty appears to have proven a pretty effective deterrent to people putting off private health insurance for too long if they plan to take it out at all.

The LHC protocol is pretty straightforward for Australian citizens, but what about migrants who arrived in Australia well after age 31 and didn't get the message about the costs of LHC loading and the deadline that applies to migrants?

Is it fair to charge LHC loading for years that a migrant did not yet live in Australia and therefore were not a burden on the Australian healthcare system? Whether it's fair or not, that's how it works.

We asked the Department of Health about this discrepancy, but a spokesperson simply reiterated the policy, saying "for migrants, the LHC loading of 2% for each year is applied regardless of whether or not they lived in Australia when they were aged 30 or over". 

It seems even less fair when you consider the migrant may well have had private health insurance in the country they came from.

LHC for migrants

• Migrants to Australia who are over 31 when they arrive have 365 days from Medicare registration to take out private health insurance and avoid LHC loading. If you miss the 365-day deadline, your 'base day' – when the 2% loading would begin – will be 1 July after your 31st birthday, regardless of where you were living at the time.
• If you migrate and turn 31 while living in Australia as a permanent resident or citizen, you have until 1 July following your 31st birthday or one year after Medicare registration to take out private health insurance and avoid LHC loading, whichever event comes second. In this case, your 'base day' is whichever of these dates applies to your situation.
• If you're a migrant who is overseas on 1 July following your 31st birthday and you registered with Medicare on or after 1 July 2009, you have 365 days after returning to Australia to take out private health insurance and avoid LHC loading.
• Australian citizens and permanent residents who were overseas on 1 July following a 31st birthday in Australia that fell after 1 July 2000 have 365 days after returning to Australia to take out private health insurance and avoid LHC loading. You can be in Australia for up to 90 days per visit before the 365-day countdown begins, though the 90 days will count toward that limit if you stay longer.
• Australian citizens and permanent residents who were overseas and over the age of 31 on 1 July 2000 have 1094 days to take out private health insurance once they return to Australia without incurring the LHC loading. The 1094 is a lifetime limit. You can return to Australia while living overseas for up to 90 days at a time without affecting the limit, but anything over 90 days counts against the 1094 total.

But bear in mind that health funds can make mistakes, either through incompetence or negligence. One Australian woman who was living overseas when LHC loading was first introduced in July 2000 recently contacted CHOICE about her LHC loading issue and ending up getting a $6200 refund from her insurer due to an incorrectly applied loading. 

If you migrate from one of the 11 countries that has reciprocal healthcare agreements with Australia, your 365-day countdown to take out private health insurance and avoid LHC loading after age 31 starts when you're granted full Medicare eligibility.

There are other ins and outs and exemptions to LHC loading. Go to the Private Health Insurance Ombudsman website to find out more.

Consider this real-life case study

• Our case study moved to Australia at age 45 and took out private health insurance (PHI) with HCF two weeks past the 365-day deadline to avoid LHC loading. He had not heard of the LHC levy, nor had his Australian wife. It was a coincidence that he was so close to the deadline. LHC information is communicated to migrants by the Department of Health and the Department of Human Services, but it's easy to miss the memo in the barrage of other migrant paperwork.
• Because our case study missed the deadline, HCF applied a 32% LHC loading. It meant that a 2% surcharge was added for every year after age 31 that this person did not have Australian private health insurance. The kicker is that this person did not migrate to Australia until age 45, so in effect he was penalised for accessing the Australian healthcare system without private health insurance for the 14 years between ages 31 and 45 – years when he did not live in Australia and could not have accessed the Australian healthcare system. Then another 2% loading was added for each year he was a resident of Australia without private health insurance, even though he was only about two weeks into his second year. During the years between ages 31 and 45 he had PHI in his own country.
• Our case study appealed to HCF regarding his situation to no avail, though his Australian wife (who had 1094 days, not 365, to take out private health insurance upon returning to Australia without incurring an LHC loading) was reimbursed $2188.55 after providing an International Movement Record .  

How much has our case study paid in LHC loading to date? Had he not caught wind of the LHC issue and requested the rebate from HCF, it would have been $5422.50 as of January 2017.

Factoring in his wife's rebate and $121.45 in LHC loading on his latest monthly premium payment, he has paid $3355.40 so far. His 10-year LHC period ends in July 2017.

According to the Department of Health spokesperson, the Department of Human Services sends migrants information about private health insurance and LHC loading along with their Medicare cards, and the Department of Health sends new migrants info about LHC in May each year.

A spokeswoman for the Department of Immigration told us "new migrants have access to a range of information about health and social services in Australia via links on the Department's website ," adding that "questions about how the Lifetime Health Cover loading is applied should be directed to the Department of Health".

Though the insurer made no such enquiries with our case study, the Private Health Insurance Ombudsman told CHOICE that health insurers should ask new customers about their immigration and citizenship status and how it might apply to LHC loading.

"It would be expected that health insurers should make appropriate enquiries at the time of joining to ensure the correct LHC loading is applied," a spokesperson said. "Where the incorrect loading has been applied, the insurer may be obliged to retrospectively correct this."

It's worth pointing out that the revenue generated by LHC loading stays with the private health funds instead of going to the health department to help offset the burden placed on the healthcare system by people without private health insurance, which would seem to make sense. 

against an LHC loading

If you're a migrant or returning citizen and think LHC loading has been inaccurately applied to your private health insurance premium, you'll need two documents to make your case.

• International Movement Record – Indicates when you first arrived in Australia as a permanent resident or returning citizen. You will need to request this from the Department of Immigration and Border Protection. Our case study received his in a few days.
• Medicare Eligibility Letter – Indicates when you first became eligible for Medicare benefits and, for migrants, is used to establish your "base day", or the day when the 365-day countdown to obtain private health insurance and avoid an LHC loading begins. Our case study had to visit a Centrelink/Medicare office to obtain this letter.

The Private Health Insurance Ombudsman requires you to try to resolve any dispute through the health insurance provider's complaints process first.

If that doesn't work out – or you think the insurer is taking too long to deal with the complaint – contact the PHIO on 1300 362 072, 9am-5pm Mon-Fri (AEST), or email [email protected].

Stock images:  Getty, unless otherwise stated.

Join the conversation

To share your thoughts or ask a question, visit the CHOICE Community forum.

Did you receive a letter regarding Lifetime Health Cover?

The federal government has sent out a word of warning to uninsured Australians. On May 4, the Department of Health posted a letter and fact sheet regarding lifetime health cover (LHC), with the aim of providing Australians with more information with which to make a decision on their private health insurance needs .

It is typically the way that people often require medical assistance to a greater extent later in life, and the cost of health insurance varies depending on a policyholder's age. Planning ahead can help ensure that any private hospital treatment is covered by health insurance benefits.

However, LHC can prove a complex issue. Not everyone understands what the term means, and it's easy to believe with the foresight of youth that medical treatment will not be necessary at any point.

With around half of all Australians covered by private health insurance, many understand the risks of going without, and there is a real reason to consider it earlier in life.

What is Lifetime Health Cover?

Lifetime Health Cover  is an initiative to encourage those over the age of 30 to use the private health insurance model and avoid premium loadings.

A 2 per cent annual loading applies for any person purchasing private health insurance after July 1 following their 31st birthday, up to a maximum 70 per cent.

This soon adds up, and a person taking out health insurance for the first time at the age of 65 could see their coverage costing 70 per cent more than the same policy bought by a 30 year old.

LHC is not a part of general treatment (extras) cover, overseas visitors' cover, overseas students' cover or international health cover, so it should not be presumed that any of these policyholders will avoid the loading.

This is why, with almost 200,000 uninsured Australians approaching the 31-year milestone, the Department of Health has taken measures to help people better understand the risks by posting out a reminder.

Have you recently turned 31?

As explained above, LHC applies on July 1 after a person has reached 31. If your 31st birthday has been during the 2014/2015 financial year and you are currently uninsured, you may wish to purchase private health cover before June 30, or the first 2 per cent loading will be activated.

This is not a cost that is immediately felt; however, if you hold off until your 40th birthday before deciding that you can benefit from private health benefits, you will be paying significantly more for the same policy than you would by taking it out today.

If you have recently turned 31 and already have a health insurance policy, you will be exempt from the LHC loadings and there is no need to worry about this added cost.

Are you a migrant?

As an overseas national working in Australia on either a permanent or a  457 working visa , you will also need to consider LHC. The government also sent its mailer to 64,000 migrants who could fall into this category.

If you are over the age of 30 and have in this financial year registered for either a blue (interim) or green (full) card to receive Medicare benefits, you have until the first anniversary of your card's registration before the same LHC premium loading begins to apply.

By becoming a private health insurance policyholder, you will be covered against this 2 per cent loading being applied.

What to do next

So, if you fall into either of these two categories, have received a letter from the Department of Health, or if you simply want to become a private health insurance policyholder for any other reason, what's the next step?

Ideally, you'll want to find a policy that meets your budget – health funds tend to charge different rates, even for identical policies. You'll also need a policy that is tailored for your needs as an individual to make sure it is one of quality.

Comparing Australia's 34 health insurance providers will help you fill both of these requirements and find a suitable level of cover.

HICA is able to offer free and extensive assistance for anyone worried about their LHC loadings or looking to purchase private health insurance. Contact us today on 1300 44 22 11 for impartial and professional advice.

Related Posts

What are the downsides of not having health insurance?

What are the benefits of private health insurance?

All Australians should understand Lifetime Health Cover

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Printed link references

Do I need Lifetime Health Cover (LHC) if my company already provided hospital cover?

My family and I got PR Visa and I also got a job offer in Australia.

My employer told me they will provide Hospital Cover for my family and me so we should be exempted from 2% of Medicare surcharge levy (MLS). My questions are:

1. Do I still need to request lifetime health cover letter when applying for Medicare?

2. How can I avoid the loading on premium if I need to buy private insurance for hospital cover again if I leave this job a few years later and my new employer doesn't provide Hospital Cover? 

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Most helpful reply

Hi @JoeCheung

Congratulations on your new job and move, that’s great to hear your employer has offered to pay Hospital Cover for you and your family.

Just to clarify the 2% is the Medicare Levy and the Medicare Levy Surcharge is extra on top, they’re two different things.

Hospital Cover doesn’t make you exempt from the Medicare Levy, but it will exempt you from the Medicare Levy surcharge.

Now to answer your questions-

1-When you apply for Medicare Levy you won’t need any lifetime health cover letter, but it’s best to speak directly to Medicare and ask them what it is you need.

2-Avoiding the loading on private health insurance premium you’ll need to speak directly to your private health insurance provider and ask how the loading works. 

You can also check out our further info on the Medicare Levy and Surcharge .

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Medicare - Lifetime Health Cover Loading.

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Guys, Here's what was written on the cover letter when I received my medicare card: " lf you first purchase private hospital insurance after 1 July following your 31 st birthday, you will be charged a 2 per cent loading for every year you are aged over 30 as part of the Australian Government's Lifetime Health Cover. A migrant aged over 31 years on their initial enrolment for Medicare benelits has 12 months from the date of enrolment with Medicare (not eligibility) to purchase private hospital insurance without incurring a Lifetime Health Cover loading. lf you are a migrant within this 12 month period and want to purchase private hospital insurance, call us on 132 011. and request a Lifetime Health Cover letter to give to your private health insurer to demonstrate your exemption from the loading." Thereafter, I contacted medicare, and they sent me a letter stating: "The Lifetime Health Cover applicable date for the Medicare card number above is 14 March 2014. " Do I have to buy private health insurance before 1st July or can I wait until March 2015 now that I have this letter from Medicare?  

You have a year from your LHC applicable date to purchase private cover - so March 2015 in your case - or you will be subject to paying the loading.  

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How Health Insurance Works

Health insurers, compare policies, lifetime health cover calculator.

This calculator will provide you with information about your Lifetime Health Cover (LHC) base day and loading based on the provisions of the Private Health Insurance Act 2007 which commenced on 1 April 2007. If you had hospital cover on 31 March 2007 and that cover is continuing, your LHC loading, if any, is based on the previous legislation. Your health insurer can provide you with details of that loading.

If you are covered under a couples or family policy you will need to complete the calculator separately for each individual adult covered by that policy. The LHC loading for a couple or family is calculated by using the average of the LHC loadings of the adults covered by the policy.

You may require the following information to complete the Lifetime Health Cover Calculator:

• Periods of hospital cover – Records of any periods during which you held private health insurance hospital cover or had your hospital cover suspended by your insurer. You can obtain this information from the relevant health insurance fund. Overseas visitors cover, overseas students cover, travel insurance and health cover that is provided by an international policy are not considered as complying hospital cover for the purposes of Lifetime Health Cover.
• Time overseas – The dates of any periods where you were overseas for more than 12 months. You can obtain a copy of your international movement record  ( Request for international movement records ) from the Department of Home Affairs .
• Alternative cover – records for any periods where you had your health care covered by the Australian Defence Forces, the Antarctic Division or under a Department of Veterans’ Affairs Gold Card.
• Medicare registration – If you have recently migrated to Australia you will need details of your registration with Medicare Australia. You can obtain a copy of your Medicare eligibility letter from Medicare Australia.

Calculate your Lifetime Health Cover loading

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• >> Live Well

How do Medicare’s lifetime reserve days work?

With her husband, James, hospitalized and awaiting a double transplant, Alice asks what happens once his Medicare lifetime reserve days are used up.

Dear Toni: Why did a hospital medical claims division employee ask my husband, James, to sign a form stating that he is aware that he is now in his “lifetime reserve days” while he was waiting for his lung/heart transplant?

He went into the hospital in December for congestive heart failure, only to discover that his heart and lungs can no longer support him. The wait for this double transplant is taking longer than expected. I am concerned that the hospital will send him home or to a nursing home to wait and he will not receive the correct medical care.

Please explain what James needs to do. He is covered by a Medicare supplement Plan G, and he has had no issues with that plan. — Alice, Atlanta

Dear Alice: The hospital staff had James sign the form regarding lifetime reserve days because once he is past that 60- day period of inpatient hospitalization Medicare stops paying and the stay is his responsibility.

For 2024, Medicare Part A covers an inpatient hospital stay with a $1,632 deductible for days 1 through 60. (An inpatient hospital deductible of $1,632 can happen six times a year.) This includes a semiprivate room and board, general nursing and miscellaneous services and supplies.

For days 61 through 90, Medicare would pay all but $408 per day.

After that, the lifetime reserve days begin. For days 91 and beyond, Medicare will pay all but $816 per day. Once the reserve days are used, then the inpatient hospital benefits are exhausted and you will pay all costs for the remainder of the hospital stay.

The good news for James: His Medicare supplement will cover an additional 365 days of inpatient hospital benefits once his Part A benefits are exhausted. He will pay $0 for the additional 365 days (except for his annual deductible in the new year).

Readers enrolled in Medicare Advantage plans should discuss lifetime reserve days with a customer service agent for their plan.

Another important note about James’ situation: If his Part D prescription drug plan does not cover his new transplant drugs, then he will end up paying for them. Alice, verify that his new prescriptions will be on his current Part D plan, and explore prescription drug availability with the transplant physician’s office or transplant facility’s caseworker.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email [email protected] or call 832-519-8664.

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HHS Finalizes Policies to Make Marketplace Coverage More Accessible and Expand Essential Health Benefits

Today, the Biden-Harris Administration, through the U.S. Department of Health and Human Services (HHS)’s Centers for Medicare & Medicaid Services (CMS), announced policies for the Affordable Care Act Marketplaces that make it easier for low-income people to enroll in coverage, provides states the ability to increase access to routine adult dental services, and sets network adequacy standards for the time and distance people travel for appointments with in-network providers. Finally, the rule will standardize certain operations across the Marketplaces to increase reliability and consistency for consumers. The 2025 Notice of Benefit and Payment Parameters final rule builds on the Administration’s previous work expanding access to quality, affordable health care and raising standards for Marketplace plans nationwide.

“More than 21 million Americans signed up for high-quality, affordable health care coverage through the ACA Marketplaces in 2024. We want to build on this success to make Marketplace plans even better,” said HHS Secretary Xavier Becerra. “This rule will allow coverage of routine dental benefits for the first time, expand requirements to ensure reliable access to health care providers, and ensure consumers with lower incomes can sign up for coverage when they need it.”

“Access to affordable, quality health care options remain a concern across the country and a top priority for CMS,” said CMS Administrator Chiquita Brooks-LaSure. “This rule includes groundbreaking ways to access health care services - such as addressing barriers for routine adult dental coverage for the first time and including considerations for how far people travel to see a health care provider. At CMS, we continue to explore ways to help Americans access high-quality coverage through the ACA Marketplaces.”

Increasing Access to Health Care Services Adult Dental Services

CMS has expanded access to dental benefits by finalizing measures to allow states the option to add routine adult dental services as an essential health benefit (EHB). For the first time, and starting on January 1, 2027, every state will be able to update their EHB-benchmark plans to include routine non-pediatric dental services, such as cleanings, diagnostic X-rays, and restorative services like fillings and root canals, through the EHB-benchmark application process beginning in 2025. 

Network Adequacy 

The final rule creates more consistent, nationwide standards on how far and how long a consumer must travel to see various types of providers in State Marketplaces and State-based Marketplaces on the Federal Platform (SBM-FPs). State Marketplaces and State-based Marketplaces must review a plan’s network information prior to certifying any plan as a qualified health plan (QHP), consistent with the reviews conducted by the Federally-facilitated Marketplaces (FFMs). 

Making It Easier to Enroll in Coverage Special Enrollment Periods

The rule extends the special enrollment period (SEP) for consumers with household incomes at or below 150% of the FPL (for the 2025 plan year, $38,730 for a family of three) to enroll in coverage in any month rather than only during Open Enrollment. Previously, this SEP was only available when enhanced subsidies under the IRA were available. 

The rule also aligns the dates of Open Enrollment periods across almost all Marketplaces to generally begin on November 1 and end no earlier than January 15, with the option to extend the Open Enrollment period beyond January 15. 

Additionally, the rule aims to prevent coverage gaps for those transitioning between different Marketplaces or from other insurance coverage by allowing those selecting coverage during certain SEPs to receive coverage beginning the first day of the month after the QHP is selected, as opposed to coverage beginning at a later date if the consumer enrolls between the 15th and the end of the month.

Streamlining the Enrollment Process  This rule includes multiple policies to standardize operations among the Federally-facilitated and State-based Marketplaces to ensure a more streamlined consumer experience, such as requiring Marketplaces to have live call center representatives available during call center hours of operation to assist consumers with QHP application submission and enrollment, generally holding Open Enrollment from November 1-January 15 (with the option for Marketplaces to extend Open Enrollment to a later date), and automatically re-enrolling people who are enrolled in a catastrophic plan for the next year, in order to prevent gaps in coverage.

For more information on the final rule, see the fact sheet at  https://www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-and-payment-parameters-2025-final-rule

Click here to view the final rule:  https://www.cms.gov/files/document/cms-9895-f-patient-protection-final.pdf

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