RELEASE VERSION : At revision: 14581

About Health Cover

Things to know about health insurance

For a better understanding of matters that relate to your membership with Australian Unity and health insurance generally in Australia, please find links to the relevant information areas below.

Be Informed

This is your health cover information resource which covers a range of private health cover related topics.

2011 Private Health Insurance Tax Statement Information

Under Federal Government legislation, Australian Unity is required to provide members with a Private Health Insurance Tax Statement. This Tax Statement details your health insurance cover during the previous financial year.


Australian Unity members with health cover will have received their 2010-2011 Private Health Insurance Tax and Lifetime Health Cover Statements by 15 July 2011.

Terms and Conditions of Health Insurance

For more information on the terms and conditions relating to health cover membership with Australian Unity, including waiting periods and much more.

Lifetime Health Cover information you need to know

Lifetime Health Cover (LHC) is a Government initiative which commenced from 1 July 2000. It is designed to encourage people to take out private health insurance earlier in life, and to maintain their cover over their lifetime.

Be informed about your Private Health Insurance

Be informed is your health cover information resource which covers a range of private health cover related topics.

  1. Why do I need Private Health Insurance?
  2. Private Health Insurance – choices for your health!
  3. Avoid Lifetime health cover loading costs
  4. Private Health Cover Tax Savings
  5. Additional benefits to health cover with Australian Unity
  6. Health Insurance Online – Manage your Cover
  7. Manage your health cover online
  8. Find out what your health coverage includes

1. Why do I need Private Health Insurance?

There are many reasons to get Private Health Insurance Cover:

  • Looking after your health when you’re sick
  • Join before age 31 and maintain cover to avoid Lifetime Health cover loading contribution increases
  • May help you avoid Medicare Levy Surcharge
  • Extra savings & benefits you might not suspect

2. Private Health Insurance – choices for your health!

Relying solely on Australia’s Public health system, as good as it is, may affect your choices.

Without private health insurance, you may not be able to afford certain medical services or have to wait longer for service via the Public Health System. Private Health Insurance let’s you enjoy the advantages of the private health sector (even in some public hospitals) without the compromises.

3. Avoid Lifetime health cover loading costs

If you don't have private hospital cover by 1 July following your 31st birthday, for every year you delay taking out private hospital cover you will pay an additional 2% loading on your health insurance payments.

The maximum loading a person will be required to pay is 70%, payable by people who first take out hospital cover for the very first time at age 65 or older.

Find out more about Lifetime Health Cover.

4. Private Health Cover Tax Savings

If you are on a higher income and do not have an appropriate level of private hospital cover for yourself and all of your dependants (including partner) during any period of the income year, you may have to pay the Medicare Levy Surcharge (MLS) for the period you were without cover.

The MLS is calculated at 1% of your taxable income and is in addition to the 1.5% Medicare Levy.

If you're single and your taxable income is more than $80,000 per annum ($160,000 for families) you may be required to pay a Medicare Levy Surcharge of 1% of your income as part of your annual tax bill.

But you can be exempt from this extra expense simply by having private hospital cover.

5. Additional benefits to health cover with Australian Unity

Private health cover can also bring other benefits which you might not expect – like access to our Wellplan® Rewards offering great savings on a range of health and lifestyle products and services.

To sign up for truly great private health coverage at Australian Unity click here.

6. Health Insurance Online – Manage your Cover

Australian Unity Health Insurance Online Services allow you to manage your health insurance cover quickly and easily, at any time.

7. Manage your health cover online

With online access you can

  • make a claim
  • Change your level of health cover
  • View your extras claims history
  • Check the details of your health insurance cover at your convenience
  • Update your address or contact details
  • Request a replacement membership card
  • View your extras benefit limits
  • Download forms
  • Set up a direct credit arrangement so claims can be paid directly into your nominated bank , building society or credit union account – the quick, easy and secure way to receive your health cover benefits
  • Set up a direct debit arrangement so that contribution payments can be deducted from your nominated bank, building society or credit union account – the quick, easy and secure way to make your payments
  • Pay your health cover contributions by credit card
  • Add or remove dependants
  • Register student dependants
  • Access Wellplan Online
  • Access baby+me resources (for members enrolled in the program)

8. Find out what your health coverage includes

Australian Unity’s online portal also includes a full service directory which features:

  • Agreement hospitals
  • Wellplan Rewards providers
  • Dental Centres
  • Gap Cover Doctors
  • Optical Centres
  • No Gap Dentists

2011 Private Health Insurance Tax Statement Information

Under Federal Government legislation, Australian Unity is required to provide members with a Private Health Insurance Tax Statement. This Tax Statement details your health insurance cover during the previous financial year.

Australian Unity members with health cover will have received their 2010-2011 Private Health Insurance Tax and Lifetime Health Cover Statements by 15 July 2011.


The Private Health Insurance Tax Statement is sent to all health insurance members each financial year. These details are required for you to complete your tax return. The Private Health Insurance Tax Statement does not set out who is entitled to claim, only what amount may be claimed.

You may require your Private Health Insurance Tax Statement to:
  • Claim a rebate as part of your tax return (if you have not already claimed it as a reduction in your premiums or from Medicare); or
  • Prove that you had an appropriate level of private patient hospital cover to be exempt from paying the additional 1% Medicare Levy Surcharge.
To help you complete the Tax Offset and Medicare Levy Surcharge sections of your tax return we have labelled the areas on your Tax Statement that correspond with the TaxPack 2011.
Australian Unity's ID is AUF. Your Private Health Insurance Tax Statement will show this ID in the box marked 'B'.
The ‘Cover Code’ is used by the Australian Taxation Office to identify what type of cover you have contributed to in the financial year. There are three codes available: (A) for General (Extras) cover only, (H) for Hospital cover only and (C) for Combined Hospital and General (Extras) covers. Your Private Health Insurance Tax Statement will show this code in the 'Private Health Insurance policy details' section.
Australian Unity members will receive their Private Health Insurance Tax Statement in the mail no later than 15 July 2011, subject to us having your correct address details and allowing for any postal delays. In addition, if you or your partner have a Lifetime Health Cover loading you will also receive a Lifetime Health Cover Statement at the same time.

Remember, it is important we have your correct address details. If you are moving, or have already moved, and have not updated your details please contact Australian Unity.

You can also choose to receive your Tax Statement via email. If you would prefer your statement electronically log onto online member services to update your communication preferences from mail to email.

As a regulatory requirement, Private Health Insurance Tax Statements for deceased members will be mailed to their estate provided Australian Unity has been notified.
If you have not received your Private Health Insurance Tax Statement by 15 July 2011 please call 13 29 39 or go to Australian Unity’s Online Services to request a copy.
Your Private Health Insurance Tax Statement is produced to Australian Taxation Office guidelines that require only that the policy holder is named on the statement. If you hold couples or family health cover with Australian Unity, any member of your family listed on your policy who pays income tax can use this statement as proof of cover for their own tax return purposes.
  1. If you don't already claim the Government Rebate as a reduced premium, you may claim it as a Tax Offset when you lodge your 2010/2011 Tax Return. The amount you may be eligible to claim is shown in Label 'G' of your Tax Return.
  2. If you have claimed the Government Rebate as a reduced premium throughout the financial year, your Private Health Insurance Tax Statement will show that you are entitled to no further offset against your tax liability ('0' will show in Label 'G' of your Tax Return).
  3. Alternatively, you can claim the Government Rebate as a direct payment over the counter at your nearest Medicare outlet. All you need to do is obtain a PHIIB receipt (Private Health Insurance Incentive Benefit) from Australian Unity and fill out a Medicare claim form. Please note that if you choose this option you will need to update your details when you lodge your tax return.
The following people can claim the Government Rebate as a Tax Offset:

  1. All Australians who are eligible for Medicare and a member of a registered health fund.
  2. People who have paid membership contributions for private health insurance, whether or not they are covered by that policy.
  3. Anyone whose employer is paying member contributions on their behalf.
The Government Rebate is available irrespective of family type or income, and is available on hospital and combination covers.
If more than one person pays for the same membership - for example, payments are made from a joint bank account - then each individual will need to make a separate claim for their portion of the Federal Government 30% Rebate. The Private Health Insurance Tax Statement provides details about the policy only; Australian Unity does not identify which person has paid which portion of any member contributions.
Even if your employer pays for your member contributions you are entitled to the Government Rebate. However, it is important to note that you may have already claimed the rebate as a reduced contribution.

Your Private Health Insurance Tax Statement will indicate the tax offset you may be entitled to claim.
The Private Health Insurance Tax Statement is in the name of the policy holder and is sent to them. The important thing to remember is that you are entitled to the Government Rebate if you make the premium payments. You can still use the details on the Tax Statement for your Tax Return as proof of cover. See question 6 for further information.
Yes. If you don't pay tax you can still receive the Government Rebate by either:

  1. Asking Australian Unity to reduce your contributions by completing a Rebate Application form and claiming the Rebate up front as a reduced contribution.
  2. As a direct payment from the Government through any Medicare outlet. Just contact Australian Unity on 13 29 39 and we will issue you a receipt for the member contributions you have paid.
The figures on your Private Health Insurance Tax Statement are the member contributions received and processed by Australian Unity between 1 July 2010 and 30 June 2011.
The figures shown on your Private Health Insurance Tax Statement will take into account only those member contributions received and processed by Australian Unity between 1 July 2010 and 30 June 2011.

In the case of Corporate members, contributions are projected to 30 June 2011. Any recent member contributions deducted from your salary may not have been received and processed prior to 30 June 2011. We may have also processed and included your last deduction from the previous financial year in July 2010.
Yes - all you need to do is fill in a Rebate Application form and forward it to Australian Unity, Reply Paid 6646, South Melbourne 8060.
From 1 April 2005, the Federal Government increased the rebate from 30% to 35% for health fund members aged 65 - 69 years, and from 30% to 40% for members aged 70 years and over. The highest level of rebate on your Private Health Insurance Tax Statement is based on the oldest adult on the health cover. For example if John is 72 years of age and his wife is 67 years of age, the rebate shown will be 40%.
As some recent member contributions deducted from your salary may not have been received and processed prior to 30 June 2011, your contributions will be projected to this date.
You need to contribute to a health fund cover that offers 'private patient hospital cover' to be exempted from paying the additional 1% Medicare Levy Surcharge. All currently available Australian Unity covers with a private patient hospital component meet this requirement (excludes the Comprehensive Hospital - Table T4 and Overseas Visitors Cover).

You should also note that the Medicare Levy Surcharge is applied on a pro-rata basis. If you were not covered by an appropriate hospital cover for 365 days, between 1 July 2011 and 30 June 2012, you will only pay the additional 1% MLS for the period you were not covered. The number of days covered by private hospital cover is shown on your Private Health Insurance Tax Statement in ‘Label A’.

Remember the Medicare Levy Surcharge only applies to those on higher incomes – currently these are single persons with a taxable income for the financial year ending 30 June 2012 greater than $80,000, or couples/families with a combined taxable income greater than $160,000. The family income threshold increases by $1,500 for each dependent child after the first.

Important notes:
  • The Medicare Levy Surcharge is payable by high income earners during any period in which a private patient hospital cover is not held, including periods when cover is suspended.
  • If you and/or your partner/spouse did not contribute to a private patient hospital cover and your taxable income for the financial year ending 30 June 2012 exceeds $80,000 (single) or $160,000 (couple/families) you are not exempt from the 1% Medicare Levy Surcharge.
The Private Health Insurance Act 2007 commenced in April 2007 and included a provision requiring health insurers to stop applying the Lifetime Health Cover loading to a person’s premiums if that person has held hospital cover for a continuous period of 10 years. Therefore, these members will no longer have to pay a Lifetime Health Cover loading on their premium. To find out more and how this may affect you, visit australianunity.com.au/lhc

Lifetime Health Cover information you need to know

Lifetime Health Cover (LHC) is a Government initiative which commenced from 1 July 2000. It is designed to encourage people to take out private health insurance earlier in life, and to maintain their cover over their lifetime.

Basically, if you don’t have hospital cover by 1 July after your 31st birthday, you’ll pay an extra 2% on the standard contribution rate for every year you don’t hold cover over the age of 30, to a maximum loading of 70%.

In 2007 the Private Health Insurance Act took effect with a new LHC provision. The new legislation states that if an individual has held hospital cover for 10 continuous years after 1 July 2000, they will no longer have to pay a LHC loading.

Yes. If you have maintained Hospital cover with Australian Unity or been with one other health fund for 10 continuous years the LHC loading will automatically be removed.

No. The legislation protects a member's right to change funds without penalty. The LHC loading will be removed if a person has paid a loading for 10 continuous years regardless of the type of hospital cover or the number of funds of which they may have been a member.

To ensure we can calculate your LHC loading correctly, we will need you to provide transfer certificates from all your previous heath funds.

Contact your previous health fund(s) and request a copy of your transfer certificate. They are required to issue your certificate within 14 business days of your request.

Review this list to see if your previous health fund has merged with another fund. If they have, contact the new fund to request a copy of your transfer certificate. If your previous health fund is not on the list please contact us on 13 29 39 to discuss your options.

No. The loading will be removed after you’ve held Hospital cover continuously for 10 years.

If you cancel your private hospital cover after the loading has been removed, and then re-purchase it at a later date, the LHC provisions will re-apply. Depending on the period of time without Hospital cover, you may be subject to the LHC loading at the same or higher rate that would have applied had the loading not been removed.

No, a period of suspension does not count towards the accumulation of the 10 year period. However the suspension period is considered as “permitted days” without hospital cover and therefore is an allowable break in the continuity of the 10 year period. Note that you have in total 1094 permitted days without hospital cover during your lifetime.

No. Extras cover does not qualify as Hospital cover and does not count towards your 10 continuous years of membership for LHC loading.

This means premiums paid in advance will be adjusted and we will further advance your current financial date.

The LHC loading applies to each individual on your membership, over age 30. Therefore the premium that you pay for your couples or family cover will take into account your LHC age as well as you partner's LHC age. Under a joint family or couple policy, the LHC loading is determined by averaging out the respective loadings of the adults covered by the policy.


Glossary

Term Explanations

Base rate premium

The amount of premium payable minus any applicable discount, govt rebate or LHC loading

Loading

A loading of 2% on top of the base premium that applies for each year a member's LHC age is above 30 when they first take out hospital cover. For example, if you join at age 40, you will pay up to an additional 20% on the base rate premium

Maximum loading

The maximum loading allowed on top of the base rate is 70%. This translates to the maximum loading for LHC age of 65 and above. However, once you have held private health insurance hospital cover for a continuous period of 10 years your loading will be removed

Lifetime health cover Age

A persons age on 1 July before the day on which they took out the hospital cover

This is the age that a new member is assigned, for the purpose of setting their premiums, and to determine what their LHC loading is when they first purchase hospital cover

New arrivals

A person who enters Australia for the first time on or after 1 July 2000 and is not an Australian citizen or permanent resident at the time of entry

Permitted days

Allowable breaks in your Hospital cover e.g. where no hospital cover is being paid for.

Permitted days include;

  • Days where a hospital cover has been suspended either for overseas travel or financial hardship.
  • Days where a member has ceased hospital cover due to travelling overseas for a continuous period of more than one year.

After joining hospital cover, the first 1094 days after the membership is cancelled and no hospital cover is paid for by the person

Continuous period overseas

A person is considered overseas if they are either;

  • Living in Norfolk Island
  • Any period in which a person returns to Australia for less than 90 days
Why go Private...
  • Don't be put on a waiting list  [i]
  • Choose your own doctor  [i]
  • Savings on tax & loadings  [i]
  • What I get with hospital cover   [i]
  • What I get with extras  [i]