With this in mind, we've created a list of FAQs below, to help explain one of the more complex areas of health insurance, the LHC loading.
And please remember, if you have any further questions, just to call our friendly team on 13 29 39 or contact us online. We’re here to help.
What is Lifetime Health Cover (LHC)?
LHC is a government initiative specifically designed to encourage people to take out private hospital insurance earlier in life and maintain it over time.
What is the Lifetime Health Cover (LHC) loading?
If you didn’t have private hospital cover
before 1 July 2000
before the 1st of July following your 31st birthday (whichever is later)
you pay 2% extra, plus an extra 2% for every year after this date you didn’t have it.
This additional amount is known as your LHC loading.
For example, if you took out hospital cover in 2008 as a 40 year old, you would pay a 20% LHC loading on top of the standard price of your hospital cover.
You stop paying the loading after you’ve paid for hospital cover for ten continuous years.
The maximum loading amount is 70%.
On 1 July 2013, new laws were introduced. What has changed?
If you earn under $136,001 as a single or $272,001 as a family, you may be entitled to receive the Australian Government Rebate on Private Health Insurance. This rebate can reduce the price of your cover from between 10% and 40% depending on your age and income.
Up until 1 July 2013, this rebate was applied to your LHC loading.
From 1 July 2013, the rebate will no longer apply to the LHC loading part of your cover's price, and now everyone who pays the loading has to pay all of it.
Will the changes affect me?
Everyone who pays an LHC loading will pay extra for health cover from 1 July 2013. The increase will depend on the amount of loading you currently pay.
If you don’t pay an LHC loading, the proposed changes will not affect you.
If you have an LHC loading but receive 0% rebate, you won’t pay any extra.
What happens to my LHC loading if I used to be with another health insurer?
So we can calculate your LHC loading correctly, please contact your previous health fund and ask them to send us a copy of your transfer certificate, if you haven’t already done so.
We can also request a transfer certificate from your previous fund on your behalf, just:
If your previous health fund has merged with another fund, please contact us on 13 29 39 so we can assist you.
Does my extras cover count towards my 10 years continuous cover for LHC?
No. LHC applies only to private hospital cover.
I have a family or couples membership. How does this affect my LHC loading?
Under a joint family or couples membership, we calculate the LHC loading is calculated by averaging out the loading of each adult member.
For example: if you have a 6% loading but your partner has no loading, your family’s LHC loading would be 3%. (6 +0) / 2 = 3
I was born before 1 July 1934
You don’t have to worry about the LHC. You’re 100% exempt.
What happens if I cancel my cover after the loading is removed, but start again a few years later?
The rules behind this situation are quite involved. First, it’s important to understand Permitted days without hospital cover.
If you use up all your permitted days without hospital cover, then decide you want private hospital cover again, you will pay an additional 2% loading and an extra 2% loading for every year over your ‘permitted days without hospital cover’ allowance, and pay the loading you previously had.
This scenario helps explain it-
- A 40 year old takes up hospital cover in 2008 (that person would pay a 20% loading.)
- Then, 11 years later (remember, after 10 continuous years of paying for private hospital cover the loading is removed) s/he cancels the private hospital cover.
- Then five years later s/he takes it up again.
In this scenario, s/he would pay a 24% LHC loading.
2% + 4% (for the 2 years over the Permitted days without hospital cover) + 20% (the original loading)
For more information, just to call our friendly team on 13 29 39. We’re here to help.
I suspended my private hospital cover. Does this still count towards the 10 continuous years?
No, a period of suspension does not count towards the accumulation of the 10-year period.
Only days on which you are paying the LHC loading will count towards your 10 continuous years.
I am a current or past member of the Australian Defence Force (ADF)
As an ADF member, the ADF provides your medical services and we consider you to have hospital cover while you are serving with the ADF.
If you discharge from the ADF:
- before the 1st of July following your 31st birthday, then the normal rules apply (see What is Lifetime Health Cover (LHC) loading?)
- after the 1st of July following your 31st birthday , you have 1,094 days (see Permitted Days Without Hospital Cover) to join a health fund and not pay an LHC loading
- but had an LHC loading before you joined, your loading will return to what it was before you joined, if you take out hospital cover immediately after discharge
I have a Department of Veterans' Affairs (DVA) Gold Card
If you hold a DVA Gold Card, we consider you to have hospital cover.
If you held the card after 1 July 1999, but now no longer have it, you can claim the period you held the card, as a period with private health insurance.
If your DVA Gold Card is cancelled, you will begin to use your Permitted Days Without Hospital Cover from the cancel date, until you take out private hospital cover.
I was overseas on the 1st of July, following my 31st birthday
If you are an Australian citizen or permanent resident who is overseas on the 1st of July following your 31st birthday, you will not pay a LHC loading if you purchase hospital cover within one year of returning to Australia.
In regards to your LHC loading, you are still considered to be overseas if you return to Australia for less than 90 consecutive days per visit.
I was over 31 and overseas when the LHC was brought in on 1 July 2000
If you were an Australian citizen or permanent resident on 1 July 2000 and overseas, the loading will not apply if you take up private hospital cover on your return to Australia.
When you return to Australia for more than 90 consecutive days, you will start to use your permitted days without hospital cover allowance from the date you returned, until you take out hospital cover.
If you exceed your ‘permitted days without hospital cover’ allowance, you will incur a 2% LHC loading on the 1095th day. This loading will increase by 2% for every additional year you continue to be without hospital cover.
- visits to Australia less than 90 consecutive days long do not affect your ‘permitted days without hospital cover’ allowance.
- In some circumstances, for example if you go overseas again, you may be eligible for a short suspension of your health cover. If you qualify, your suspension period won’t impact your ‘permitted days without hospital cover’ allowance or your need to re-serve waiting periods.
For more information, just call our friendly team on 13 29 39 or contact us online. We’re here to help.
I’ve been living on Norfolk Island
Time spent on Norfolk Island is considered time spent overseas. If you’ve been living on Norfolk Island, please contact us on 13 29 39 so we can help you calculate your LHC loading.
I recently migrated to Australia
If you’re a new migrant, you will not pay an LHC loading if you take out private hospital cover by:
1 July following your 31st birthday
The first anniversary of the day you registered for full Medicare benefits.
To enrol in Medicare, visit a Medicare office 7 to 10 days after your arrival in Australia and take your passport or travel documents. You’ll find more information on registering for Medicare here.
What does ‘permitted days without hospital cover’ mean?
Once you've taken up private hospital cover you can cancel it for up to 1,094 days (ie 3 years minus 1 day) during your life, without it affecting your loading. For exceptions to this rule, please see I was over 31 and overseas when the LHC was brought in on 1 July 2000
We refer to this period as your ‘permitted days without hospital cover’ allowance.