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Hospital Cover

Why do I need hospital cover?

The publicly funded Medicare scheme allows for certain kinds of treatment, but it is limited. For instance, you can be treated as a public patient in a public hospital, however you won't get to choose your own doctor. With private hospital cover, you'll get to choose your own doctor. You'll also get to elect whether to attend a private or public hospital. Better yet, when you obtain private-patient treatment in any kind of hospital, the Medicare scheme covers 75% of the Medicare Benefits Schedule for related costs. The remaining 25% of costs - from hospital accommodation to diagnostic tests - may be covered by your private health insurance. If you obtain comprehensive hospital cover, you may have much greater peace of mind, and will be far less likely to be out of pocket if you require hospital care. Medicare doesn't cover these private-patient hospital costs, nor does it cover medical services that aren't deemed clinically necessary.

Medicare Levy Surcharge

Medicare Levy Surcharge

Will I have to pay the Medicare Levy Surcharge?

If you earn $90,000 or more per year as a single, there’s yet another incentive to obtain hospital cover sooner rather than later. Those earning more than this amount will incur a Medicare Levy Surcharge (MLS) if they don’t have private hospital cover. This surcharge is designed to reduce the demand on public healthcare.

On the other hand, for families and couples, if your annual joint income is $180,000 or more, you’ll incur the MLS if you don’t have private hospital cover.

Regardless of whether you’re in need of individual, family or couples cover, it’s in your best interest to be aware of the MLS. By taking out private hospital cover, you can avoid the MLS altogether.

If you don’t have hospital cover or a private health insurance policy that includes eligible hospital policy, you’ll need to pay the MLS in addition to the Medicare Levy of 2 per cent that most taxpayers pay.

By taking out private health insurance, you may be eligible for a government rebate which is based on how much you earn. Income threshold entitlements can change from year-to-year so it’s worth heading to the Australian Taxation Office’s website for more details.

Lifetime Health Cover loading

What is Lifetime Health Cover loading?

Lifetime Health Cover is a loading the Federal Government put in place to encourage people to take out private hospital cover earlier in life.

It works like this: once you turn 31, you need to have hospital cover before July 1 to avoid paying an additional 2% loading on top of your premium. If you don’t get cover after your 31st birthday, an additional 2% loading will be applied for every year you are uninsured. The maximum loading is 70%.

For example, if you take out hospital cover at 35 years old, you'll incur LHC loading of 10% on top of your premium. Take it out at 40, and your LHC loading will be 20%.


If you pay the loading for 10 years continuously, it will be removed. However, it makes sense to avoid paying it in the first place by getting hospital cover before June 30 following your 31st birthday. You don't have to wait until this age, however. Many people take out hospital cover well before their 31st birthday in order to obtain the healthcare benefits that Medicare doesn't cover. Complete a health insurance comparison now in order to find hospital cover that's right for you.

Lifetime Health Cover Loading chart