Lifetime health cover

Lifetime Health Cover - Frequently Asked Questions

This page contains questions and answers regarding the Lifetime Health Cover.

Do people under 31 pay less under Lifetime Health Cover?

No. A person who is aged under 31 when they take out hospital cover will pay the same premium as a person who first takes out hospital cover when aged 31. That is, they will pay the base rate premium.

Can I vary the level of my private health insurance cover without affecting my premium under Lifetime Health Cover?

Yes. You are able to upgrade or downgrade your hospital cover policy under Lifetime Health Cover without affecting your certified age at entry. The usual waiting periods and applicable pre-existing ailment rules will still apply.

The only circumstances under which your certified age at entry would be affected by a variation to your private health insurance cover would be if you drop your hospital cover. In this case the period of absence rules would apply. That is, your certified age at entry would be unaffected for the 1094 days that you were without hospital cover. If you purchase hospital cover 1095 days after dropping you previous cover you will pay a 2% loading. The loading increases by 2% for every additional 365 days you did not have hospital cover thereafter.

Do premiums for general products and ambulance cover count towards Lifetime Health Cover?

No. Lifetime Health Cover does not apply to ancillary products or ambulance cover.

Therefore, you need to take out a private health insurance policy that includes hospital cover in order to be assigned a certified age at entry and lock in lower premiums for the rest of your life.

What if I take out private health insurance after 1st July following my 31st birthday?

People who purchase hospital cover for the first time after the 1 July following their 31st birthday will pay a Lifetime Health Cover Loading. This loading is based on the person's Lifetime Health Cover Age. The loading equals 2% for each year the person's Lifetime Health Cover age is over 31. There is a LHC calculator on the Private Health website at www.privatehealth.gov.au. The calculator will calculate your loading based on the answers you provide to a series of questions designed to determine your LHC age. Top of page

How can I find out how much of my period of absence I have used?

The Government understands that there are various reasons members may need to drop their membership for brief periods. Therefore, the Lifetime Health Cover rules provide members of private health insurance who need to drop their membership, for whatever reason, a cumulative period of 1094 days absence through their lifetime without affecting their certified age at entry. If you want to find out how much of your period of absence you have used, you should contact your insurer.

How can I find out how much loading I am paying?

If you are unsure how much loading you are paying, then contact your health insurer or refer to the annual statement that your health insurer sends you detailing your Lifetime Health Cover status.

How is my Lifetime Health Cover premium affected if I want to change from a single policy to a family or couples policy?

If in the future you decide to take up family or couples cover, there is no problem doing so.

The premium that you pay for your couples or family cover will take into account your certified age at entry as well as you partner's certified age at entry. In case of joint hospital cover, the LHC loading is determined by averaging out the respective loadings of the adults covered by the policy.

Why doesn't my health insurance policy overseas count towards Lifetime Health Cover?

Private health insurance overseas does not count towards Lifetime Health Cover. This is because any private health insurance held overseas does not contribute to the support of community rating, as Australian private health insurance is required to do.

Community rating requires Australian private health insurance funds to charge everyone the same premium regardless of health status and claims history. This ensures that health insurers cannot charge the elderly and the chronically ill a higher premium.

What is the base rate premium?

The base rate premium is the price a person joining before 1st July following their 31st birthday would pay for hospital cover. This premium is set by individual health insurers. The base rate premium will vary between different health insurer products and between different health insurers and may increase over time as a result of cost pressures such as new, expensive health technologies and the ageing of the population.
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