Lifetime Health Cover loading
Learn all about Lifetime Health Cover (LHC) loading, what it may cost you, and why your 31st birthday matters.
What is Lifetime Health Cover (LHC) loading?
Lifetime Health Cover loading is an age-based initiative introduced by the Australian Government to encourage people to take out hospital cover earlier in life.
Why is turning 31 so important?
It’s because you have until 1 July following your 31st birthday to take out hospital cover. After this time, a 2% loading is added to your hospital cover premium for every year you didn't have cover.
LHC loading is removed after 10 years of continuous hospital cover.
To see what your individual loading might be, use the Lifetime Health Cover calculator.
How could Lifetime Health Cover loading affect you?
If you take out hospital cover after 1 July following your 31st birthday, LHC loading will apply.
If you’re getting close to turning 31 and don’t have hospital cover, you may receive a letter and fact sheet about LHC from the Department of Health and Aged Care. As tempting as it may be to pop it straight into the recycling bin, it’s well worth taking some time to read it. Future you may just thank you.
Here’s a few reasons why you might need hospital cover:
- You may have a specific health need that you may want covered in the future
- Maybe the idea of sitting on a public hospital waiting list fills you with dread
- If you’re planning to have a family and would be more comfortable with what private care can offer for pregnancy and birth
- Maybe your income is likely to increase beyond $97k if you're a single or $194k for couples/families in the next year or two. Nice work! It does mean that you may then be liable for the Medicare Levy Surcharge (MLS), an additional levy paid by higher income earners without private health insurance hospital cover. If this applies to you, you may be able to avoid paying MLS by taking out private health insurance hospital cover. Learn more about MLS.
How Lifetime Health Cover loading adds up
If you were to take out hospital cover after the 1 July following your 31st birthday, the following LHC loading would be applicable based on your age below.
|
AGE |
LHC loading |
|---|---|
| < 31 years old | No loading applies |
| 31 years old after 1 July | 2% |
| 32 years old | 4% |
| 33 years old | 6% |
| 34 years old | 8% |
| 35 years old | 10% |
| 36 years old | 12% |
| 37 years old | 14% |
| 38 years old | 16% |
| 39 - 65 years old |
Continues to increase by 2% for each year. Loading is capped at 70% |
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LHC loading for single and single parent policies
For example - Elliot has never had hospital cover. While she isn’t quite there yet, Elliot knows that she wants to start a family in the next year or two.
Friends have told her there's a 12-month waiting period for pregnancy and birth, so she gets herself organised ahead of time.
How it works: single and single parent policies
| Age when Elliot first purchased hospital policy |
Scenario A: 30 years old |
Scenario B: 34 years old |
| LHC applicable to policy |
Elliot doesn't need to worry about paying LHC loading because she took out hospital cover before she turned 31. Elliot will pay the standard hospital premium. |
Elliot will pay an additional 8% on top of her standard hospital premium for her cover. She’ll need to pay this loading for 10 years of continuous cover before it’s removed and she returns to paying the standard hospital premium. |
LHC loading for couple and family policies
For example - James and Henry made the most of their carefree 20’s. We all know time flies when you’re having fun, and they’ve now somehow reached the far side of 30.
They’ve had a few health issues start to crop up. While that’s nothing new at this age, they’ve decided it’s probably time to take out hospital cover for the first time.
How it works: couple and family policies
| Age when first purchased hospital policy | James - 35 years old | Henry - 37 years old |
| LHC applicable per person | 10% LHC loading | 14% LHC loading |
| LHC applicable to policy |
As a couple, James and Henry’s individual LHC loading is averaged out across their policy. They will pay an additional 12% on top of the standard hospital premium for their cover. They’ll need to pay this loading for 10 years of continuous cover before it’s removed. They can then breathe a sigh of relief and return to paying the standard hospital premium. |
|
Turning 31 and considering hospital cover?
Good news - it's not too late to take out hospital cover and avoid paying LHC loading.
We have a range of hospital covers to suit your needs.
Exemptions and exceptions to Lifetime Health Cover loading
There are some limited circumstances where you could be exempt from paying LHC loading.
If you fall within any of the exemption categories, we’ll need the document/s listed below to confirm whether LHC loading applies to your circumstance.
Without the right documentation it's important to note that LHC loading cannot be altered or removed, as it’s required by the government.
|
Possible LHC exemptions include: |
Document(s) required by GMHBA: |
|---|---|
|
New migrants to Australia, aged 31 or over Required to take out private health insurance hospital cover within 12 months of registering for interim or full Medicare benefits. |
Medicare Registration date letter |
|
Australian citizens or permanent residents living overseas on 1 July after their 31st birthday. You must take out hospital cover within 12 months of returning to Australia full time. |
International Movement Record |
|
Australian citizens or permanent residents aged over 31 and overseas on 1 July 2000. You must take out hospital cover within 12 months of returning to Australia full time. |
International Movement Record |
|
Australian citizens or permanent residents, who held private health insurance hospital cover after the age of 31 and went overseas for 12 months or more. If you have returned to Australia for periods of 90 days or less, you're still considered to be overseas for LHC purposes. |
Clearance Certificate from your old fund showing your CAE AND International Movement Record |
Learn more about LHC exemptions and special circumstances or view this fact sheet for new migrants.
Where can I find these documents?
Let us point you in the right direction:
- Medicare Registration date letter: you can ask Medicare for this
- International Movement Record: this is available from the Department of Home Affairs
- Clearance Certificate: you can ask your previous fund for this (also known as a Transfer Certificate), or if you tell us who you were previously with we can follow up. If you have an existing LHC loading this will be shown on the certificate and applied to your GMHBA policy.
All you need to do is to provide the relevant documentation within 30 days of joining GMHBA or get in touch if you need any help navigating it all.
FAQs about Lifetime Health Cover (LHC) loading
LHC is based on your age when you first took out hospital cover. It's calculated at 2% for each year you didn’t have hospital cover after you turn 31.
LHC doesn’t apply to extras cover, but if you have combined hospital and extras, LHC will only be applied to the hospital portion of your premium if applicable.
Your LHC loading moves with you if you switch health funds.
When you leave a health fund, they're required to give you a Transfer Certificate. It’s a record of your private health insurance history, including any LHC applicable, waiting periods served, previous claims and continuity of cover.
No. They are both Australian Government initiatives, but quite different.
LHC is based on your age when first purchasing hospital insurance whereas the MLS is an additional levy based on your income reaching certain thresholds. Learn more about the Medicare Levy Surcharge.
There are some circumstances where people may not have to pay LHC. Learn more about LHC exemption special circumstances.
If you're over 31 and hold hospital cover, you're able to access 'permitted days without hospital cover'. This means that you can be without hospital cover for a total of 1094 days during your lifetime without affecting your LHC loading.
Permitted days without hospital cover only relate to LHC loading, so it’s always best to check with your health fund to make sure you won’t have to re-serve any waiting periods if you have a break in your cover.
Your LHC loading will be automatically removed by your health fund after ten years of continuous hospital cover. GMHBA will advise you when this happens and of your revised premium without LHC loading.
If you suspend your membership (instead of cancelling it), you won’t pay any additional LHC loading on your hospital cover when you reactivate. The 10 years of continuous cover end date (when loading is removed) will be extended for the length of the suspension period. It’s worth noting that MLS may apply if you’re a higher income earner and do not have active hospital cover. Learn more about MLS.
Heading overseas?
If GMHBA has approved your cover suspension, overseas travel will not impact your LHC loading, as you're still considered to be maintaining your fund membership. This approved suspension period won't count towards your 1094 permitted days of absence from hospital cover.
If you suspend your cover to head overseas (up to a maximum of 3 years with GMHBA) you won’t need to use any of your permitted days of absence.
As with all things health insurance, suspension rules apply. Have a read through the GMHBA Important Information Guide to see if you’re eligible to suspend your cover. Or even easier, have a chat with our customer service team so you can jet off without any worries.
Your LHC base day is usually the later of 1 July 2000 (when LHC was first introduced) or 1 July following your 31st birthday.
The Australian Government introduced LHC loading in July 2000. All health funds must apply LHC to member policies if applicable.
For a couple or family policy, the amount added to your premium is the average of both your individual loadings. For example, if you're on a couple policy and one adult has a loading of 16% and the other has no loading, the total LHC applied to the policy would be 8%.
When you take out private health hospital cover for the first time, you're given a ‘certified age of entry’ (CAE). This is used throughout your lifetime to calculate any applicable LHC loading when you hold hospital cover.