Tax Time with GMHBA
Find out more about some of the complicated areas of Private Health Insurance, such as some of the tax benefits of having health cover, and the impacts of the Medicare Levy Surcharge, Lifetime Health Cover loading and Age Based Discount.

Private health insurance and your taxes
While you can't directly claim it as a deduction, there are a couple of ways health cover can help you out. Things like the Medicare Levy Surcharge and the Australian Government Rebate are actually incentives designed to encourage Australians to get hospital cover. It's about making sure our private and public health systems work hand-in-hand to give everyone great care.

Medicare Levy Surcharge (MLS)
If you don’t have appropriate hospital cover and you are a high-income earner, you may have to pay the Medicare Levy Surcharge (MLS).

Lifetime Health Cover loading (LHC)
Lifetime Health Cover (LHC) loading is an aged based initiative introduced by the Australian Government to encourage people to take out hospital cover earlier in life, and to maintain cover ongoing.

Age-based discount
The age-based discount is a perk for the under 30s. It's a 2% reduction on premiums for each year you might be aged under 30 when you purchase eligible hospital cover. The highest age-based discount that can be applied is 10% for 18 to 25 year olds.
^Pricing based on Single, aged 30 living in VIC earning $101,000 or less (Base Tier Australian Government Rebate) and excludes . Prices and displayed products can change if details vary.
Hospital cover with GMHBA
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Basic Plus Starter Hospital
FROM$ 19 .50
-
per week
Hospital Excess $750Basic Plus Hospital cover with some key inclusions, as well as accident protection-
Upgraded cover in the event of an accident
-
Excess waiver for same day stays
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Dental surgery
-
Joint reconstructions
Hospital Services
- Tonsils, adenoids and grommets
- Joint reconstructions
- Hernia and appendix
- Gynaecology
- Dental surgery
- Brain and nervous system
- Eye (not cataracts)
- Ear, nose and throat
- Bone, joint and muscle
- Kidney and bladder
- Male reproductive system
- Digestive system
- Gastrointestinal endoscopy
- Miscarriage and termination of pregnancy
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Pain management
- Skin
- Breast surgery (medically necessary)
- Diabetes management (excluding insulin pumps)
- Blood
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (by an accredited podiatric surgeon)
- Back, neck and spine
- Rehabilitation
- Palliative care
- Heart and vascular system
- Lung & Chest
- Implantation of hearing devices
- Sleep studies
- Cataracts
- Joint replacements
- Dialysis for chronic kidney disease
- Insulin pumps
- Pain management with device
- Hospital psychiatric services
- Pregnancy and birth
- Assisted reproductive services
- Weight loss surgery
-
-
Bronze Plus Hospital
FROM$ 24 .10
-
per week
Hospital Excess $750Everyday value cover for a range of procedures with exclusions-
Upgraded cover in the event of an accident
-
Excess waiver for same day stays
-
Bone, joint & muscle
-
Blood
Hospital Services
- Tonsils, adenoids and grommets
- Joint reconstructions
- Hernia and appendix
- Gynaecology
- Dental surgery
- Brain and nervous system
- Eye (not cataracts)
- Ear, nose and throat
- Bone, joint and muscle
- Kidney and bladder
- Male reproductive system
- Digestive system
- Gastrointestinal endoscopy
- Miscarriage and termination of pregnancy
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Pain management
- Skin
- Breast surgery (medically necessary)
- Diabetes management (excluding insulin pumps)
- Blood
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (by an accredited podiatric surgeon)
- Back, neck and spine
- Rehabilitation
- Palliative care
- Heart and vascular system
- Lung & Chest
- Implantation of hearing devices
- Sleep studies
- Cataracts
- Joint replacements
- Dialysis for chronic kidney disease
- Insulin pumps
- Pain management with device
- Hospital psychiatric services
- Pregnancy and birth
- Assisted reproductive services
- Weight loss surgery
-
-
Bronze Plus Advantage Hospital
FROM$ 24 .35
-
per week
Hospital Excess $750Our most comprehensive Bronze Plus cover which balances peace of mind with great value-
Upgraded cover in the event of an accident
-
Excess waiver for same day stays
-
Plastic & reconstructive surgery (medically necessary)
-
Back, neck & spine
Hospital Services
- Tonsils, adenoids and grommets
- Joint reconstructions
- Hernia and appendix
- Gynaecology
- Dental surgery
- Brain and nervous system
- Eye (not cataracts)
- Ear, nose and throat
- Bone, joint and muscle
- Kidney and bladder
- Male reproductive system
- Digestive system
- Gastrointestinal endoscopy
- Miscarriage and termination of pregnancy
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Pain management
- Skin
- Breast surgery (medically necessary)
- Diabetes management (excluding insulin pumps)
- Blood
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (by an accredited podiatric surgeon)
- Back, neck and spine
- Rehabilitation
- Palliative care
- Heart and vascular system
- Lung & Chest
- Implantation of hearing devices
- Sleep studies
- Cataracts
- Joint replacements
- Dialysis for chronic kidney disease
- Insulin pumps
- Pain management with device
- Hospital psychiatric services
- Pregnancy and birth
- Assisted reproductive services
- Weight loss surgery
-
-
Silver Plus Hospital
FROM$ 30 .25
-
per week
Hospital Excess $750A popular choice offering a range of services with some exclusions to keep costs down-
No excess for children under 21
-
Excess waiver for same day stays
-
Heart & vascular system
-
Lung & chest
Hospital Services
- Tonsils, adenoids and grommets
- Joint reconstructions
- Hernia and appendix
- Gynaecology
- Dental surgery
- Brain and nervous system
- Eye (not cataracts)
- Ear, nose and throat
- Bone, joint and muscle
- Kidney and bladder
- Male reproductive system
- Digestive system
- Gastrointestinal endoscopy
- Miscarriage and termination of pregnancy
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Pain management
- Skin
- Breast surgery (medically necessary)
- Diabetes management (excluding insulin pumps)
- Blood
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (by an accredited podiatric surgeon)
- Back, neck and spine
- Rehabilitation
- Palliative care
- Heart and vascular system
- Lung & Chest
- Implantation of hearing devices
- Sleep studies
- Cataracts
- Joint replacements
- Dialysis for chronic kidney disease
- Insulin pumps
- Pain management with device
- Hospital psychiatric services
- Pregnancy and birth
- Assisted reproductive services
- Weight loss surgery
-
Lifetime Health Cover (LHC)
The Lifetime Health Cover (LHC) loading is a Government loading on your private hospital cover premiums. It was introduced on July 1, 2000 to encourage people to take out private hospital cover earlier, and to maintain their cover.
Understanding what services are covered
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Included
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Not Included
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Restricted
Restricted services are limited to a minimum (default) benefit as set by the Australian Government for accommodation as a private patient in a shared room of a public hospital. The benefit does not cover the cost of a private room in a public hospital or any room in a private hospital, and does not cover theatre costs. If you are admitted to a private hospital for treatment that is restricted by your policy, large out-of-pocket expenses will apply.
Waiting periods
Hospital services
A waiting period is the time between when you first take out health insurance or upgrade your cover and when you're actually covered for a hospital treatment.
Hospital waiting period durations – when treatment or service is included on your cover – are as follows:
Waiting period: 0 days (accidents must occur after joining)
Accidents - bodily injuries resulting from accidents which occur after the date of joining GMHBA or upgrading to a higher cover.
Waiting period: 2 months
Any other benefit for hospital (or hospital substitution) treatment unless otherwise stated.
Waiting period: 12 months
Obstetrics and maternity, pre-existing ailment, illness or condition (other than psychiatric, rehabilitation and palliative care).
Pre-existing conditions
A pre-existing condition is one where signs or symptoms of your ailment, illness or condition, in the opinion of a medical practitioner appointed by GMHBA (not your own doctor), existed at any time during the six months preceding the day on which you purchased your hospital insurance or upgraded to a higher level of hospital cover and/or benefit entitlement.
A special waiting period applies to obtain benefits for hospital treatment for new members who have pre-existing conditions. The waiting period also applies to existing members who have recently upgraded their level of hospital cover. If the ailment, illness or condition is considered pre-existing:
New members
New members must wait 12 months for any hospital benefits (other than psychiatric, rehabilitation and palliative care).
Existing members (transferring or upgrading)
Members transferring/upgrading to a higher hospital cover must wait 12 months to get the higher hospital benefits (other than psychiatric, rehabilitation and palliative care).
Waiting periods
Extras services
A waiting period is the time between when you first take out health insurance or upgrade your cover and when you're actually covered for a treatment or service.
Waiting periods for extras services – when included on your cover – are as follows:
Waiting period: 0 days
Ambulance transport and subscriptions
Waiting period: 2 months
Any services that are not specified below
Waiting period: 6 months
Optical
Waiting period: 12 Months
Major dental, orthodontics, podiatry surgical procedures and orthotic appliances (foot), orthopaedic appliances (GMHBA approved), medical devices and aids including hearing aids, blood glucose monitor, extremity pump, nebuliser pump, pressure garments, prostheses (GMHBA approved, non-surgical), sleep apnoea monitor and tens monitor.
Frequently asked questions about private health insurance and tax
You can’t claim private health insurance premiums as a tax deduction, but you can apply to receive the Australian Government Rebate on private health insurance. This is an income-tested rebate designed to encourage more people to take out private health insurance and helps to reduce the cost of premiums for your hospital, extras or combined cover.
If you are a high-income earner and subject to the Medicare Levy Surcharge (MLS), you will be exempt from paying this for the days that you held a complying level of private health insurance hospital cover during the financial year. Depending on your annual taxable income and the level of hospital cover that you hold, this may save you money when you complete your tax return.
How much you can save at tax time will depend on your annual taxable income, your family situation – whether you are single or part of a couple or family, including single parents – your age (for Australian Government Rebate purposes only) and the type and level of cover that you hold.
Private health insurance, and more specifically hospital cover, does not save you directly on tax. If your annual income falls into Tier 1, Tier 2 or Tier 3, you may be exempt from paying the Medicare Levy Surcharge (MLS) if you hold an appropriate level of hospital cover.
This depends on your individual circumstances and the type of private health insurance cover that you hold. Remember that all GMHBA hospital covers count as an appropriate level of hospital cover for Medicare Levy Surcharge purposes and holding an appropriate level of hospital cover for the full financial year can save you from paying an additional 1-1.5% of your annual taxable income (if you are a high-income earner in Tier 1, 2, or 3) when you lodge your tax return.
No, you cannot claim your extras cover at tax time, but if you are eligible to claim the private health insurance rebate that will assist with the cost. Your income tier and age will affect the amount you are entitled to.
Your eligibility to claim the rebate is determined by your total taxable income and the threshold tier that this places you in based on your family situation (single, couple or family thresholds). If you are placed in the Tier 3 you will be ineligible for the rebate.
Extras cover, on its own, will not exempt you from paying the Medicare Levy Surcharge (MLS) if you’re a high-income earner and it applies to you, or affect your Certified Age of Entry for the Lifetime Health Cover (LHC) loading. Only hospital cover or combined hospital and extras cover will count for MLS or LHC purposes.
Also referred to as the ‘tax offset’, the Australian Government Rebate on private health insurance is means-tested and can help to make private health insurance more affordable for Australian taxpayers.
MLS is an additional tax that high-income earners have to pay in Australia if they fall into Tier 1, 2 or 3 for MLS purposes and do not hold a complying level of hospital cover for the full financial year. Find out more about the Medicare Levy Surcharge.
The Medicare Levy Surcharge is separate to the Medicare levy, which most Australian taxpayers will have to pay at tax time. This levy helps to fund Australia’s public health system Medicare, and is set at 2% of your taxable income. Find out more about the Medicare levy.
Further information
At GMHBA we are committed to providing clear and helpful advice about private health insurance and tax in Australia. We always recommend speaking to an income tax professional about your individual circumstances and tax return. Visit the ATO to learn more