How the loading is worked out
Your loading depends on one number: your age on the 1 July before the day you take out hospital cover. Subtract 30 and multiply by 2%. The Government's own example: Shona turned 40 in April 2019 and took out her first hospital policy in May 2019. On 1 July 2018 she was 39, so her loading is 18%. Someone who joins on 30 June and someone who joins the following 2 July can pay different loadings, because a new 1 July has passed in between.
| Age on the 1 July before joining | Loading | What it means |
|---|---|---|
| 30 or under (joined by base day) | 0% | No loading, as long as you keep the cover |
| 31 | 2% | Missed the base day by less than a year |
| 35 | 10% | Five years over 30 |
| 40 | 20% | Ten years over 30 |
| 45 | 30% | |
| 50 | 40% | |
| 55 | 50% | |
| 60 | 60% | |
| 65 or older | 70% | The cap: the loading cannot go higher |
The loading is charged on the hospital part of your premium only, and the government rebate is not paid on the loading component. So a 20% loading costs you close to the full 20% extra on hospital cover, even if you get the rebate on the rest.
Your LHC base day
For most people the base day is the 1 July following their 31st birthday. If you turn 31 in January 2026, your base day is 1 July 2026, and you have until then to take out hospital cover with no loading. Nobody's base day is earlier than 1 July 2000, when the scheme started. Holding cover on the base day matters: in the Government's example, Chloe had cover on her 31st birthday but cancelled it before her base day, and paid a 2% loading when she rejoined later that year.
The 1,094-day rule: breaks in cover
Once you have held hospital cover on or after your base day, you get a lifetime allowance of 1,094 days (three years less a day) without cover that does not affect your loading. It is designed for gaps such as switching funds or a stretch of unemployment. Two kinds of time do not use it up:
- Approved suspensions. If your insurer agrees to suspend your cover (for example while you travel), the suspension does not count.
- Living overseas. If you cancel cover to go overseas for at least a year, days outside Australia do not count. You can come back for visits of up to 90 consecutive days and still be treated as overseas; a stay of 90 days or more is deducted from the allowance.
Go past 1,094 days and you pay 2% on top of any loading you had, plus 2% for each further year without cover. The Government's example: Wei was without cover for 1,114 days (20 days over the allowance) and paid a 2% loading when he rejoined. The allowance is for the loading only; a break can still mean serving waiting periods again.
When the loading is removed
The loading comes off once you have held hospital cover and paid the loading for 10 continuous years. Permitted breaks pause the clock rather than reset it. In the Government's example Kaia joined in 2005 with a 6% loading, cancelled after about nine years and two months to live overseas, rejoined on her return, and had the loading removed after a further 297 days. If you use up the 1,094 days, the continuity is broken and the 10 years start again from the day you rejoin.
Couples and families
On a couple or family policy the loading is the average of the adults' individual loadings. Lukas (22%) and Noor (0%) on a couples policy pay 11%. A dependant with a disability who carries a loading counts as one of the adults, so in the Government's example Lucy's 6% becomes 2% across a three-adult family policy. Enter your partner's loading in the calculator to see the combined figure.
New migrants and Australians returning from overseas
If you migrated to Australia, your base day is the later of the 1 July after your 31st birthday or the first anniversary of your full Medicare registration. That gives you 12 months from registration to take out hospital cover without a loading. Miss it and the loading is calculated on your age in the normal way, so a migrant who is 45 on the 1 July before they join, after the 12 months are up, pays 30%. Reciprocal Medicare from a visitor agreement does not count as registration.
| Situation | Rule |
|---|---|
| Born on or before 1 July 1934 | Exempt from LHC altogether |
| New migrant | Base day is the later of the 1 July after your 31st birthday or the first anniversary of your full Medicare registration. Reciprocal Medicare does not count |
| New migrant who was overseas on the base day (registered with Medicare on or after 1 July 2009) | No loading if you buy hospital cover within 12 months of your first return to Australia for 90 days or more |
| Australian citizen or permanent resident overseas on the 1 July after your 31st birthday | No loading if you buy hospital cover by the first anniversary of your return (your first stay in Australia of 90 days or more) |
| ADF member on continuous full-time service | Treated as holding hospital cover. If you discharge after your base day you have 1,094 days to join without a loading |
| DVA Gold Card holder | Treated as holding hospital cover. If the card is withdrawn you have 1,094 days to join without a loading |
| Dependant with a disability on a family policy | Normal rules apply; their loading is averaged across all adults on the policy |
LHC, the age-based discount and the surcharge
Three government settings pull in the same direction. Insurers may offer people aged 18 to 29 a discount of up to 10% on hospital premiums (2% for each year under 30), kept until age 41 and then phased out by 2% a year. LHC loading penalises joining after your base day. And the Medicare Levy Surcharge adds 1% to 1.5% to the tax of higher earners without hospital cover. If you are close to 31 and earn over the MLS threshold, all three point to taking out hospital cover now; the calculator's "if you wait" line shows what one more 1 July costs you.
Our guide to Lifetime Health Cover loading covers the history, the paperwork and more worked examples. To see what the loading means for a real policy, look at the funds in our directory of Australian health insurers or start with how hospital cover tiers work.
Frequently asked questions
How do I calculate my Lifetime Health Cover loading?
Take your age on the 1 July before the day you take out hospital cover, subtract 30 and multiply by 2%. Someone who is 38 on that 1 July pays 16%. The loading is capped at 70% and is 0% if you take out cover on or before your LHC base day and keep it.
How do I avoid the LHC loading?
Hold private hospital cover with an Australian registered insurer by the 1 July after your 31st birthday (your base day) and keep it. You can have up to 1,094 days without cover over your lifetime after that without the loading growing. Any hospital tier counts, including Basic.
When does the LHC loading come off?
After you have held hospital cover and paid the loading for 10 continuous years. Permitted breaks don't reset the clock but also don't count towards the 10 years. Once removed the loading stays at 0% while you keep your cover.
Why do I have to pay Lifetime Health Cover loading?
LHC started on 1 July 2000 to encourage people to take out hospital cover young and keep it. Younger members pay premiums while they claim little, which keeps premiums lower for everyone; the loading charges people who join later for the years they were not contributing.
Do I need a Lifetime Health Cover letter?
When you switch insurers your old fund passes on your LHC details, and you can ask any insurer for a transfer certificate. New migrants usually need a letter from Medicare showing their registration date, and people who lived overseas may need an international movement record from the Department of Home Affairs.
Does the loading apply to extras cover?
No. LHC loading only applies to the hospital part of your premium. Extras (general treatment) cover, overseas visitors cover and overseas student cover are not hospital cover for LHC purposes and carry no loading.
