Guide to Medicare levy

Appropriate level of private patient hospital cover

Private patient hospital cover is cover provided by an insurance policy issued by a registered health insurer for some or all hospital treatment provided in an Australian hospital or day hospital facility. However, an insurance policy for hospital cover taken out after 24 May 2000 that has an 'annual front-end deductible' amount or excess of more than $500 in the case of a policy covering only one person, or more than $1,000 for all other policies, does not provide private patient hospital cover for MLS purposes. The same applies to an insurance policy for hospital cover with a high front-end deductible amount or excess that was taken out before 24 May 2000 if the policy either ceased to provide continuous cover after that date or has provided continuous cover but has increased the front-end deductible amount or excess.

If you made a payment to cover a shortfall in the cost of hospital treatment, other than the excess agreed in your policy, this is not a front-end deductible amount or excess. Your health insurer may include details of the level of front-end deductible amount or excess that applied to your policy in the private health insurance statement that it sent you.

Your health insurer statement will indicate the maximum number of days that your policy may have provided an appropriate level of private patient hospital cover at label A.

Travel insurance is not private patient hospital cover for MLS purposes. Private patient hospital cover does not include cover provided by an overseas or unregistered fund or insurer.

To find out: if your health insurer is a registered health insurer, contact the Private Health Insurance Administration Council or visit their website at www.phiac.gov.au about government incentives and surcharges to encourage people to take out and maintain private health insurance, visit the Australian government website www.privatehealth.gov.au/healthinsurance/incentivessurcharges

Extras cover General cover (formerly called ancillary cover) is commonly known as 'extras'. General cover is not private patient hospital cover. It covers items such as optical, dental, physiotherapy or chiropractic treatment.

Medicare levy - home

Sections within Medicare levy surcharge

• When don't you have to pay the surcharge?
• When do you have to pay the surcharge?
• Appropriate level of private patient hospital cover
• Family situation
• Income for MLS purposes