Show download pdf controls
  • Private health insurance rebate letter

    We may send you a letter about your private health insurance (PHI) rebate, if we receive information from your health fund that shows you may not be entitled to the level of rebate you claimed in your tax return.

    The letter will include a schedule that compares the details you declared in your tax return with the information the health fund reports. It will also include a reason for the proposed adjustment to your PHI rebate details.

    We'll send the letter to the most recent postal address we have for you.

    On this page:

    What you need to do

    You need to review the details in the PHI rebate schedule and compare the information it contains with your records. You can then determine if you agree or disagree with our amendment.

    If you have a question, we have a dedicated phone line you can use. You can phone us on 1300 768 912 and select option 3 between 8.00am and 6.00pm, Monday to Friday.

    You’ll need to quote the reference number from your letter when you contact us. The reference number can be found at the top right of your letter.

    Find out about:

    PHI rebate schedule – sample

    Below is a sample PHI rebate schedule. Keep in mind that the schedule in your letter will contain your own details and may not look exactly like this. Use the definitions to help you understand your schedule.

    Sample: PHI rebate schedule for the year ended 30 June <CCYY>

    Tax return information

    B – Health insurer ID

    C – Membership number

    J – Your share of premiums paid in the financial year

    K – Your share of Australian Government rebate received

    L – Benefit code

    Tax claim code

    ABC

    G12345

    $1,313

    $381

    30

    A

    Proposed changes to your tax return

    B – Health insurer ID

    C – Membership number

    J – Your share of premiums paid in the financial year

    K – Your share of Australian Government rebate received

    L – Benefit code

    Tax claim code

    ABC

    G12345

    $1,422

    $395

    31

    A

    We'll provide one of the following reasons for the proposed adjustment to your PHI rebate details:

    • Incorrect tax claim code reported – this code affects the amount of PHI you are entitled to receive.
    • Under reported family income – your income and your spouse's income combined determines the level of rebate you are entitled to receive.
    • Automatic transfer of liability – liability owed by your spouse transferred to you because they either did not lodge a tax return or told us they are not required to lodge a tax return.
    • Reporting error – you may have duplicated or incorrectly reported your share of premiums paid.
    • Unable to match PHI policy details – we are unable to determine you had appropriate private health insurance with data sent to us.

    Schedule definitions

    The following definitions will help you understand your schedule:

    • Your share of premiums paid in the financial year – the amount of premiums you paid during the financial year eligible for the rebate (this figure is split between each adult covered by the policy).
    • Your share of Australian Government rebate received – the amount the Australian Government has paid towards your private health insurance.
    • Benefit code – these codes relate to the level of rebate you are entitled to, based on age.
    • Private health insurance policy details – your private health insurance policy details, as provided to us from your private health fund (including the name of the fund, the amount of premiums you paid, and your share of Australian Government rebate received).
    • Tax claim code – this is the code that best matches your situation (for example, if you are in a relationship and if you have dependants).

    If you agree

    If you agree with our information, you don’t need to do anything. We’ll send you an amended notice of assessment 28 days after the date shown on your letter. If you have a myGov account linked to ATO online services, we'll send your amended notice to your myGov inbox.

    Once you receive your amended notice of assessment, you'll need to pay any amounts you owe us by the due date.

    If you disagree

    If you disagree with the details reported, you need to let us know before the due date noted in your letter. You can contact us by either:

    Be aware that the internet isn't a secure environment. We don't control the path of inbound and outbound emails. If you choose to communicate with us by email, the privacy of your personal information can't be guaranteed.

    Once we've assessed your response, you'll receive an amended notice of assessment. The case officer reviewing your supporting documents may contact you if we require additional information.

    If we don't receive a response from you within 28 days of your letter's date of issue, we’ll automatically amend your tax return using the information we have. You'll then receive an amended notice of assessment.

    If you have a myGov account linked to ATO online services, we'll send your amended notice to your myGov inbox.

    Supporting documents

    We may ask you to provide your private health insurance statement for the period of review, showing:

    • the amount of premiums you paid
    • any premium reductions you received.

    See also:

    Last modified: 11 Jan 2021QC 41725