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  • Your private health insurance statement

    Your private health insurance statement gives you information about your private health insurance premiums and private hospital cover. The law has recently changed in regards to the way health insurers give you information about your private health insurance premiums.

    Previously, your health insurer was required to send a private health insurance statement to each adult covered by the policy by 15 July each year. It is now optional for them to send you this information. A statement will only be provided if you request one.

    If you lodge your tax return online using myTax or lodge using a registered tax agent, your health insurance details should be pre-filled. If your health insurance details are not pre-filled or you lodge a paper tax return, you will need to contact your health insurer in order to get a private health insurance statement.

    If you are an adult covered by a private health insurance policy when the premiums were paid, you will be income tested on your share of the policy, regardless of:

    • who paid the premiums
    • how many other people are covered on your policy.

    It is important to complete the private health insurance policy section of your tax return as we need to assess your entitlement for a private health insurance rebate.

    Understanding the details on your statement

    If you have received a private health insurance statement, the following provides more information about what each label on your statement means:

    • Health insurer ID – This is a unique code that helps us identify your health insurer.
    • Membership number – This is the number that your fund gave you for your policy.
    • Your premiums eligible for Australian Government rebate – This is your share (in dollars) of the premiums that have been paid for your policy. Note that    
      • it doesn't include any Lifetime health cover loading
      • it doesn’t matter if you didn’t pay for the policy. If you are an adult covered by the policy when the payments were made, you are entitled to receive a share of the rebate based on your share in the policy
      • your share will be the amount paid for the policy divided by the number of adults on the policy – for example, if the total payments for a premium are $2,000 and two adults are covered by the policy, then your share of premiums eligible for the rebate will be $1,000    
        • when completing your tax return, do not enter a percentage amount in this field. Using the statement shown in the example statement below, at Your premiums eligible for Australian Government rebate on your return, you would enter 1322 on one line and 280 on the next line.
         
       
    • Your Australian Government rebate received – This is your share (in dollars) of the private health insurance rebate that you have received by reduced premiums from your insurer. Your share will be the amount of reduced premiums received on your policy divided by the number of adults on the policy.
      Note: When you do your tax return, use the dollar amount – not the percentage amount. Using the statement shown in the example statement, at Your Australian Government rebate received on your return you would enter 343 on one line and 71 on the next line.
    • Benefit code – We use the benefit code to apply the right level of rebate. The level of your rebate is calculated on the age of the oldest person covered by the policy. Note that    
      • valid benefit codes are 30, 31, 35, 36, 40 and 41
      • benefit codes 30, 35 and 40 are used for any premiums paid between 1 July and 31 March
      • benefit codes 31, 36 and 41 are used for any premiums paid between 1 April and 30 June.
       
    Guide to benefit codes by age of oldest person covered

     Age

    Benefit code for premiums paid between 1 July and 31 March

    Benefit code for premiums paid between 1 April and 30 June

    Under 65 years old

    30

    31

    65–69 years old

    35

    36

    70 years old or over

    40

    41

    • Other adult beneficiaries for the policy – If your policy covered more than one adult at the time the payments were made, then the other beneficiaries will be listed here. Note that    
      • if you and your spouse were on the policy for the same period of time and payments, your spouse's name would be listed to indicate they shared the overall costs of the private health insurance policy
      • if you were on a single policy for the whole year, there will be no other adult beneficiaries in respect of the policy.
       
    • Number of days this policy provides an appropriate level of private patient hospital cover – This is the number of days your policy provided you with an appropriate level of private hospital insurance cover. The Medicare levy surcharge may apply if you and your dependants did not have an appropriate level of cover for the full year.

    Find out about:

    Why there are two rows of information on your statement

    There are two rows of information on your private health insurance statement because of changes to the way the private health insurance rebate is calculated. On 1 April each year, your rebate percentage is adjusted by a rebate adjustment factor.

    One row of information on your statement will be for the premiums paid and rebate received before 1 April, and the other row will be for premiums paid and rebate received from 1 April. Each row will have a different Benefit code.

    There may also be two or more rows because the oldest person covered by the policy turned 65 or 70 during the year. If this occurs, all adults covered by the policy are entitled to a higher rebate percentage (provided their income for surcharge purposes is less than the Tier 3 threshold). As with the annual adjustment of the rebate percentage on 1 April, each row will have a different benefit code.

    Note: Make sure you enter all lines of information into your income tax return separately, without performing any calculations.

    Find out about:

    Example statement

    Below is a sample private health insurance statement for 2017–18. You should receive something similar from your private health insurer if you request a copy of your statement.

    Example: Private health insurance statement

    Private health insurance statement, 1 July 2017 to 30 June 2018 – Stephen Smith

    Table: Sample private health insurance statement for 2017–18
    Table: Sample private health insurance statement for 2017–18

    Health insurer ID

    Membership number

    Your premiums eligible for Australian Government rebate

    Your Australian Government rebate received

    Benefit code

    Other adult beneficiaries for the policy

    B ABC

    C 123456

    J 1,322

    K 343

    L 30

    Mary Smith

    B ABC

    C 123456

    J 280

    K 71

    L 31

    Mary Smith

    Note: If you have more than one line of information in the table above, make sure each line is input separately into your tax return. Do not add up amounts reported in any column or row and input a total.

    Table: Sample Medicare levy surcharge details for 2017–18

    M2

    Medicare Levy Surcharge

    Number of days this policy provides an appropriate level of private patient hospital cover

    A

    365

    If you and all your dependants (including your spouse) did not have an appropriate level of private patient hospital cover for the full financial year (365 days), you may be liable for Medicare levy surcharge – see 2018 Individual tax return instructions question M2.

    End of example
    Last modified: 14 Feb 2019QC 49966