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Family and dependants for Medicare levy surcharge purposes

Find out who is a member of a family and who is a dependant for the purposes of the Medicare levy surcharge.

Last updated 21 August 2026

When you are a member of a family for the MLS

For Medicare levy surcharge (MLS) purposes, you are a member of a family during a period of the year, if for the period you:

  • had a spouse or a child who was an Australian resident (regardless of their income), and
  • contributed to their maintenance.

Maintenance of a dependant for MLS purposes

You maintained a dependant if any of the following applied:

  • you both lived in the same house
  • you gave them food, clothing and lodging
  • you helped them to pay for their living, medical and educational costs
  • you are paying child support even if they don't live with you.

If you had a spouse for the whole income year and your spouse worked at any time during the income year, we will still consider you to have maintained your spouse as a dependant for the whole income year.

If the 2 of you were temporarily separated, for example, because of holidays or overseas travel, we still consider you to have maintained a dependant.

A child is treated as an equal dependant of each parent (irrespective of the number of days the child was in each parent’s care) if:

  • the parents of the child lived separately and apart for all, or part, of the income year, and
  • the child was a dependant of each of them (note: unlike for other Medicare levy purposes, one or both parents receiving Family Tax Benefit Part A does not change that the child is a dependant of both parents at the same time.)

Spouse (married or de facto) for MLS purposes

Your spouse includes another person (of any sex) who either:

  • you were in a relationship with that was registered under a prescribed state or territory law
  • although not legally married to you, lived with you on a genuine domestic basis in a relationship as a couple.

An ex-spouse you pay maintenance or child support to is not your dependant.

Child for MLS purposes

Your child is only your dependant if they are:

  • under 21 years old
  • 21 to 24 years old and studying full-time at school, college or university.

Your child includes:

  • your child, whether born in marriage or not
  • your adopted child
  • a newborn or newly adopted child
  • a child of your spouse (your stepchild)
  • someone who is your child within the meaning of the Family Law Act 1975 (for example, a child who is considered to be a child of a person under a state or territory court order giving effect to a surrogacy agreement).

A foster child is not included as a dependant for MLS purposes.

When you pay the MLS

You may have to pay the MLS if:

  • any member of the family did not have an appropriate level of private patient hospital cover, and
  • your income is above a certain amount.

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