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Medicare levy surcharge letter

What to do if you get a Medicare levy surcharge letter from us and you disagree with the details we provide.

Last updated 26 June 2023

Receiving your letter

We may send you a letter about the Medicare levy surcharge (MLS) if we receive information that shows, for all or part of the relevant year, you and all your dependants (including your spouse):

  • were not a member of a registered health fund
  • did not have an appropriate level of private patient hospital insurance cover
  • had family income that was above the MLS threshold.

The letter will include an MLS schedule that compares relevant information from your tax return with information we have.

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

What you need to do

You need to review the MLS schedule and compare the information it contains with your records. You can then determine if you agree or disagree.

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 8:00 am and 6:00 pm, 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.

MLS schedule – sample

Below is a sample MLS schedule. Keep in mind that your schedule will contain your own details and may not look exactly like this one.

Use the definitions to help you understand your schedule.

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

Your income for Medicare levy surcharge (MLS) purposes


Single or family status


Your family income for MLS

Tier 1 earner

The number of days you reported on your tax return, at label M2, that you were not liable to pay the MLS


The number of days that you held an appropriate level of private patient hospital cover


Private health insurance fund information

Name of fund

Hospital cover

Type of cover

Cover start date

Cover end date

Healthy People Insurance



1 July 2019

7 June 2020

Schedule definitions

The following definitions will help you understand your schedule:

  • Income for MLS purposes – your income that is used to determine whether you are liable to pay the Medicare levy surcharge.
  • MLS tier – this is determined by your income for MLS purposes; the rate of MLS then depends on your MLS tier.
  • Private health insurance fund information – provides details of your private health insurance policy, as provided to us by your private health insurer. It includes the name of your fund, the type of cover and the period of cover during the financial year.

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.

Supporting documents

We may ask you to provide your private health insurance statements for the relevant year showing the number of days that you and all of your dependants (including your spouse) had private patient hospital cover.