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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. The health insurer may send the statement by mail, email, or as a link to an online version.

    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 so that you can complete your income tax return. It will also help you complete the Medicare levy surcharge related items on your tax return.

    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.

    If you share your policy with another adult, you can each request your own statement showing equal shares of the premium.

    Understanding the details on your statement

    The following information explains what each label on your private health insurance statement means:

    Health insurer ID

    This unique code helps us to identify your private 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.   

    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.

    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.

    The valid benefit codes are 30, 31, 35, 36, 40 and 41.

    If the oldest person's age is:

    • under 65, the code for the period 1 July to 31 March is 30 and the code for the period 1 April to 30 June is 31
    • 65 to 69, the code for the period 1 July to 31 March is 35 and the code for the period 1 April to 30 June is 36
    • 70 or over, the code for the period 1 July to 31 March is 40 and the code for the period 1 April to 30 June is 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 2018–19. You should receive something similar, by mail, email, or online link, from your private health insurer if you requested a copy.

    Example: Private health insurance statement

    Private health insurance statement, 1 July 2018 to 30 June 2019 – Stephen Smith

    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

    In situations where you have more than one line of information in the table above, you make sure each line is input separately into your income tax return. Do not add up amounts reported in any column or row to input its total.

    As shown below, the private health insurance statement will also include the number of days that your policy provided the appropriate level of private health hospital cover.

    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 2019 Individual tax return instructions question M2.

    End of example
    Last modified: 06 Jun 2019QC 49966