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For the well-being of teachers & their families.

Lifetime Health Cover (LHC)

You don’t have to be old to get unexpectedly sick or to have an injury that requires hospital treatment. The government know this too, which is why they add a loading to your private health insurance contributions for each year you delay taking out Hospital cover after your 31st birthday. So it’s better to get in early, so that you don’t end up paying for it later.

What is LHC?

The Federal Government Lifetime Health Cover initiative rewards those who take out Hospital cover earlier in life, allowing them to pay a lower contribution compared to others who take out Hospital cover when they’re older.

When does the loading apply?

If you delay taking out Hospital cover, you will pay a 2% loading on top of the base contribution amount for every year you are over the age of 30 until you first take out Hospital cover.

This loading will only apply to Hospital cover – not to Extras or Ambulance cover.

This includes Top Hospital, Private Hospital Saver, Public Hospital, CoreElect and StarterPak.

How does it work?

When you first purchase Hospital cover, you are assigned an age which is then referred to as your ‘certified age at entry’ (CAE). If your CAE is 31 or more and you have not previously held Hospital cover, you will be required to pay the Lifetime Health Cover loading.

If this is the case, once you take our Hospital cover you will lock in the loading percentage you are subjected to and after 10 years of continuous Hospital cover, the loading will be removed.

You are able to drop your Hospital cover for a cumulative period of 1094 days (one day less than three years) in your lifetime without affecting your CAE. On the 1095th day your LHC loading will increase by 2%, and will continue to increase by 2% for every year you are without Hospital cover. As a Teachers Health Fund member you can suspend your Hospital cover without incurring days of absence if you:

  • are overseas for more than three months and under 36 months, or
  • have had a suspension of Hospital cover granted by Teachers Health Fund

Examples:

    • Nathan turned 31 on 20 May 2011. He took out Hospital cover for the first time with Teachers Health Fund on 27 June 2011. Nathan’s CAE is 30, so he does not pay a loading on his health fund contribution amount.
    • Sarah turned 39 on 20 April 2011. She took out Hospital cover for the first time with Teachers Health Fund on 30 May 2012. Sarah’s CAE is 38 (the age she was last 1 July) and will be required to pay the LHC loading. Her loading will be 16%, which is a 2% loading for each year she is over the age of 30 before taking out Hospital cover.
    • Sam is 32 years old. He currently holds Hospital cover with another health fund but would like to transfer to Teachers Health Fund. His CAE is 30. When he transfers to Teachers Health Fund, his CAE will not be affected and he will not have to pay a loading on his health fund contribution amount.
Your age on 1 July prior to taking out Hospital cover Lifetime Health Cover loading Your age on 1 July prior to taking out Hospital cover Lifetime Health Cover loading
30 and under 0% 48 36%
31 2% 49 38%
32 4% 50 40%
33 6% 51 42%
34 8% 52 44%
35 10% 53 46%
36 12% 54 48%
37 14% 55 50%
38 16% 56 52%
39 18% 57 54%
40 20% 58 56%
41 22% 59 58%
42 24% 60 60%
43 26% 61 62%
44 28% 62 64%
45 30% 63 66%
Related Resources

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You

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Your Cover

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Your Rebate

All Australian residents, who are entitled to Medicare, are able to claim an income tested rebate on their private health insurance; would you like to apply your rebate?

For individuals earning between $88,001 - $102,000 (or $176,001 - $204,000 for families*).
*For families with children, the thresholds are increased by $1,500 for each child after the first.

How rebate tiers workX

Most Australians with private health insurance currently receive a rebate from the Australian Government to help cover the cost of their premiums. The private health insurance rebate is income tested. The table below details the different rebate amounts and Medicare Levy Surcharge levels.

The rebate applies to hospital, general treatment and ambulance policies. It does not apply to overseas visitors cover. The rebate levels applicable for 1 July 2013 to 30 June 2014 are:

Singles
Families
≤$88,000
≤$176,000
≤$88,001-102,000
≤$176,001-204,000
≤$102,001-136,000
≤$204,001-272,000
≤$136,001
≤$272,001
Rebate
< Age 6530%20%10%0%
Age 65-6935%25%15%0%
Age 70+40%30%20%0%

Single parents and couples (including de facto couples) are subject to family tiers. For families with children, the thresholds are increased by $1,500 for each child after the first. http://www.privatehealth.gov.au/healthinsurance/incentivessurcharges/insurancerebate.htm