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Health insurance terms for new members

To help you understand your health insurance, here are a few terms for you to get to grips with:

Lifetime Health Cover

LHC - an additional loading you are required to pay if you take out hospital cover after the first of July following your 31st birthday. If you join a health fund after you turn 31 you must pay an extra loading on your base rate premium equivalent to 2% for every year by which you delay joining (also referred to as "penalty for late entry"). Find out more.

You may also hear these terms in reference to the LHC:

Absent days - to cover small gaps, such as switching from one fund to another, you are able to be without hospital cover for periods totalling 1094 days (i.e. three years less one day) during your lifetime, without affecting your LHC.

CAE (Certified Age of Entry) - the age at which you first took out hospital cover, which is used to calculate how much LHC loading you need to pay.

Combined Lifetime Health Cover Loading: For a family policy the average age (CAE) of the two adults will be used to calculate the LHC loading that will apply.

Australian Government Rebate

Families and individuals who pay private health insurance premiums may be eligible for the Australian Government Rebate on Private Health Insurance. You may take this as a reduction in your ongoing payments or claim it back at a later date.

Rebate tier - There are three rebate tiers which are based on the amount of money you and your family earns. These tiers determine how much of a rebate you will receive to assist you to pay your premiums. Find out more.

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