Lifetime Health Cover

The Lifetime Health Cover (LHC) is applied to your ‘base rate’ Hospital cover premium, prior to any Australian Government Private Health Insurance Rebates you might be eligible for. The LHC loading does not apply to Extras cover premiums.

Any LHC loading applied to your premium will be removed after maintaining 10 years of continuous Hospital cover.

Once you turn 31, you have until the following June 30 following your 31st birthday to get Hospital cover to avoid the LHC loading.

So, if you turned 31 on 1 Jan 2019, you have until midnight on June 30, 2019 to get Hospital cover before the LHC loading will apply.

If you are over 31 and missed the June 30 cutoff, take out Hospital cover as soon as possible to minimise the LHC loading. Each year you delay, your loading will increase by 2%, up to a maximum of 70%..

LHC loading does not apply for Australian citizens and residents, over the age of 31, with Hospital cover.

You also won’t have to pay the LHC loading if you:

• Had Hospital cover on 1 July 2000 and have maintained it since then.
• Were born on or before 1 July 1934.

Special rules apply to:

• New migrants to Australia who take up private health cover within a year of receiving their Medicare eligibility letter.
• Australian citizens or permanent residents returning to Australia who were overseas on the 1 July following their 31st birthday.
• Australian citizens or permanent residents returning to Australia who were over 31 and overseas on 1 July 2000.
• Members of the Australian Defence Forces, or those who hold a Department of Veterans' Affairs (DVA) Gold Card.
• Residents of Norfolk Island who have purchased a domestic private hospital product prior to 1 July 2017.

For more information, visit the Department of Health and Ageing website.

Yes. You can still upgrade or downgrade your Hospital cover without being impacted by LHC loading. The usual waiting periods and applicable pre-existing condition rules will still apply where cover is upgraded.

For couples, de facto couples or families, the total LHC loading on your Hospital cover is an average of the loading for each adult. Here are some examples of how this works:

Example 1

• Lisa and Brian took out Hospital cover on a base rate of $2,000 per year*, by 30 June.
• Lisa has an LHC age of 30 and Brian has an LHC age of 32.
• Lisa attracts a 0% LHC loading while Brian draws a 4% LHC loading, meaning the total average loading on the policy is 2% (0% + 4% = 4. 4 divided by 2 = 2%).
• The LHC loading on Lisa and Brian’s Hospital cover equates to an additional $40 per year and $400 extra over 10 years based on their current premium.

Example 2

• Amy and Steve took out Hospital cover on a base rate of $2,000 per year*, by 30 June.
• Amy has an LHC age of 35 and Steve has an LHC age of 37.
• Amy attracts a 10% LHC loading whilst Steve draws a 14% LHC loading, meaning the total average loading on the policy is 12% (10% + 14% = 24%. 24% divided by 2 = 12%).
• The LHC loading on Amy and Steve’s Hospital cover equates to an additional $240 per year and $2400 extra over 10 years based on their current premium.

*No rebate applied. LHC is an additional amount that you pay each year, applied on top of your premium.

If you are eligible for the Australian Government’s private health insurance rebate, this will apply to your ‘base rate’ Hospital cover premium excluding the LHC loading – you do not receive a rebate on your loading.

Lifetime Health Cover does not apply to Extras cover, Emergency Only Ambulance Cover and Premium Ambulance Cover. It only applies to Hospital cover.

The Australian Government recognises that there may be times when you need to drop your Hospital cover (for example, if you are travelling overseas for extended periods of time or are unemployed).

To cater for this, you can drop your Hospital cover for up to 1,094 days in total throughout your lifetime without incurring the Lifetime Health Cover loading when you take out Hospital cover again. These are known as ‘permitted days without hospital cover’.

Permitted days without Hospital cover are only available if you have held Hospital cover on or after your LHC base day and have been assigned a Lifetime Health Cover Age. Permitted days without Hospital cover do not count towards your days with continuous cover.

There are certain days that we won’t count towards your 1,094 days, including when you:

• Suspended your membership in accordance with fund rule.
• Are overseas for a continuous period of more than one year and have not returned to Australia for a period of more than 90 days.

Under LHC, you can transfer your Hospital cover between health insurers. All health insurers are obliged to recognise the Lifetime Health Cover Age of a new member transferring from another insurer. Any days that have been accumulated as permitted days without Hospital cover will also transfer across to your new insurer.

Remember if you have a break between switching from your old insurer to your new insurer, these may be permitted days without Hospital cover and will be included in your total of 1,094 days allowed before LHC loading is added to your cover.

All Bupa Hospital cover options, except any overseas visitor cover, allow you to lock in your Lifetime Health Cover Age.

No. To lock in your Lifetime Health Cover Age you need to hold Hospital cover.

Under certain circumstances you can suspend your Bupa membership (such as when travelling overseas) without affecting your LHC loading. Call us on 134 135 to see if you are eligible for this type of suspension. If you do suspend your cover, it’s important to remember that this won’t exempt you from paying the Medicare Levy Surcharge* if it applies to you.

*The Medicare Levy Surcharge is an additional tax on top of the Medicare Levy for Australian taxpayers who do not have an appropriate level of private patient hospital cover and earn above an income threshold.

Each year, Bupa will issue you with your Summary of Cover if you are paying the Lifetime Health Cover loading, which you can find in myBupa. We store your Summary of Cover along with any other tax statements for up to 7 years. Login to myBupa.

Maximum loading
The maximum loading allowed on top of the base rate is 70%. This translates to the maximum loading for a Lifetime Health Cover Age of 65 and above. However, once you have held private Hospital cover for a continuous period of 10 years your loading will be removed.

Lifetime Health Cover Age
Your age on 1 July before the day on which you take out Hospital cover.

Base rate
The 'base rate' for private Hospital cover is the standard premium payable for the cover if no loading or Australian Government private health insurance rebate applies.

Lifetime Health Cover base day
The deadline by which you must have taken out Hospital cover to avoid incurring a LHC loading. For most people this will be 1 July following their 31st birthday, although there are exceptions to this. If you are a new migrant to Australia, your LHC base day is the later of either:

• 1 July, following your 31st birthday.
• The anniversary of when you register for full Medicare benefits.