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Defence Community Organisation

For ADF members and their families

1800 624 608

Private health insurance

Before you transition, you should consider your health insurance needs. Medicare covers most Australian residents for basic health care, but it doesn’t cover everything. You can choose to take out private health insurance to give yourself a wider range of options and more comprehensive cover. There are two types of health insurance – hospital and general treatment (extras). You can buy them separately or most funds offer combined policies. The Government subsidises part of the cost of private health insurance through the Private Health Insurance Rebate.

As a permanent member of the ADF you’re considered to have had private hospital cover while serving. If you start a private health insurance policy the day after your transition, no waiting periods for benefits should apply. Your ADF Transition Coach can provide a Health Insurance Letter confirming the provision of full medical and dental healthcare during your service.

The Government encourages people to take up private health insurance through a range of health insurance initiatives.

  • The Medicare Levy Surcharge is a tax that affects people earning above a certain earning threshold who don’t hold private hospital cover. Visit privatehealth.gov.au for more information.

  • Lifetime Health Cover loading aims to encourage people to purchase private health cover when they are younger and to stay covered.

Lifetime Health Cover Loading is a surcharge for people at the age of 30 who don’t take out hospital insurance. The Lifetime Health Cover Loading surcharge applies on 1 July following your 31st birthday. An additional 2% loading fee is applied to your premium every year you don’t have hospital cover after age 30 and the loading is not removed until you have maintained cover for 10 years.

  • If you enlisted prior to 1 July 2000, you are considered to be 30 when you leave the ADF regardless of your actual age. For example, if you leave when you are 48, you are considered to be 30 and therefore the lifetime health cover loading surcharge will not apply to you yet.

  • If you enlisted after 1 July 2000, you are considered to be the same age at which you enlisted. For example, if you joined when you are 24, you are considered to be 24 and you won’t attract the Lifetime Health Covering Loading yet.

You have until 1 July before your 31st birthday to take out private hospital cover after you transition, before you are considered to not have private health insurance cover and subsequently attract a loading on your premiums under the Lifetime Health Cover loading rules. If you never take out private hospital cover and so pay no premiums, lifetime loading rules won’t affect you.

Health Insurance Rebate

Your rebate amount will depend on your household income and your age:

  • Income thresholds change on 1 July each year, they are currently frozen until 31 March 2019

  • Family threshold increases by $1500 for each child after the first

  • Rebates are adjusted annually on 1 April

You can calculate your rebate through the Australian Taxation Website.

My table caption
Policy Type Full Rebate Tier 1 Tier 2 Tier 3
Single < 90K 90,001 – 105K 105,001– 140K >140,001
Family <180K 180,001 - 210K 210,001 – 280K >280,001
Age PHI Rebate
Under 65 25.415% 16.943% 8.471% 0%
65-69 29.651% 21.180% 12.707% 0%
>70 33.887% 25.415% 16.493% 0%