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General information and comparison estimates only. Not financial, credit, tax, legal or health advice, and it does not consider your circumstances.General information and estimates only. Not financial, credit, tax or health advice.

Methodology and sources

HealthSense shows the maths for a person in a given situation. Here is exactly how every number is worked out, and where each rate comes from. Nothing is a black box.

The premium chain

A policy premium is built in a set order, because the order is set by law. The government rebate does not apply to the Lifetime Health Cover loading, and the loading applies only to the hospital part of the premium.

standard = base premium x (1 - age discount)
loading  = hospital component x (1 - age discount) x LHC rate
final    = standard x (1 - rebate) + loading

Medicare Levy Surcharge

The surcharge is a percentage of your income for surcharge purposes, levied for any part of the year you hold no complying hospital cover. Our calculators assume a whole year. Tiers for 2026-27: a single is over the threshold above $105,000, a family above $210,000, with $1,500 added per dependent child after the first. Rates step from 1% to 1.25% to 1.5%. Source: ATO and privatehealth.gov.au.

The government rebate

The rebate reduces your premium by a percentage set by income tier and by the age of the oldest person covered. It is adjusted every 1 April. The base rate for under-65s from 1 April 2026 is 24.118%. Source: PHI Circular 12/26 and privatehealth.gov.au.

Lifetime Health Cover loading

If you first take hospital cover after your base day, which is the 1 July following your 31st birthday, you pay a 2% loading for each year you were aged over 30, based on your age at the 1 July before you joined. The loading is capped at 70% and is removed after 10 continuous years of cover. For a couple, the loading is the average of both people. Source: privatehealth.gov.au.

Age-based discount

Insurers may offer a discount on hospital cover of 2% for each year you are under 30 when you first take it out, up to 10% for ages 18 to 25. It is retained until age 40, then reduces by 2% a year to zero by age 45. Source: privatehealth.gov.au.

Which premium we use

For the surcharge decision we take the cheapest complying, surcharge-exempt hospital or combined policy for your state and cover type from the monthly PrivateHealth.gov.au data, then run it through the premium chain with your rebate, loading and any discount. We show only the cheapest compliant options a decision needs, not the whole market.

Assumptions

  • The surcharge is calculated for a whole year.
  • Lifetime Health Cover removal assumes 10 years of continuous cover.
  • Premiums are annual comparison figures from the published data.
  • Figures use the financial year that applies to today's date.

Data and licence

Product and premium data is sourced from PrivateHealth.gov.au via data.gov.au, © Commonwealth of Australia, licensed under CC BY 3.0 AU. The data refreshes monthly.

General information only

HealthSense is general information. It is not personal or financial advice, and it does not take your personal circumstances into account. Premiums shown are comparison figures. The insurer quote is the source of truth.