Private health insurance rebate: Everything you need to know

Are you struggling to navigate the sometimes-complicated world of private health insurance? Given the current economic climate, plenty of Aussies are tightening their purse strings wherever possible. But that doesn’t mean you should cancel your private health cover – especially if you’re entitled to a health insurance rebate.

Any type of government kickback could provide a much-needed boost come tax time. So here’s what you need to know about the private health insurance rebate.

This rebate isn't just a government initiative – it’s an incentive to secure quality healthcare without burning a hole in your pocket.

So what exactly is it? Simply put, the rebate is a helping hand from the government to make private health insurance more affordable for you. Think of it as an excess private health insurance premium reduction or refund – with the added benefit of you having private cover in case you’re ever injured or get sick.

Also known as the Australian Government Rebate (AGR), the government chips in for a portion of your health insurance premiums depending on your age and income. The lower your income and the older you are, the more the government coughs up. It’s like a tailored discount that eases the burden on your wallet. If you're eligible for it, you can make a claim either by having it deducted upfront from your premiums, or by grabbing it back as a refundable tax rebate when you file your annual return.

Wondering if you qualify? Well, if your taxable income is $144,000 or less as a single, or up to $288,000 as a family, you’re in the sweet spot. There are different tiers based on income thresholds, and as long as you stay within these limits, you’re eligible to take advantage of the private health rebate.

If you’re one of the many Australians who decided to take out private health insurance to avoid having to pay the Medicare levy surcharge, then the good news is you might be eligible for some extra savings thanks to this government rebate.

Now that you know what the private health insurance rebate is and how you can claim it, you probably want to find out the most important bit: how much can you actually save? Picture it like a discount that’s personalised to your age, income and family situation.

The rebate comes in four tiers, which we’ll go into deep in the next section. Your income and age determine which tier you fall into, but essentially if your income is over $144,000 as a single or more than $288,000 as a family then you won’t be able to claim any rebate at all. For the rest of us, the government’s got your back.

If you’re aged under 65 and earn below the lowest threshold, you’ll be in the Base Tier which offers a very healthy rebate of 24.608%. As you get older and hit the 65-69 mark and then the 70+ age brackets, your rebate increases – so long as your income stays the same. It can get a little complicated and it’s easier to visualise in a table, so read on to see exactly what rebate percentage you’re entitled to.

The following figures are correct for the 2023–24 financial year, according to the ATO. Bear in mind that the income thresholds have risen since the previous financial year.

Still confused? Let’s break it down: if your health insurance premiums are $1,000, you could save up to $328.12 per year. That’s nearly a third of your annual premiums covered by the government. And it’s real money back in your pocket.

This tax rebate isn’t a one-size-fits-all deal. Eligibility is where the rubber meets the road, so here’s what you need to factor in:

• Income matters: To qualify, your taxable income should be less than $144,001 as a single or $288,001 as a family. The government only pays out for those in specific income brackets.
• Citizenship and Medicare card: You must be an Australian citizen or permanent resident with a valid Medicare card. The private health insurance rebate is designed to support those with a stake in the Australian healthcare system.
• Private health insurance: You’ll need to currently have a private health insurance policy from an Australian-registered insurer.
• Family tiers: If you’re in a family set-up with your health cover, whether it’s as a couple or a family with kids, you’ll be considered a family unit for rebate purposes. Your income threshold increases by $1,500 for each dependent child after the first.
• Overseas visitors cover exemption: The private health insurance rebate doesn't apply to overseas visitors health cover.
• Lifetime health cover: If you have lifetime health cover (LHC) loading, the rebate doesn't apply to the LHC component of your premiums. But don't worry, LHC loading disappears after 10 continuous years of having hospital cover.

Claiming the rebate is straightforward and can be done via two easy methods:

• Method 1: The first option is to have the rebate applied directly to your health insurance premiums. This means you’ll pay less upfront to your insurer, as they will adjust your premiums based on your estimated income. If you plan on going down this route, you need to share your estimated income with your health fund, and they will calculate the premium reduction for you. You can initiate this process by filling out a Medicare rebate claim form.
• Method 2: The second approach is to claim your rebate as a refundable tax offset when you file your annual tax return. With this method, the ATO will reconcile your estimated income with your actual income reported on your tax return. This guarantees you’ll receive the correct rebate amount.

No matter which option you choose, the good news is that the process is super user-friendly and doesn't involve any complex paperwork or hours spent trying to figure things out. Whether you prefer immediate savings on premiums or a financial windfall come tax time, the decision is yours.

The private health insurance rebate is a welcome gift for many Aussies who are trying to save money while still keeping their private health cover. Whether you opt for reduced premiums or an end-of-year refund, the rebate can be flexible to your unique circumstances.

Bottom line? If you’re wondering whether you can afford private health insurance right now, the rebate can be a valuable lifeline. You’ll get the peace of mind knowing you have great health cover without having to break the bank. Because looking after your physical health shouldn’t mean neglecting your financial health.