Are you a migrant who has had to pay a Lifetime Health Cover loading on your private health insurance that covered years after age 31 when you didn’t yet live in Australia?
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I though they were exempt from the LHC for a period of up to 12 months after they get full Medicare registration?
From the privatehealth.gov.au website:
"New migrants to Australia
If you are a new migrant to Australia, then you have until the later of 1 July following your 31st birthday or the first anniversary of your full Medicare registration to take out private hospital cover without incurring a Lifetime Health Cover loading.
If the latter applies to you, your Lifetime Health Cover base day is the 12 month anniversary of your registration for full Medicare benefits (i.e. when you are eligible for a blue or green Medicare card).
However if you are subsequently overseas on your Lifetime Health Cover base day and if you registered with Medicare on or after 1 July 2009, then you will not have to pay a Lifetime Health Cover loading if you purchase hospital cover within 12 months of your return to Australia. The anniversary of your return to Australia becomes your new Lifetime Health Cover base day."
I have to pay it as an aussie citizen who lived overseas when it was first introduced and over the age of 31 when returning. Doesn’t seem to matter who I contacted, nobody wanted to know or care. I took out insurance within a month or so of arriving back here, but still didn’t change the outcome.
@grahroll beat me to that. The text at http://www.privatehealth.gov.au/healthinsurance/incentivessurcharges/lifetimehealthcover.htm also states that for Aussies
Overseas on the 1st of July following your 31st birthday - if you are an Australian citizen or permanent resident who is overseas on the 1st of July following your 31st birthday, and your 31st birthday falls after 1 July 2000, you will not pay a Lifetime Health Cover loading if you purchase hospital cover by the first anniversary of the day you return to Australia. You are able to return to Australia for periods of up to 90 consecutive days, per visit, and are still considered to be overseas. If you do not purchase hospital insurance during this one year grace period and purchase insurance later, then loading will be applied based on your age at the date of joining.
You might need to start with an International Movement Record as described at the bottom of that web page and move forward from that. Our government is not known for being helpful for anything that reduces their revenue from us, earned or unearned, as individuals.
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Thanks everyone. The issue I’m interested in is the application of a LHC loading levy to non-citizen migrants for the years after age 31 before they migrated to Australia, years during which they did not have Australian private health insurance (for obvious reasons, since they didn’t live in Australia).
Consider this real-life case study we’re looking at:
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A person moves to Australia at age 45 and takes out private health insurance (PHI) two weeks past the 365-day deadline to avoid LHC loading. This person had not heard of LHC, nor had his Australian wife. It was a coincidence that he was so close to the deadline. (Note: this information is ostensibly communicated to migrants, but not very effectively it would seem.)
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Because this person missed the deadline, the private health insurer applies a whopping 32% LHC loading. It means that 2% was added for every year after age 31 that the person did not have Australian private health insurance. The kicker is that the person did not migrate to Australia until age 45, so in effect he has been penalised for accessing the Australian healthcare system without PHI for the 14 years between ages 31 and 45 (28%) - years when he did not live in Australia and could not have accessed the Australian healthcare system - plus another 2% for each year as a resident of Australia without PHI, even though he was only about two weeks into his second year. During the years between ages 31 and 45 he held PHI in his own country.
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He appealed to his insurer to no avail regarding his situation, though his Australian wife (who had 1094 days, not 365, to take out PHI upon returning to Australia without incurring an LHC loading) was reimbursed about $2200 after providing an International Movement Record.
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Question: Is it fair to have to pay LHC loading for years before migrants actually moved to Australia?
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I think they may have used the Australian Resident guidelines in assessing his LHC and if he was an Australian Resident before arriving in Australia then perhaps they are correct by the “Letter of the Law”.
However if he was a new migrant the dot Gov website states that his base day is the 12 Mth Anniversary after his registration for full Medicare benefits. So he should only have had 2% added in this case. Perhaps a complaint (http://www.ombudsman.gov.au/making-a-complaint) to the Commonwealth Ombudsman in their role as the Private Health Insurance Ombudsman (http://www.ombudsman.gov.au/about/private-health-insurance) or an appeal to the AAT would be a step that should be taken.
To the question posed, I think it is grossly unfair to impose penalties on people who have as yet not resided in Australia. This though seems to be covered in the website where it states that the new Migrant is only assessed for LHC once the 12 Mths period after they became registered for Medicare full benefits has expired and that anniversary is considered the base date.
Also if a person has had Health Insurance coverage in their Country why are we then imposing a surcharge for non-coverage?
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It is not fair (been there, arriving from the US as an “over 50” and who was never without medical insurance, but fortunately government corrected the problem so there was minimal personal impact). The legislation is very clear about how it affects new migrants as well as travelling citizens.
One cannot make legislation with soft discretionary boundaries or the “rule of law” becomes discretionary also.
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Personally I think it is grossly unfair. My partner is now in the same situation as he never realised this was required and is now facing a massive 40%+ penalty. He didn’t arrive in Australia until he was nearly 40, and as migrant myself I know that nobody ever tells you directly that this is required. I was fortunate that I have a well-paid job and just happened to take it out in my first year here. He was in low-paid job and it just never occurred to him to take out health insurance. Medicare should tell migrants EXPLICITLY that if they don’t take it out at least basic hospital cover in their first year then this is what happens.
I lived in the UK from ages 23-33. When I returned to Australia, I had to show evidence that I had been living overseas by going to immigration to get my international movements and then the exemption to LHC was issued.
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It is not Medicare’s responsibility to sell private health insurance. It seems to be quite clear that you have 12 months grace after arriving to take out private health insurance regardless of your age on arrival. Seems reasonable to me. After all private health insurance is not compulsory.
An honest question is whose responsibility it is, if anyone’s, to advise new migrants of the norms and rules of government rules and services of their adopted country. Some are in one’s face early on, eg what one is and is not entitled to and when, but others such as the lifetime load are not so obvious until you shop for private health. With medicare many migrants would not be interested until they became quite settled, and reasonably could miss the window.
I don’t think it is anyone’s responsibility to tell migrants - or anyone come to that - about private health insurance. Perhaps the whole issue of private health insurance could be in the migrant pack everyone gets with their visa along with the information about English lessons! But I think it would still be hard sell (except perhapsfor those from countries with no or little public health who are used to having health insurance e.g. USA). Most others would be very happy with medicare.
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Who should tell newly arrived citizens?
I arrived in Australia at age 45. I had lived in the U.K. and was philosophical committed to public healthcare. There was no ‘welcome pack’ or other information from the government to inform me that I had a year’s grace with regard to the loading.I used an Australian accountant to set up a small business and file my tax returns. He offered no advice with regard to private health cover and its tax implications. It took me several years to realize that private healthcare is much more common here and as my income rose I was faced with additional taxes if I did not take private healthcare. When I applied for cover I was quoted the standard premium. When the bill arrived it contained a 43% loading! The insurers blamed the government! I have just finished paying 10 years of the loaded premiums and am now back to standard premium. My point is, if an English speaking, degree educated, Choice reading (Which, in the U.K.) person like me gets caught in this way, what chance for anyone with English as a second language? There is lots to love about Australia but we sure do pay over the odds for goods and services.
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@AndyKollmorgen’s article on lifetime health cover loading for migrants is here. Thanks for all the contributions to this thread 
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Interesting discussion re where responsibility falls.
It seems to me the Government is loading the cost of private health with what is essentially a penalty amount which appears to be collected for them by the private health fund you insure with? Obviously they can’t warn you, they don’t know you are coming so to speak …
The Department of Health and Aging seem to be behind the loading, but I’m not sure that a migrant’s path would cross that of Department of Health at time of immigration?
The paths that do cross are the migrant and Department of Human Services when the migrant applies for a Medicare card - and while it is not their responsibility to recommend or sell private health, it is the act of obtaining the Medicare card that starts the one year deadline clock ticking - maybe DHS are linked back to DH&A, but it’s DHS who run Medicare and that’s the trigger point - so my view is that when the migrant receives their medicare card, DHS/Medicare should be informing them as part of that process that the clock is ticking to get private health and avoid the loading.
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