What should we check when our health insurance renews?

What you need depends on your visa. Temporary visa holders usually must keep health cover as a visa condition. Permanent residents use Medicare, and private hospital cover then becomes a tax and timing decision.

Temporary visa holders: condition 8501

If your visa has condition 8501 (check your grant letter or VEVO), you must keep adequate health insurance for yourself and your family on the visa for your whole stay. Home Affairs says the cover must pay for medically necessary treatment, and recommends cover for GP and specialist visits, hospital treatment, medical devices and prescription medicines. Policies with a buy-out clause don’t count.

UK residents can enrol in Medicare under the reciprocal health care agreement. It covers medically necessary care outside hospital, treatment as a public patient in a public hospital and some PBS medicines. It ends when your visa expires, and it doesn’t cover private hospitals, ambulances or dental work. That’s why most people on work visas also hold Overseas Visitors Health Cover (OVHC). Hospital care for visitors without cover can cost more than A$1,000 a day, even in a public hospital.

What to check at OVHC renewal

• That the policy still says it meets condition 8501, and covers everyone on your visa
• Waiting periods and pre-existing conditions: some OVHC policies exclude pre-existing conditions entirely. Most apply a 12-month wait
• Pregnancy: check the waiting period well before you plan a baby
• Ambulance cover: check it’s included, as it’s expensive without it
• The excess and any gaps you pay towards specialists and hospital bills
• Never let the cover lapse, even for a day: a break could breach your visa condition

Medicare holders: private hospital cover

Permanent residents and citizens are covered by Medicare for public hospital treatment. Private hospital cover adds choice of doctor and private hospital treatment, and affects your tax. When you switch insurer or policy:

• The government caps hospital waiting periods: 12 months for pre-existing conditions and for pregnancy and birth, and 2 months for most other treatment
• A pre-existing condition is one you had signs or symptoms of in the 6 months before you joined or upgraded, even if it wasn’t diagnosed
• If you move to an equal policy, you shouldn’t have to serve waiting periods again, as long as you switch within the time allowed. Upgrading means new waits on the extra benefits
• Extras cover (dental, physio, optical) has waiting periods set by each insurer

Medicare levy surcharge 2026–27

If you’re eligible for Medicare and don’t hold appropriate private hospital cover, you pay an extra surcharge in your tax return once your income for surcharge purposes passes the threshold:

Family thresholds go up by A$1,500 for each child after the first. Income for the surcharge includes reportable fringe benefits and some super contributions, so it can be higher than your taxable income.

Lifetime Health Cover: the timing rule

If you don’t take out hospital cover by your “base day”, you pay a loading of 2% on hospital premiums for every year you’re over 30 when you join, up to 70%. The loading is removed after 10 continuous years of cover.

• Usually, your base day is 1 July after your 31st birthday
• For new migrants, it’s the later of that date and the first anniversary of your full Medicare registration
• Reciprocal Medicare as a UK visitor doesn’t count, so for most British people the clock starts when they get full Medicare as a permanent resident
• If you miss your base day, the loading is worked out from your age when you do join: joining at 36, for example, adds 12%
• Ask Services Australia (13 20 11) for a letter confirming your registration date, and give it to your insurer

The rebate and the 1 April price rise

Most insurers raise premiums every 1 April. In 2026 the approved average rise was 4.41%, from 1.98% to 5.98% depending on the insurer. The government’s private health insurance rebate reduces your premium, by income:

People aged 65 and over get a higher rate now. The government plans to give everyone the same rate within each income tier from 1 April 2027, if Parliament passes the law.