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What Is My Benefit Code For Private Health Insurance? 

Find out all about benefit codes for private health insurance and what they are here with Savvy.

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, updated on July 10th, 2023       

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Health Insurance Banner - Middle-aged couple completing their tax returns on their computer

If you’re completing your Australian tax return, you may be wondering what your benefit code is for private health insurance. The benefit code on your private health statement tells the tax office the rebate you’re eligible for, based on your age and personal circumstances.  

Find out all about benefit codes, where to find them and how they may affect your private health insurance tax rebate right here with Savvy.  

What is a benefit code in private health insurance?

On an Australian tax return form, there is a section you’re required to complete which provides the ATO with details of the private health insurance you’ve paid for in that financial year. The details you provide in this section of the tax return (in the form of a tax claim code and a benefit code) will determine the private health insurance rebate you receive. 

The benefit code you must supply is a unique identifier which helps the Australian Taxation Office (ATO) identify the private health insurance coverage you've paid for in that financial year in relation to your age. The code is used to determine the amount of private health insurance rebate you will receive and is based on the age of the oldest person listed on the policy, and the time period when premiums were paid.  

If you didn’t have appropriate hospital cover in the financial year, and so do not supply a relevant benefit code, you may be liable to pay the Medicare Levy Surcharge if you earn an eligible income. 

There are two rows on the form which relate to the months in the year when premiums for health cover were paid. The first row is for premiums paid between 1 July and 31 March, and the second row for premiums paid between 1 April and 30 June. The appropriate codes are as follows*: 

Age of oldest policyholder Benefit Code: 1 July to 31 March Benefit Code: 1 April to 30 June
Under 65
30
31
65-69
35
36
70+
40
41

*Correct as of May 2023. 

How do I know what my correct benefit code is?

Your benefit code can be found on your private health insurance statement which was supplied to you when you first took out your private health insurance policy, or when you first received a quote for your health cover. You can always contact your health fund and request this information again if you can’t find your original policy documents. 

In addition, all health funds must supply policyholders with an annual tax statement. This details the information required by the ATO about the private health insurance you've paid for in that financial year, including the benefit code which applies to you. 

However, your health insurer may no longer send this tax statement directly to you if you've previously submitted your tax return online or through a tax agent. The information may be submitted electronically and may be pre-filled in your electronic tax return. This means you won’t have to manually enter your benefit code, as it will already be in the form. 

What is a tax claim code in relation to health insurance?

A tax claim code is similar to a benefit code in that it tells the tax office about your rebate status. Tax claim codes are either A, B, C, D, E or F, with each one describing a different personal situation. For example, there are codes for single people, single parents, couples and more. 

The code definitions are as follows*:

Code Description
Tax code A
Single adult on 30 June
Tax code B
Single adult on 30 June with dependent child/children
Tax code C
Policyholder with spouse on 30 June (including if spouse passed away during the tax year and policyholder did not have another spouse before 30 June)
Tax code D
Policyholder with spouse on 30 June and claiming their share of rebate because spouse isn't claiming it themselves
Tax code E
Policyholder with spouse on 30 June and agreeing that spouse should claim policyholder's share of rebate because policyholder isn't claiming it themselves
Tax code F
Dependent child covered under a private health insurance policy and not entitled to receive the rebate

*Correct as of May 2023. 

You will need both your tax claim code and benefit code to correctly fill in your tax return, although, as already mentioned, this information may be pre-filled in your tax return if you've previously submitted your tax information electronically.

More questions about benefit codes and private health insurance

What is the private health insurance rebate in Australia?

The private health insurance rebate is a government subsidy that helps to reduce the cost of private health insurance premiums for eligible policyholders. The rebate amount varies depending on the policyholder's age and income, and can either be claimed annually through your tax return or in the form of reduced premiums through your health fund. 

Will my tax professional be able to advise me about my benefit code?

Your tax professional may be able to access your private health insurance tax statement online and see what your benefit code is, or the tax office may already have the relevant details from your health fund when you go to complete your tax return. If not, you can always request this information from your private health insurer. 

Is the private health insurance rebate means-tested?

Yes – the private health insurance rebate is means-tested, which means that your income will affect the rebate you receive. The rebate is reduced as your income increases and may be completely phased out for high-income earners. 

Can I receive the private health insurance rebate if I have Overseas Visitor Health Cover?

No – the private health insurance rebate is only available to eligible Australian residents who hold a complying hospital cover health insurance policy. Those who hold Overseas Visitor Health Cover aren’t eligible for the rebate. 

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