Written by A benefit code 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'll receive and is based on the age of the oldest person listed on the policy and the period when premiums were paid.
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 benefit code and tax claim code you provide helps determine what rebate you'll receive.
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*:Â
| 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 January 2025.
If you didn’t have appropriate hospital cover in the financial year, and don't supply a relevant benefit code, you may be liable to pay the Medicare Levy Surcharge if you earn an eligible income.
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.Â
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.Â
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.Â
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.Â
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 January 2025.Â
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.
The types of health insurance
More questions about benefit codes and private health insurance
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.
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.
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.
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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