Private Health Insurance Benefit Code

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Last Updated 21/01/2025
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Last Updated 21/01/2025

Our aim is to help you make better informed decisions. That’s why iSelect’s content is produced in accordance with our fact-checking and editorial guidelines.

Find out more about how we make money.

View our Privacy Policy.

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Long story short

1
Your private health insurance benefit code helps you claim the private health insurance rebate

It lets the government know the age of the oldest person on your policy.

2
You’ll also need your tax claim code

This tells the government about your circumstances, including whether you have a partner and whether you’re claiming for the both of you.

3
Usually, your health fund tells the Australian Taxation Office what your benefit code is

It’s often pre-filled on your tax forms, so you don’t have to worry about it.

What is a health insurance benefit code?

The Australian Taxation Office (ATO) needs to check an awful lot of tax returns each year. Using codes helps to make things more efficient – and avoid mistakes that mean you don’t get the right amount back or, worse, end up paying more. 

The health insurance benefit code tells the ATO the age of the oldest person covered on your policy. With this information, they’ve got part one of two for figuring out your private health insurance rebate.  

What is my benefit code?

Your benefit code depends on two things: your age and the period you’re claiming for. There tends to be a different code for two separate periods during the year, since there’s an annual premium rate change that usually happens around 1 April. This way, your rebate percentage more closely aligns with what you paid in premiums. 

If the oldest person on your policy ages into another bracket during the year, an additional code will then apply. It’s okay if that’s not the birthday present you were hoping for, though. 

Period Age of the oldest person on your policy Private health insurance benefit code 
1 July – 31 March Under 65 years old 30 
65–69 years old 35 
70 years old or older 40 
1 April – 30 June Under 65 years old 31 
65–69 years old 36 
70 years old or older 41 

Conveniently, your health insurance benefit code tends to be pre-filled automatically on your tax. Otherwise, you can double-check it by looking at Label L on your private health insurance tax statement. 

Is a benefit code different from a tax claim code?

Your tax claim code tells the ATO about your circumstances, like if you have any dependents. By looking at it alongside your benefit code, they can then give you the proper rebate. 

Marital status Your circumstances Tax claim code 
Single  You have no dependents. 
You have a dependent. 
You paid for a policy that only covers a dependent. 
Married or de facto You’re a parent with a policy that only covers a dependent. 
You have a spouse and want to claim only your own share of the rebate. 
You want to claim both your share and your spouse’s share of the rebate. 
Your spouse isn’t claiming their share of the rebate and has agreed you should claim it. 
Your spouse is claiming your share of the rebate. 
Not applicable You were listed as a dependent on a private health insurance policy. 
iSelect illustration entitled Code Case Studies with two examples. A female figure with a child with text 'Shannon held a hospital policy in 2023-24 that only covered their 13-year-old son. Shannon's benefit code would be 30 and 31, while their tax code claim code would be B'. A second example is a male figure and female figure with the text 'Courtney and Liam had a couples combined policy in 2023-24. Courtney is 68, while Liam is 71, Liam has agreed that Courtney will claim both their shares of the rebate. Courtney and Liam would use the same benefit codes: 40 and 41. Courtney's tax claim codes would be C and D. Liam's tax claim code would be E.

How much is my private health insurance rebate?

Assuming you meet the eligibility requirements for the rebate, like not earning over the threshold,1For more information, see ATO – Private health insurance rebate eligibility your rebate rate depends on the age of the oldest person on your policy and your income for surcharge purposes. That’s the same income figure the ATO uses to work out whether you need to pay the Medicare Levy Surcharge; it’s more than just your taxable income.  

The rebate rates can change from year to year, so you might not receive the same amount every time. 

Family status Age of oldest person covered on policy Income for surcharge purposes Rebate rate for 1 July 2024– 30 June 2025 
Single person Under 65 years old $97,000 or less 24.608% 
$97,001–$113,000 16.405% 
$113,001–$151,000  8.202% 
$151,001 or more  Not eligible 
65–69 years old $97,000 or less 28.710% 
$97,001–$113,000 20.507% 
$113,001–$151,000  12.303% 
$151,001 or more  Not eligible 
70 years old or older $97,000 or less 32.812% 
$97,001–$113,000 24.608% 
$113,001–$151,000  16.405% 
$151,001 or more  Not eligible 
Family Under 65 years old $194,000 or less 24.608% 
$194,001–$226,000 16.405% 
$226,001–$302,000 8.202% 
$302,001 or more Not eligible 
65–69 years old $194,000 or less 28.710% 
$194,001–$226,000 20.507% 
$226,001–$302,000 12.303% 
$302,001 or more Not eligible 
70 years old or older $194,000 or less 32.812% 
$194,001–$226,000 24.608% 
$226,001–$302,000 16.405% 
$302,001 or more Not eligible 

Source: Privatehealth.gov.au – Australian Government Private Health Insurance Rebate 

The private health insurance rebate is certainly one way to look at reducing your health insurance premiums. However, you can also try other things, like changing your cover, and shopping around. The great thing about these tricks is that anyone can try them – there isn’t an eligibility cut-off. 

Andres Gutierrez

General Manager – Health

Where can I find and compare health insurance?

Before you can start claiming the private health insurance rebate, you’ll need to have some health insurance. iSelect can help you find and compare policies in far less time and with much less effort than it takes to do your tax. Start comparing online or over the phone at 1800 784 772 today.  

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