Private ruling: Medicare levy surcharge
Published: December 2012
Ruling period: Year ending 30 June 2012
Date scheme commenced: 1 July 2011

Ruling: Q1: Does your international health insurance policy qualify as a complying health insurance policy for Medicare levy surcharge (MLS) purposes? | A1: No.


Relevant legislative provisions: Medicare Levy Act 1986 Subsection 3(5)

Reasons for decision: Summary: The MLS is in addition to the Medicare levy. The MLS is payable if you or your dependants did not have an appropriate level of private patient hospital cover for the whole of the 2011-12 financial year and your taxable income was above the surcharge threshold amount. An appropriate level of private patient hospital cover is cover provided by an insurance policy issued by a registered health insurer for hospital treatment in Australia. Subsection 3(5) of the Medicare Levy Act 1986 (MLA) states that a person is covered by an insurance policy that provides private patient hospital cover if the policy is a complying health insurance policy (within the meaning of the Private Health Insurance Act 2007 (PHIA)) that covers hospital treatment. The Private Health Insurance Administration Council (PHIAC) administers the PHIA 2007 and maintains on its website ( www.phiac.gov.au) an up to date record of all private health insurers providing complying policies. Your overseas health Insurer does not appear on the PHIAC's website. This health insurance plan is not a complying health insurance policy within the meaning of the PHIA and does not satisfy the requirement of subsection 3(5) of the MLA. While we accept that your spouse has hospital cover with an approved provider, your policy is not an approved hospital cover with a registered fund under the PHIA. There are no other exemptions that apply to your specific circumstances therefore you are liable for the MLS.

Please check this edited version to be sure that there are no details remaining that you think may allow you to be identified. If you have any concerns about this ruling you wish to discuss, you will find our contact details in the fact sheet. | Relevant facts: You have private health insurance provided by an overseas country which covers you in Australia but is not a complying health insurance policy. | You have been paying this insurer for full hospital cover. | You have provided copies of this policy and bank statements