Document ID: chunk:federal_register_of_legislation:C2025C00097:section:3:p5
Version: federal_register_of_legislation:C2025C00097
Segment Type: section
Provision Reference: s 3 (pt 5/18)
Character Range: 45346–47915

an *adult who takes out *hospital cover after his or her *lifetime health cover base day, means the adult's age on the 1 July before the day on which the adult took out the hospital cover.

34‑5  Increased premiums for person who ceases to have hospital cover after his or her lifetime health cover base day
 (1) A private health insurer must increase the amount of premiums payable for *hospital cover in respect of an *adult if, after the adult's *lifetime health cover base day, the adult ceases to have hospital cover.
 (2) The amount of the increase is worked out as follows:

where:
base rate is the *base rate for the *hospital cover.
years without hospital cover is the number obtained by:
 (a) dividing by 365 the number of days (other than *permitted days without hospital cover), after the first day on which subsection (1) applied to the *adult, on which he or she did not have *hospital cover; and
 (b) rounding up the result to the nearest whole number.
 (3) Any increase under this section in the amount of premiums payable for *hospital cover is in addition to any increase under section 34‑1 in the amount of premiums payable for that hospital cover.

34‑10  Increased premiums stop after 10 years' continuous cover
 (1) A private health insurer must stop increasing the amount of premiums payable for *hospital cover in respect of an *adult under this Part if the adult has had hospital cover (including under an *applicable benefits arrangement), the premiums for which have been increased under this Part or *old Schedule 2:
 (a) for a continuous period of 10 years; or
 (b) for a period of 10 years that has been interrupted only by *permitted days without hospital cover or periods during which the adult was taken to have had hospital cover otherwise than because of paragraph 34‑15(2)(a) (none of which count towards the 10 years).
 (2) The amount must stop being increased on the day after the last day of the 10 year period.
 (3) The amount of premiums payable for *hospital cover in respect of the *adult must start to be increased under this Part again if:
 (a) after the end of the 10 year period, the adult ceases to have hospital cover; and
 (b) the adult later takes out hospital cover again; and
 (c) the days in the period between ceasing to have the cover and taking it out again are not all *permitted days without hospital cover in respect of the adult.
 (4) Subsection (3) does not prevent this section applying again in respect of any later 10 year period.
 (5) In subsection (1):
old Schedule 2 means Schedule 2 to the National