Tax claim codes and benefit codes

Learn about why these codes are important at tax time if you have health insurance.

It's important to get every cent you can from your tax return to help cover your private health insurance costs, but knowing what to claim can be confusing for many people.

The Australian Government does offer a tax rebate on private health insurance which is means tested, and you'll often be asked for a code.

Areas that are generally not fully understood include tax claim codes, health insurance statements and benefit codes, and this guide looks at all three and how they affect your health insurance rebate.

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What are tax claim codes?

Tax claim codes indicate the amount of private health insurance rebate you'll receive in line with your particular circumstances. When claiming a rebate, you must select a code that matches your situation to provide on your tax return, as it does not appear on your private health insurance statement.

The following are the tax claim codes used by the ATO to determine your rebate:

What are benefit codes?

If you have private health insurance, you'll receive a health insurance statement each year from your health fund and you will need to complete the private health insurance policy section and Medicare levy surcharge items on your tax return. Each adult covered by your private health policy receives their own health insurance statement.

The benefit code is listed on this document and indicates which rebate percentage (based on the maximum policyholder’s age) is applicable to you and when the premium was paid. The valid benefit codes are:

• What other information should be on my health insurance statement?

  • Health Insurer ID. A unique code that identifies your private health insurer.
  • Membership number. The number of your health insurance policy.
  • Your premiums eligible for Australian Government rebate. Your share of the premiums that have been paid for your policy.
  • Your Australian Government rebate received. Your share of the private health insurance rebate you have received by reduced premiums from your insurer (the amount of reduced premiums divided by the number of adults on the policy).
  • Other adult beneficiaries for the policy. If the policy covered more than one adult at the time the payments were made.
  • Number of days the policy provided an appropriate level of private hospital cover. This determines whether you are liable for the Medicare levy surcharge.

Why are there two rows of info on my statement?

There will be two rows of information on your health insurance statement because, thanks to recent changes in the way the rebate is calculated, there are now two lots of benefit codes applicable to each person’s situation.

Benefit codes 30, 35 and 40 are used for premiums paid between 1 July and 31 March and benefit codes 31, 36 and 41 are used for premiums paid between 1 April and 30 June.

There may also be two rows of information on your statement if the oldest person on the policy turned 65 or 70 during the tax year, in which case all adults on the policy receive a higher rebate percentage. As with the annual adjustment of the rebate percentage on 1 April, each row will have a different benefit code.

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