Tax claim codes and benefit codes
Understand the key details of the private health insurance benefit code and the tax claim code.
Key takeaways
- Use tax claim codes A-F to match your family situation for the correct rebate.
- Benefit codes 30-41 reflect your age and premium payment date for the correct rebate.
- Your tax details are often pre-filled but contact your insurer for your statement if not.
The two codes you'll need are as follows:
The tax claim code
This is the code that matches your situation e.g. your relationship status and any dependents you might have.
The private health insurance benefit code
This is the benefit code you will need based on your age.
When it comes to tax time, insurers may no longer send your end-of-financial-year private health insurance statement directly to you. If you do your tax online or through an agent, the information should be pre-filled on your tax return. If not, just contact your health insurer so that you can get a private health insurance statement and fill in all the relevant details.
If you need to complete a tax return, you can get the tax claim code and health insurance benefit codes below.
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.
The following are the tax claim codes used by the ATO to determine your rebate:
| Code | Definition |
|---|---|
| Tax code A | You were single on 30 June and had no dependants. |
| Tax code B | You were single on 30 June and had a dependent person – a dependent child, or a sibling who depends on you for economic support – or you paid for a dependent-person-only policy. A single parent with a dependent child must use code B so the family income thresholds are applied. |
| Tax code C | You have a spouse on 30 June (including if your spouse died during the tax year and you did not have another spouse before 30 June), and you are claiming your own share of the rebate – or you are claiming both your share and your spouse's share, which requires that you were both covered under the same policy for the same period, were together on 30 June, and your spouse agrees that you will claim. |
| Tax code D | You do not select this code yourself. myTax applies it automatically to your spouse's share, in a read-only panel, when you claim both shares under code C. |
| Tax code E | You have a spouse on 30 June and you have agreed that they should claim your share of the rebate because you aren't going to claim it yourself. |
| Tax code F | You are covered as a dependent person on a private health insurance policy and are not entitled to receive the rebate. You may still be exempt from the Medicare levy surcharge, so you still need to complete this section of your return. |
Finder survey: What are the main reasons people have hospital insurance?
| Response | Male | Female |
|---|---|---|
| Peace of mind | 37.5% | 32.76% |
| To avoid public surgery waiting lists | 24.17% | 22.99% |
| For tax reasons | 17.29% | 11.49% |
| To get better health care as I get older | 14.17% | 11.3% |
| To have a private hospital room | 12.29% | 8.81% |
| To get better health care for my family | 9.58% | 9.96% |
| To pick my own surgeon | 6.88% | 6.9% |
| To cover a specific issue (non-pregnancy) | 2.92% | 4.79% |
| For pregnancy cover | 1.04% | 3.07% |
| None of the above | 0.83% | 0.38% |
| Other | 0.21% | 0.57% |
Source: Finder survey by Pure Profile of 1006 Australians, December 2023
What are benefit codes?
If you have private health insurance, you may still receive a private 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:
| Age groups | Codes for premiums paid between 1 July and 31 March | Codes for premiums paid between 1 April and 30 June |
|---|---|---|
| Under 65 | Benefit code 30 | Benefit code 31 |
| 65 to 69 | Benefit code 35 | Benefit code 36 |
| 70 or older | Benefit code 40 | Benefit code 41 |
Why are there two rows of info on my statement?
Your rebate percentage is generally adjusted by a rebate adjustment factor on 1 April each year, so your statement splits the premiums you paid before 1 April from those you paid from 1 April, and there are 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, provided their income for surcharge purposes has not reached the Tier 3 threshold. As with the annual adjustment of the rebate percentage on 1 April, each row will have a different benefit code.
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