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Do I have to pay the Lifetime Health Cover Loading if there has been a gap in my Hospital Cover?

Reviewed and updated 3 April 2024

Yes. You will have to pay the Lifetime Health Cover Loading if there was a gap in your Hospital Cover.

However, if you had Hospital Cover on your Base Day and then cancelled or suspended your Hospital Cover, and the gap in your Hospital Cover is less than 1,094 days (3 years minus 1 day) during your lifetime, then you will not have to pay the Lifetime Health Cover Loading. 

The 1,094 days are known as your ‘Days of Absence’.

Your ‘Days of Absence’ exclude gaps in your Hospital Cover such as:

  • switching between health insurers 
  • suspending your Hospital Cover (if your insurer agrees) because you have gone overseas.

If you have a gap in your Hospital Cover of 1,094 or more days, you will have to pay a Lifetime Health Cover Loading when you take out Hospital Cover. Your Lifetime Health Cover Loading is 2% for every year outside the 1,094 days without cover.

Here are some examples of how the ‘Days of Absence’ work in practice:

A gap of 610 days in Hospital Cover

Crystal took out Hospital Cover when she was 29. A year later, she decided to cancel it. After 20 months, she took out Hospital Cover again. She did not have to pay the Lifetime Health Cover Loading because, when it was calculated, she had only 610 ‘Days of Absence’.

A gap of 1,830 days in Hospital Cover

Gerry took out hospital cover when he was 26. When he turned 33, he cancelled his Hospital Cover. Five years later, he took out Hospital Cover again. He had to pay the Lifetime Health Cover Loading because, when it was calculated, he had 1,830 ‘Days of Absence’.

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