Medicare Levy Surcharge vs Private Health Insurance

If you earn above $101,000 (single) or $202,000 (family) and don't have private hospital cover, you pay the Medicare Levy Surcharge. Sometimes the surcharge is cheaper than insurance—sometimes it's not. This page helps you understand the trade-off.

When does the MLS apply?

The Medicare Levy Surcharge applies to Australian residents for tax purposes who:

  • Earn above the income threshold ($101,000 single / $202,000 family in 2024-25)
  • Do not have an appropriate level of private hospital cover

The surcharge is 1% to 1.5% of your income, depending on how far above the threshold you are. This is in addition to the standard 2% Medicare Levy that all residents pay.

Example: Income of $120,000

No private hospital cover

MLS applies

MLS rate
1.25%
Annual MLS
$1,500
Medicare Levy (2%)
$2,400
Total levies
$3,900

With basic hospital cover

MLS avoided

MLS rate
0%
Annual MLS
$0
Medicare Levy (2%)
$2,400
Total levies
$2,400
Break-even: If basic hospital cover costs less than $1,500/year (~$125/month), you save money by getting cover. If cover costs more, you may prefer paying the surcharge—unless you value the insurance itself.

Example: Income of $180,000

No private hospital cover

MLS applies

MLS rate
1.5%
Annual MLS
$2,700

With basic hospital cover

MLS avoided

MLS rate
0%
Annual MLS
$0
Result: At $180,000 income, the MLS is $2,700/year. Most basic hospital policies cost less than this, making private cover the financially better option—plus you get hospital coverage.

MLS rates by income tier (2025-26)

No MLS

0%

Singles: $0 – $101,000

Families: $0 – $202,000

Tier 1

1.0%

Singles: $101,001 – $118,000

Families: $202,001 – $236,000

Tier 2

1.25%

Singles: $118,001 – $158,000

Families: $236,001 – $316,000

Tier 3

1.5%

Singles: $158,001+

Families: $316,001+

Family thresholds increase by $1,500 for each dependent child after the first.

Why private cover can be cheaper than the surcharge

The MLS is calculated as a percentage of your income. Basic hospital cover is a fixed annual premium. As your income rises, the MLS grows while your premium stays constant—creating a crossover point.

  • At $105,000: MLS is $1,050/year. Basic cover might cost similar or more.
  • At $140,000: MLS is $1,750/year (Tier 2). Basic cover likely costs less.
  • At $200,000: MLS is $3,000/year (Tier 3). Cover is almost certainly cheaper.

The exact crossover depends on your age (premiums increase with age), state, and the policy you choose. Use the calculator below to check your MLS exposure, then compare with insurer quotes.

Common misconceptions

"Extras-only cover avoids the MLS"

Extras policies (dental, optical, physio) do not satisfy the private hospital cover requirement. You need hospital cover—or combined hospital and extras—to avoid the surcharge.

"The cheapest hospital policy won't count"

As long as it's classified as hospital cover and has an excess of $750 or less (singles) or $1,500 or less (families), it satisfies the MLS exemption. Basic hospital policies with high excesses still qualify.

"Salary sacrificing into super lowers my MLS income"

MLS income includes reportable super contributions (RSC). If you salary sacrifice into super, those contributions are added back when calculating your MLS income. This differs from HELP, where salary sacrifice does reduce repayment income.

"Private health is a waste of money"

Whether insurance is "worth it" depends on more than avoiding the MLS. Consider: choice of doctor and hospital, shorter wait times for elective surgery, coverage for services Medicare doesn't cover, and the Lifetime Health Cover loading if you delay. The MLS calculation is just one factor.

FAQ

Is it cheaper to pay the MLS or get private health insurance?

It depends on your income. At lower incomes above the threshold, the MLS may cost less than basic hospital cover. At higher incomes (above roughly $140,000), the MLS typically exceeds the cost of basic cover, making insurance the cheaper option purely on cost.

What income triggers the Medicare Levy Surcharge?

For singles, the MLS applies when your income exceeds $101,000 (2025-26). For families, the threshold is $202,000 plus $1,500 for each dependent child after the first. 'Income' for MLS purposes includes taxable income plus some fringe benefits and super contributions.

Does extras-only cover avoid the Medicare Levy Surcharge?

No. Only private hospital cover (or combined hospital and extras cover) avoids the MLS. Extras-only policies covering dental, optical, and physio do not satisfy the MLS exemption requirement.

What is MLS income and how is it calculated?

MLS income is your taxable income plus reportable fringe benefits, reportable super contributions, and net investment losses (added back). This means salary sacrificing into super doesn't reduce your MLS income—the reportable super contributions are added back.

Check your MLS exposure

Use the Medicare Levy & MLS calculator to see exactly how much surcharge applies at your income level.

Check your MLS exposure →
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