Private health insurance benefit codes explained: 30, 31, 35, 36, 40 and 41

What is a private health insurance benefit code?

A benefit code is a two-digit number the Australian Taxation Office uses to work out which Australian Government Rebate percentage applies to a line of your private health insurance statement. It carries two facts, and only two: the age of the oldest person covered by the policy, and whether the premiums on that line were paid before or after 1 April. There are six valid codes, 30, 31, 35, 36, 40 and 41, according to the ATO’s statement page, last updated 22 June 2026 and checked on 8 October 2026.

The code does not record your income. That is the part people assume, and one fund’s own statement guide describes the code as reflecting age and income. The ATO’s definition is narrower: “Your level of rebate is calculated on the age of the oldest person covered by the policy.” Your income tier is worked out separately, from the income in your tax return, when the ATO assesses it.

So benefit code 30 can be worth 24.288%, 16.192%, 8.095% or nothing on a 2025–26 return, depending on which rebate income tier your income lands in. The code picks the row of the rebate table; your income picks the column.

What is my benefit code?

Your benefit code is the number at label L on your private health insurance statement, and in an Australian tax return lodged through myTax it is normally pre-filled. If you need to work it out yourself, two questions decide it: how old was the oldest person on the policy, and when did your fund receive the premium. The ATO’s list, checked 8 October 2026, is below.

Source: ATO, Your private health insurance statement (QC 49966), last updated 22 June 2026, checked 8 October 2026.

A code ending in 0 or 5 is always the 1 July to 31 March period, a code ending in 1 or 6 is always 1 April to 30 June, and the number rises by 5 for each older age band. A couple aged 63 and 66 on one policy both use 35 and 36, because the 66-year-old is the oldest person covered. The ATO also says a statement can carry extra lines when the oldest person turns 65 or 70 during the year, since the rebate percentage rises from that point and each line gets its own code.

Benefit code 30 or 31: what is the difference?

Benefit code 30 is for premiums paid between 1 July and 31 March, and benefit code 31 is for premiums paid between 1 April and 30 June, in both cases where everyone on the policy is under 65. In a 2025–26 Australian tax return, code 30 covers premiums paid from 1 July 2025 to 31 March 2026 and code 31 covers 1 April to 30 June 2026.

The split exists because the rebate itself changes on 1 April. The ATO’s claiming page, last updated 22 June 2026, says: “All private health insurance rebate percentages are adjusted annually on 1 April by a ‘rebate adjustment factor’.” PrivateHealth.gov.au, checked 8 October 2026, says that factor has applied since 1 April 2014 and is set by a formula that takes into account growth in the Consumer Price Index. In each of the last two years the adjustment has lowered the percentage, so on a 2025–26 return code 30 carries 24.288% at the base tier and code 31 carries 24.118%.

What decides the line is when the money reached your fund, not the months the premium covers. The ATO says a premium is paid “when your private health insurer receives the amount you paid”. A direct debit received on 31 March 2026 is a code 30 payment; the same debit received on 1 April 2026 is code 31.

What is each benefit code worth in dollars on a 2025–26 tax return?

Each benefit code carries a rebate percentage, and the percentage only means something once it is applied to a premium. The table converts every code into Australian dollars for one stated premium: a policy priced at A$2,400 a year before the rebate, with no Lifetime Health Cover loading, paid in equal monthly amounts. That puts A$1,800 of premiums on the 1 July 2025 to 31 March 2026 line and A$600 on the 1 April to 30 June 2026 line.

Rates: ATO, Income thresholds and rates for the private health insurance rebate (QC 49965), periods 1 July 2025 to 31 March 2026 and 1 April 2026 to 30 June 2026, checked 8 October 2026. Tier 3 is 0% on every code. Dollar figures are Plain Cover’s arithmetic.

Added up, a single under 65 on the base tier is entitled to A$581.89 on that A$2,400 policy for 2025–26. The tier is set by income for surcharge purposes. For 2025–26 the ATO puts singles on the base tier up to A$101,000, tier 1 to A$118,000 and tier 2 to A$158,000, with families at A$202,000, A$236,000 and A$316,000. How income is counted is explained in the guide to rebate tiers and income.

How did the benefit code percentages change on 1 April 2025 and 1 April 2026?

The Australian Government Rebate fell slightly on each of the last two 1 April adjustments, so the same benefit code is worth a little less on a 2025–26 return than it was on a 2024–25 return. The table below repeats the dollar conversion for the 2024–25 Australian tax return, on the same A$1,800 and A$600 split, so the two years can be compared line by line.

Rates: ATO, periods 1 July 2024 to 31 March 2025 and 1 April 2025 to 30 June 2025, checked 8 October 2026. 2024–25 singles tiers: base to A$97,000, tier 1 to A$113,000, tier 2 to A$151,000.

One pattern makes the codes easier to read. A percentage set on 1 April runs until the next 31 March, so code 31 in one return carries the same rate as code 30 in the next: 24.288% for code 31 in 2024–25 and for code 30 in 2025–26. For the 2026–27 return, the ATO lists 24.118% for code 30 (1 July 2026 to 31 March 2027) and says the rates from 1 April 2027 will be published in March 2027, while a bill before the Senate would remove the 65 to 69 and 70 and over rates from that date. As at 8 October 2026 there is no code 31 rate for 2026–27. A single under 65 on the base tier gets A$581.89 on this policy for 2025–26, against A$588.67 for 2024–25, a drop of A$6.78.

Worked example: one policy across the 1 April 2026 change

Mei is 45, single, has no dependants and lives in Australia. Her hospital policy is priced at A$2,400 a year before the rebate, carries no Lifetime Health Cover loading, and is paid by monthly direct debit of A$200. When she renewed she nominated the base income tier with her fund, so the fund took the base-tier rebate off every payment. Her income for surcharge purposes in 2025–26 turned out to be A$112,000, which is tier 1.

Rates: ATO, 2025–26 periods, checked 8 October 2026. Arithmetic: Plain Cover.

Mei enters the two lines separately, exactly as printed. The ATO then applies tier 1 to each line and finds she received A$193.96 more rebate than her income allows. Its claiming page says it recovers that “as a tax liability”, which shows on the notice of assessment as an excess private health insurance refund or reduction. Her statement shows whole dollars, so the ATO’s figure can differ by a few cents.

Two variations change the lines and move the answer by cents, not dollars. Had Mei paid the whole year on 1 July 2025, her statement would carry one code 30 line of A$2,400, and her tier 1 entitlement would be 16.192% of A$2,400, or A$388.61. Had her March debit reached the fund on 1 April 2026, it would sit on the code 31 line instead. The ATO’s own version of this sum is a 67-year-old on a A$2,400 policy who owed A$194.

Which tax claim code do I use: A, B, C, D, E or F?

The tax claim code is a letter, not a number, and it describes your household on 30 June 2026 for a 2025–26 Australian tax return. The ATO’s myTax 2026 instructions, published 1 June 2026, set out six. The letter matters because it tells the ATO whether to test your income against the single or the family thresholds: the ATO says single parents should select code B “to ensure that we apply the family thresholds”.

Source: ATO myTax 2026 Private health insurance (QC 106835) and Individual tax return instructions 2026 (QC 106624), checked 8 October 2026.

The tax claim code follows your situation on 30 June, while the benefit code follows the dates of each payment. So a single person with no dependants uses A on both their code 30 line and their code 31 line. On the 2026 paper return, the ATO tells a person with dependent-person cover to print F in the tax claim code box and finish there.

How do couples sharing one policy use tax claim codes C, D and E?

When two adults share one private health insurance policy in Australia, each owns half the premiums and half the rebate. The ATO says each adult’s share is “the amount paid for the policy divided by the number of adults on the policy”, it does not matter which of them paid, and each can ask the fund for a statement showing their own half.

A couple then has two ways to claim on 2025–26 returns. Each partner can enter their own statement lines with code C. Or one partner can claim both halves: that partner enters their own lines with code C and their spouse’s lines with code D, and the spouse enters code E. The ATO allows this only if both were covered by the same policy for the same period, were together on 30 June 2026, and agree that only one of them will claim. The 2026 paper return instructions add a check: the number of rows with code D must equal the number of rows with code C.

For a couple under 65 sharing a A$4,800 policy paid monthly, each half is A$2,400, split into A$1,800 on code 30 and A$600 on code 31, so each partner’s base-tier entitlement is A$581.89 on 2025–26 rates. A couple who separated during the year can each claim only their own share, the ATO says. If the claiming partner’s spouse has a rebate liability and does not lodge when required, the ATO says that liability becomes the claiming partner’s.

Where do the codes go in the 2025–26 tax return?

In myTax the codes usually arrive on their own. The ATO’s myTax 2026 instructions say it aims to pre-fill private health insurance policies “by mid-July”, and its myTax page, updated 22 September 2026, says most third-party information is pre-filled by late July. The same ATO page gives 31 October as the due date for lodging your own return, which for a 2025–26 Australian tax return is 31 October 2026.

Each pre-filled panel holds one statement line: the health insurer ID, the membership number, your premiums eligible for the rebate, the rebate you received, and the benefit code. You check every line, including the tax claim code, against your statement and your situation on 30 June 2026, and add any policy that did not pre-fill. The ATO’s myTax instructions say to enter each line separately, “as they appear on your PHI statement”, and that in most cases there will be two.

On the 2026 paper return the same items go to labels B, C, J, K and L in the private health insurance policy details section, with one row for each statement line. Amounts are in whole dollars. If there are more than four rows, the ATO asks for a schedule of additional information. The premiums at label J never include a Lifetime Health Cover loading, because the rebate does not apply to the loading. The days of hospital cover on the same statement go to the Medicare Levy Surcharge questions, not to this section.

Is the benefit code different at Bupa, Medibank or another fund?

No. Benefit codes are set by the Australian Taxation Office, not by health funds, so a Bupa, Medibank, nib, HCF or Frank member under 65 uses code 30 and code 31 in exactly the same way on a 2025–26 return. The ATO lists the same six codes for every registered Australian health insurer, checked 8 October 2026. What differs between funds is where the statement lives and when it appears.

Sources: Bupa, Medibank and Frank help pages, each read 8 October 2026.

So the answer to “what is my Bupa benefit code” is the same as for any fund. Open the statement, read label L on each line, and expect 30 and 31 if everyone covered is under 65.

What if your private health insurance statement is missing or wrong?

A missing statement is normal in Australia. The ATO’s statement page, checked 8 October 2026, says “It’s optional for health insurers to provide you with a private health insurance statement”, and an insurer sends one only if you ask. Most funds report to the ATO directly and put a copy in their member portal, so a missing paper statement rarely means missing data.

If myTax has not pre-filled a policy for 2025–26, the ATO’s instruction is to add it yourself using the insurer and membership number, which needs the statement. Request it from the fund or download it. The ATO’s 2026 return instructions warn: “There may be a delay processing your tax return if you don’t use your PHI statement and the private health insurance details you provided are incorrect.”

If the statement itself looks wrong, the fix sits with the fund, not the ATO. Bupa says pre-filled details are correct “as long as your information with Bupa is correct”, so a wrong date of birth or a partner missing from the policy goes back to the insurer. A wrong income tier is different: it is not an error on the statement, and the ATO squares it up when it assesses the return. If the return has already been lodged with a wrong line, the ATO says to wait until you are told the original return has been processed, then amend it through ATO online services in myGov, on paper or by letter.

Why do people end up with a tax bill or a delay over benefit codes?

Most problems with Australian Government Rebate claims at tax time trace back to a handful of avoidable mistakes. These are the ones the ATO’s 2026 instructions and the funds’ own guides warn about, checked 8 October 2026.

Adding the two lines together. Frank’s guide puts it bluntly: “Don’t add the amounts together!” Medibank’s says not to add up amounts in any column or row. A combined line can only carry one benefit code, so A$600 of April to June premiums ends up on the wrong percentage.

Typing the benefit code into the tax claim code, or the reverse. The ATO’s statement page spells it out: the benefit code is different to the tax claim code. One is a number about age and dates, the other a letter about your household on 30 June.

Both partners claiming the whole policy. Each adult owns only their share. Only one partner may claim both halves, with codes C, D and E, and both must agree first.

Nominating too low an income tier with the fund. This is the mistake that produces a bill. Mei’s example above shows A$193.96 recovered on an ordinary A$2,400 policy. The rebate tiers guide sets out what counts as income for surcharge purposes, which takes in more than salary.

This is general information about how benefit codes and tax claim codes work in Australia, not advice about your own tax return. A registered tax agent can check a specific return.