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Paying the Medicare levy surcharge

Find out when you have to pay the Medicare levy surcharge (MLS) and how much you will pay.

Last updated 29 June 2023

When you pay the Medicare levy surcharge

If you have to pay the Medicare levy, you may have to pay the Medicare levy surcharge (MLS) if both:

The MLS is an amount you pay on top of the Medicare levy.

If you've paid the MLS and you want to avoid paying it in the future, you can take out the appropriate level of private patient hospital cover for yourself, your spouse and all your dependants.

How much Medicare levy surcharge you will pay

The Medicare levy surcharge (MLS) rate of 1%, 1.25% or 1.5% is levied on:

  • your taxable income
  • total reportable fringe benefits, and
  • any amount on which family trust distribution tax has been paid.

We use a special definition of income (called income for MLS purposes) to work out if you have to pay the MLS and the rate you will pay. This income is different from your taxable income.

You will not pay the MLS if your income is less than the base income threshold, which is:

  • $90,000 for singles
  • $180,000 (plus $1,500 for each dependent child after the first one) for families.

You can use the Income tax estimator to work out your MLS.

Medicare levy surcharge if you had a spouse

If you had a spouse for the full year, you do not have to pay the MLS if:

  • your family income exceeds the $180,000 (plus $1,500 for each dependent child after the first one), but
  • your own income for MLS purposes was $23,365 or less.

If you had a new spouse, or you separated from your spouse, during the year:

  • you may be liable for MLS for the number of days you were single – if your own income for MLS purposes was more than the single surcharge threshold of $90,000
  • you may be liable for MLS for the number of days you had a spouse or dependent children – if your own income for MLS purposes was more than the family surcharge threshold of $180,000 (plus $1,500 for each dependent child after the first one).

We will work out if you have to pay the MLS based on the information you provide in your tax return. We will include MLS with your Medicare levy. It will show as one amount on your notice of assessment, called Medicare levy and surcharge.

Change in circumstances during the year

If circumstances for yourself, your spouse or your dependent children change at any time during the year, you may become liable to pay the MLS.

Changes in circumstances may relate to your:

  • income
  • spouse
  • dependants
  • private health insurance.

If you travel overseas and cancel your private patient hospital cover during that time, you may be liable to pay the Medicare levy surcharge (MLS).

If you don't have an appropriate level of private patient hospital you may have to pay the Medicare levy surcharge.

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