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NATIONAL HEALTH (LIFETIME HEALTH COVER) AMENDMENT REGULATIONS 2000 (NO. 1) 2000 NO. 273
EXPLANATORY STATEMENTSTATUTORY RULES 2000 No. 273
Issued by the Authority of the Minister for Health and Aged Care
National Health Act 1953
National Health (Lifetime Health Cover) Amendment Regulations 2000 (No. 1)
Section 140 of the National Health Act 1953 (the Act) allows the Governor-General to make regulations prescribing matters that are required or permitted by the Act to be prescribed, or that are necessary and convenient to be prescribed for carrying out or giving effect to the Act.
Schedule 2 of the Act contains rules relating to a new system of private health insurance called Lifetime Health Cover. Under Lifetime Health Cover, registered organizations (health funds) are able to set different premiums depending on the age when a member first takes out hospital cover with a health fund. Schedule 2 of the Act commenced on 1 July 2000.
The purpose of the regulations is to amend the National Health (Lifetime Health Cover) Regulations 2000 to
* broaden regulation 6 to specify that a person who is an Australian citizen or the holder of a permanent visa is taken to have hospital cover if the person was not residing in Australia on 1 July 2000 even if the person was in Australia on 1 July 2000, provided the person was not in Australia for a continuous period of longer than 90 days; and
* amend regulations 7 and 9 to expand the circumstances that the Minister must be satisfied apply to a person in order for the person to be determined to have had hospital cover on 1 July 2000 and 30 June 1999 to include a person who: - has been a member of the Australian Defence Force on continuous full-time service who had his or her health services provided by the Australian Defence Force for at least 3 years; or
- during the three year period beginning on 1 July 1997 and ending on 1 July 2000:
- has been a member of the Australian Defence Force on continuous full-time service who had his or her health services provided by the Australian Defence Force for at least 12 months.
The regulations provide that a person who is an Australian citizen or the holder of a permanent visa is taken to have hospital cover if the person was not residing in Australia on 1 July 2000. Such a person is taken to have hospital cover even if the person was in Australia on 1 July 2000, provided the person was not in Australia for a continuous period of longer. than 90 days. A person in this class of persons will be given the right to pay the base rate premium under Lifetime Health Cover. Once the person ceases to be in this class of persons, that is, the person ceases to be a resident of another country, the person will need to take out hospital cover with a registered health fund. If the person does not take out hospital cover with a registered health fund within 2 years a 2 per cent loading will be applied to the person's hospital cover premium for every additional 365 days that they are absent from hospital cover.
The regulations also make it easier for former Australian Defence Force members to be determined to have had hospital cover on 1 July 2000 and 30 June 1999.
Details of the regulations are set out in the Attachment.
The regulations commence on gazettal.
ATTACHMENT
Regulation 1: Name of Regulations
Regulation 1 provides that the Regulations may be cited as the National Health (Lifetime Health Cover) Amendment Regulations 2000 (No. 1).
Regulation 2: Commencement
Regulation 2 provides that the Regulations commence on gazettal.
Regulation 3: Amendment of National Health (Lifetime Health Cover) Regulations 2000
Regulation 3 provides that Schedule 1, amends the National Health (Lifetime Health Cover) Regulations 2000.
Schedule 1: Amendments
Items 1 and 2
These items extend the classes of persons taken to have hospital cover under subclause 4(2) of Schedule 2 of the Act. Item 1 amends paragraph 6(1)(d) to provide that Australian citizens and the holders of permanent visas who were residing in another country on 1 July 2000 are taken to have hospital cover even if they were in Australia on 1 July 2000.
Item 2 inserts a new subregulation 6(3) into the National Health (Lifetime Health Cover) Regulations 2000 to provide that an Australian citizen or holder of a permanent visa will not be considered to be residing in Australia if the person is not in Australia for a continuous period of longer than 90 days. That is, if a person was in Australia for more than 90 days at a time, that person is not considered to be in the class of persons who are taken to have hospital cover.
These people are taken to have hospital cover in addition to class of people already identified in existing paragraph 6(1)(d) - Australian citizens and the holders of permanent visas who were overseas on 1 July 2000 and who have not subsequently returned to Australia for more than 90 days.
Under paragraph 6(1)(d), Australian citizens and the holders of permanent visas who were residing in another country on 1 July 2000 may return to Australia for up to 90 days at a time and still be taken to have hospital cover.
Items 3 and 4
These items extend the hardship criteria for financial difficulty or exceptional circumstances to include former members of the Australian Defence Force.
Item 3 replaces paragraph 7(b) with new paragraphs 7(b) and 7(c). The new paragraphs provide that in order for the Minister to determine that a person is to be treated, for the purposes of Schedule 2 to the Act, as having had hospital cover on 1 July 2000 and 30 June 1999 the Minister must be satisfied that the person was in receipt of an income support payment (as defined in the Social Security Act 1991) or was the holder of a Health Care Card at any time during the 12 month period 1 July 1999 to 30 June 2000 and:
- the person has had hospital cover or ancillary cover with a health fund for at least 3 years in total in the past; or
- the person has had hospital cover or ancillary cover with a health fund for at least 12 months in total during the 3 year period 1 July 1997 to 30 June 2000 inclusive; or
- the person was a member of the Australian Defence Force on continuous full-time service who had their health services provided by the Australian Defence Force for at least 3 years in the past, or
- the person was a member of the Australian Defence Force on continuous full-time service who had their health services provided by the Australian Defence Force for at least 12 months during the period 1 July 1997 to 1 July 2000 inclusive.
Item 4 makes a! similar amendment to the exceptional circumstances criteria in Regulation 9. New paragraphs 9(b) and 9(c) provide that in order for the Minister to determine that a person is to be treated, for the purposes of Schedule 2 to the Act, as having had hospital cover on 1 July 2000 and 30 June 1999 the Minister must be satisfied that:
* because of exceptional circumstances affecting the person it would be unreasonable to expect the person to have had hospital cover on 1 July 2000 and:
- the person has had hospital cover or ancillary cover with a health fund for at least 3 years in total in the past; or
- the person has had hospital cover or ancillary cover with a health fund for at least 12 months in total during the 3 year period 1 July 1997 to 30 June 2000 inclusive; or
- the person was a member of the Australian Defence Force on continuous full-time service who had their health services provided by the Australian Defence Force for at least 3 years in the past; or
- the person was a member of the Australian Defence Force on continuous full-time service who had their health services provided by the Australian Defence Force for at least 12 months during the period 1 July 1997 to 1 July 2000 inclusive.