Low Income Health Care Card (LIC) 101-06040000

The LIC entitles the customer and their dependents (their partner and any Family Tax Benefit (FTB) children or regular care children) to Commonwealth health concessions such as cheaper pharmaceuticals. The LIC is granted for a period of 12 months unless entitlement is lost.

To qualify for a LIC, the customer must meet all of the following:

• be living in Australia
• be physically in Australia on the day they lodge their valid claim
• satisfy the residence requirements, and
• satisfy the Health Care Card (HCC) income test

LIC is not subject to an assets test.

Customers currently entitled to other concession cards may also apply for a LIC. Cards issued with Income Support Payments are priority concession cards.

Low Income Health Care Cards have no age specific requirements, however children under 16 would generally be included on parents or guardians FTB eligibility. The exception are foster children residing in an Approved Care Organisation (ACO).

A child who is a foster child, ward of the state, refugee or orphan and is in the care of an institution such as an ACO, is not in the care of an individual who is an Australian resident.

Children in the care of organisations are able to qualify for a LIC in their own right as long as no individual is being paid FTB for the care of the child.

Dependants must meet certain age qualifications to be eligible on their parent's LIC card. Claimants in receipt of a Prescribed Education Payment are eligible to claim LIC regardless of their status as a dependent. These payments are:

• Veterans’ Children Education Scheme (VCES)
• Postgraduate Awards Scheme

Self-Employment Assistance participants who do not receive an income support payment may also be eligible for a LIC and should be advised to claim a LIC.

Note: as the Disaster Recovery Allowance (DRA) does not automatically issue the customer a Health Care Card (HCC), staff should invite customers to claim a LIC.

Eligible customers receive payments or concession cards from the date they submit a complete claim with all relevant supporting documentation. Different processes apply for customers in vulnerable circumstances.

Documents required can include identity confirmation, residency and income verification. Customers and their partners can both claim LIC on a single paper claim, if required.

Nominees may lodge an online claim on behalf of their principle if the nominee is registered online and the nominee arrangement is on record.

Note: customers receiving a pension or benefit who submit a LIC claim may need to re-key personal details they have already provided.

Online claims

The preferred method of claiming LIC is to apply online.

Customers must be registered with an active Centrelink online account to apply online.

Partnered customers must complete separate online claims if they both want to claim. Documents required can include confirmation of identity, residency and income verification.

Customers must provide all their required documents and verify their identity (if their identity status is not confirmed) to be able to submit their claim. Exceptions will be made for some vulnerable customers.

Customers can submit or cancel their online claims and withdraw a submitted claim via their Centrelink online account or Express Plus Centrelink mobile app. When a customer submits an online claim, details are uploaded to the customer's Centrelink record. The online claim information can be viewed on the customer record.

Nominees who have an online account can submit an online claim for principals they are a correspondence nominee for.

Assisted Customer Claim

If the customer is deemed unable or unsuitable to complete an online claim, Service Officers can use an Assisted Customer Claim (ACC) to collect and record the claim information with the customer. ACC is similar to the online claim workflow and contains the same questions to ask the customer.

Paper claim - SS487 or SS050

If the customer is unable or unsuitable to complete an online claim, they will need to complete a:

• customised Claim for Low Income Health Care Card (SS487) issued via the First Contact Service Offer (FCSO) workflow, or
• Claim for a Health Care Card (SS050)

The customer, partner or correspondence nominee can lodge the claim if a signed statement from the customer has been provided detailing the person to whom they give permission to lodge the claim.

A LIC can be claimed by both members of a couple by completing a single customised SS487 or SS050. Partnered customers claiming LIC online must each lodge a separate claim.

All customers lodging a SS487, SS050 or online LIC claim must each provide:

• proof of Australian residence if not previously recorded. If a newly arrived resident or customer born overseas is unable to provide proof of arrival documents, the Residence verification script should be used to establish residence
• identity confirmation. For the list of identity documents, see Identity documents A to Z
• proof of income for the 8 weeks LIC assessment period, this includes details of investments, bank accounts and any lump sum payments received

Note: no further verification is required when earnings have already been provided for the 8 week LIC assessment period as part of a customer/partner’s income support payment.

See Documents required for Centrelink new claims.

Claims may only be backdated for a medical service or treatment if the customer remained eligible for the entire period between the date of medical service or treatment and the date of claim.

For LIC, this means:

• verifying that the income in the 8 weeks ending on the date of medical service or treatment was below the allowable income limit applicable to the customer, and
• the claimant must verify that relevant income remained below the LIC threshold for the entire past period ending on the date the claim was lodged

See Processing Low Income Health Care Card (LIC) claims.

Advice to customer when backdating LIC claim

The claim start date can only be backdated if the customer has lodged a claim.

If the start date is backdated, customers may be able to claim reimbursement for past period expenses, for example Pharmaceutical Benefit Scheme (PBS) medication purchases. Tell the customer to take their itemised receipt for the prescription/medical treatment and their concession card to Medicare to request a refund of medical expenses.

See the Resources page for a link to the Services Australia website about refunds.

Consider processing the LIC claim urgently if a customer asks for a LIC immediately and they:

• will be placed in financial hardship because of a delay in processing their LIC claim, or
• have an urgent medical need such as a medical appointment or a prescription

When the LIC is granted, the customer can go to their local service centre to obtain an interim voucher while they wait for their card to be delivered by post.

Customers can access their digital wallet in the myGov app or on the Express Plus Centrelink app to present their concession card using their smart device. Accepting the digital card is at the discretion of the concession provider, so it is important that customers have their physical card with them.