Residence assessment for adult customers claiming a Low Income Health Care Card (LIC), Foster Child Health Care Card (FST) or Ex-Carer Allowance (child) Health Care Card (EHC) 101-06040050
This document outlines the procedure to assess if an adult claimant of a Low Income Health Care Card (LIC), Foster Child Health Care Card (FST) or Ex-Carer Allowance (child) Health Care Card (EHC) satisfies the residence requirements to qualify for the concession entitlements. The assessment includes whether the customer is residentially qualified to lodge a legal claim and whether they are required to serve the Newly Arrived Resident's Waiting Period (NARWP).
On this page:
Determining residence requirements for LIC, FST or EHC
Assessing if the NARWP has been served or there is an exemption
Determining residence requirements for LIC, FST or EHC
Table 1
Step |
Action |
1 |
Residence requirements for LIC, FST or EHC + Read more ... To lodge an eligible claim for LIC, FST or EHC, the customer must generally be:
The claim workflow will present the Immigration Enquiry (RSIMME) screen. Ensure the customer's country of birth and any travel documents are recorded. The system will automatically link to the Department of Home Affairs and update the customer's residence and movement information on their Centrelink record. If more information is required, see Activating the Department of Home Affairs datalink and contingency procedures if datalink is unavailable. |
2 |
Check residence details + Read more ... Check the:
Is the customer in Australia?
|
3 |
Customer is in Australia and claiming LIC + Read more ... Check if the customer is:
For assistance to decide if a customer is residing in Australia, see Assessing if a customer is an Australian resident. Code the decision on the Country of Residence (CRES) screen. Does the customer meet the residence requirements for LIC?
|
4 |
Customer is in Australia and claiming FST + Read more ... Check if the customer is:
For assistance to decide if a customer is residing in Australia, see Assessing if a customer is an Australian resident. Code the decision on the Country of Residence (CRES) screen. Does the customer meet the residence requirements for FST?
|
5 |
Customer is in Australia and claiming EHC + Read more ... Check if the customer is an Australian resident. For assistance to decide if a customer is residing in Australia, see Assessing if a customer is an Australian resident. Code the decision on the Country of Residence (CRES) screen. Does the customer meet the residence requirements for EHC?
|
6 |
Customer is not in Australia + Read more ... The customer can only lodge a legal claim for a LIC, FST or EHC while they are outside Australia if they meet an exception to the lodgement inside Australia rule. Does the customer meet an exception to the lodgement inside Australia rule?
|
7 |
Customer cannot lodge outside Australia + Read more ... Advise the customer to lodge a claim if they return to Australia in the future. Continue to assess the claim, the claim will reject for a residence related reason. Procedure ends here. |
8 |
Customer does not meet the residence requirements for LIC, FST or EHC + Read more ... If not already recorded, code the:
Continue to assess the claim, the claim will reject for a residence related reason. The customer may be entitled to some of the following. Offer to the customer if appropriate:
Procedure ends here. |
Assessing if the NARWP has been served or there is an exemption
Table 2
Step |
Action |
1 |
Check citizenship + Read more ... An automatic exemption from the NARWP applies to a customer who is an Australian citizen. Citizenship must be verified. To determine if the customer is an Australian citizen, see Proof of Australian citizenship. Country of citizenship details are recorded on the Legal Residence Details (RSLEG) screen. Is the customer an Australian citizen?
|
2 |
Check if the LIC claimant has already served the NARWP + Read more ... The customer will have a 2 year (104 week) NARWP if:
Otherwise, the customer is required to serve a 4 year (208 week) NARWP. Note: if the holder of an SCV or partner provisional visa (subclasses 309 and 820) is granted a permanent visa on or after 1 January 2019, they will become subject to a 4 year (208 week) NARWP for the LIC. The calculation of the NARWP still commences from the application date for partner provisional visa (subclasses 309 and 820), and does not restart upon commencement of the permanent visa. The NARWP generally starts on the day the person:
For LIC claimed by a person who holds a 309 or 820 partner provisional visa, the NARWP starts on the day the person:
Check the Periods of Australian Presence (RSPAP) screen. This screen displays the periods the customer has been physically in Australia while an Australian resident. Has the customer been in Australia as an Australian resident, a holder of an SCV residing in Australia or after lodging an application for a 309 or 820 visa for at least 2 years (104 weeks) or 4 years (208) weeks?
|
3 |
Check if the LIC claimant is the holder of a visa subclass 060, 070, 449, 785, 786, 790 or ZB951 + Read more ... Check the Legal Residence Details (RSLEG) screen for visa details. Is the customer the holder of a visa subclass 060, 070, 449, 785, 786, 790 or ZB951 (coded as 787)?
|
4 |
Check if the EHC claimant has already served the NARWP + Read more ... The customer will have a 2 year (104 week) NARWP if:
Otherwise, the customer is required to serve a 4 year (208 week) NARWP. Check the Periods of Australian Presence (RSPAP) screen. This screen displays the periods the customer has been physically in Australia while an Australian resident. Has the customer been in Australia as an Australian resident for at least 2 years (104 weeks) or 4 years (208 weeks)?
|
5 |
Check if customer holds visa subclass 852 + Read more ... The holder of a visa subclass 852 is exempt from the NARWP. Check the RSLEG screen for a current or previous visa subclass 852. This can also generally be found in the customer’s passport. Does the customer hold visa subclass 852?
|
6 |
Check if a refugee visa is or was held + Read more ... A customer who is a refugee or former refugee has an automatic exemption from the NARWP. To determine if the customer is a refugee or former refugee, go the RSLEG screen. If the customer's visa subclass (either now or previously) was a refugee visa, it should have been automatically recorded on this screen from the Immigration Datalink. Refugee visas can be determined using:
If the customer advises they are or were a refugee and this is not evident on the RSLEG screen or from their passport contact Centrelink International Services (CIS) or refer to CIS via the Immigration Match Questionnaire (IMQ). Is the customer a refugee or former refugee?
|
7 |
Family member of a refugee or former refugee + Read more ... A customer who is a family member of a refugee or former refugee has an automatic exemption from the NARWP. For this purpose, family members include the following:
To be eligible for an exemption as the family member of a refugee or former refugee, a person must have been a family member, both:
Does the customer have a family member who could be considered under this exemption?
|
8 |
Check if the customer was the family member of a refugee or former refugee when they arrived in Australia + Read more ... Was the customer a family member of a refugee or former refugee at the time that the refugee or former refugee arrived in Australia?
|
9 |
Check if the customer is currently the family member of a refugee or former refugee + Read more ... Note: the customer must have been the family member of that person at the time the refugee first arrived in Australia. However, if the family member is now an Australian citizen, they are no longer considered to be a refugee (they are a former refugee) and the customer may be covered by this exemption provision. Is the customer currently the family member of a refugee or former refugee?
|
10 |
Check if the customer was the family member of a refugee or former refugee when the refugee or former refugee died + Read more ... Note: the customer must have been the family member of that person at the time the refugee first arrived in Australia. If the family member had become an Australian citizen, they are considered to have been a former refugee and the customer can be covered by this exemption provision. Was the customer the family member of a refugee or former refugee at the time the refugee/former refugee died?
|
11 |
Substantial change in circumstances (LIC only) + Read more ... Has the customer suffered a substantial change in circumstances beyond their control and the change in circumstances occurred after the customer's arrival in Australia?
|
12 |
Customer claiming LIC and has FTB child in their care + Read more ... Is the customer claiming LIC and has a Family Tax Benefit (FTB) child in their care?
|
13 |
Customer is claiming LIC or EHC and has not yet served the NARWP + Read more ... Continue to assess the claim. The end date of the NARWP (assuming they remain in Australia) is calculated and displayed on the Periods of Australian Presence (RSPAP) screen. This can be used to advise the customer of future entitlement. For an SCV holder claiming LIC, the Projected end 104wks/208 wks Aust. Presence (inc. SCV): field on the Residency Results Explanation (RSREX) screen displays the date when a non-protected SCV holder has 2 years (104 weeks) or 4 years (208 weeks) presence in Australia. As the customer has not yet served the NARWP, the claim will either:
If the claim is incorrectly granting when the customer has not served or is not exempt from the NARWP, check the Family Member/Refugee Code on the Residence Savings (RSS) screen. If FMC, FME or PRE is coded, refer case to CIS for exemption coding to be ended. Note: if the claim is granted with a start date more than 13 weeks in the future, but no exemption is coded on RSS, manually reject the claim with a reason of 'NRQ' on the Benefit Action (BA) screen. An automatic letter will be issued. The customer may be entitled to some of the following. Offer to the customer if appropriate:
|