Claiming Commonwealth Seniors Health Card (CSHC) 065-06010000

Check the customer or nominee is registered with an active Centrelink online account. Organisation nominees must be registered for nominee organisation online services. Organisation nominees must log into Provider Digital Access (PRODA) to access nominee services. Nominees must select the person they wish to act for.

Advise the customer how they can create a myGov account and link it to Centrelink service. This will also enable them to receive Centrelink mail online through the myGov Inbox.

If the customer is partnered, consider if the partner may also be eligible for a Commonwealth Seniors Health Card or another service offer. If the customer has permission to enquire on their partner’s behalf or their partner is present, discuss whether they would also like to lodge a claim.

Service centre staff can help customers with their online claim through self service terminals.

Customers can access the Payment and Service Finder on the website to check if Commonwealth Seniors Health Card is an appropriate payment for them, and to start their claim.

Record the claim contact in a DOC and advise the customer to start and submit a claim as soon as possible to receive their card from the earliest possible date. Advise the customer if they are having difficulty submitting the claim to contact Services Australia for assistance.

Note: for customers in vulnerable circumstances, see Intent to claim and vulnerable customers.

Once registered with an 'active' online account, customers must:

• sign into myGov and access their linked Centrelink online account
• go to the main menu and select the My Details > Personal and contact details > My profile to make updates
• The My profile page shows information from their Centrelink record
• Select Update (relevant service name) in the sections such as Relationship status or Interpreter details that need updating.

Electronic Messaging

Customers who provide a mobile phone number or email address are advised they are automatically subscribed to Electronic Messaging (EM) services, unless they have previously declined EM. They are asked to nominate a preferred contact method (SMS or email) for electronic messages.

They are automatically subscribed to receive their Centrelink mail online in their myGov Inbox.

They can opt out of these services at any time.

To start a new claim:

• Select Payments and Claims from the banner or from the Menu
• Select Make a claim, or My online claims
• From the My online claims, select Make a claim
• In the Concession Cards category, select Get Started
• Select Apply for a Concession Card
• Answer the pre-claim questions on the Eligibility Check page to check eligibility for a concession card. Based on the information provided, the system will determine which card the customer may be eligible to apply for.
• After completing the streaming questions, select Continue until the Concession card claim options appear
• Select Apply for a Commonwealth Seniors Health Card. Continue through until Your Commonwealth Seniors Health Card claim has been started is displayed

Note: customers can test their eligibility for more than one card type but will require a separate claim to be completed, and relevant documentation to be supplied, for each claim.

Customers must provide all required documents and verify their identity (if there is no Identify Confirmation (ICI) recorded) to submit their claim. Exceptions will be made for some vulnerable customers.

The Claim navigation page shows the steps of the claim the customer must complete. They must complete each step in order before they can start the next.

They select Start to access steps.

Each step contains modules with relevant questions. On each question page, the customer can select Previous to go back to the previous question.

Customers can select Launch the Digital Assistant for help with the questions on the current page.

After completing each section, the customer returns to the Claim navigation page to select the next section. They have the option to select Edit to correct answers to a previous section. They can then return to the Claim navigation page by selecting the arrow under the last dot on the side navigation and Continue.

Customers can use the dots on the side navigation of each page to go between pages in the online claim. If they answer a question incorrectly, a red cross will appear in the dots on the right of the page. They can select the red cross to go to the page with the error.

They do not need to complete the claim in one session. Customers can leave the Claim navigation page at any time and the responses will save for them to continue later.

All compulsory questions must be answered before the claim can be submitted.

Question sets include:

• Personal and interpreter details
• Address
• Contact details
• Relationship details
• Partner details (if applicable)
• Contact requirements
• Australian residence
• Child details

Questions sets include:

• Payment destination
• Tax file number/s
• Financial Year and Tax Lodgement details
• Account-Based Income Streams

The income test for the CSHC uses adjusted taxable income (ATI) for:

• the customer and their partner (if relevant), and
• the applicable financial year

This includes deemed income from account-based income streams.

See Commonwealth Seniors Health Card (CSHC) income test and reference tax year, and Lodgement of Notice of Assessment (NOA) and other evidence of income for Commonwealth Seniors Health Card (CSHC).

ATI is the sum of:

• taxable income
• employer provided fringe benefits in excess of $1,000
• reportable superannuation contributions
• total net investment losses, and
• foreign income

Deemed income is calculated from the current balance of income streams.

The deemed income is added to the ATI amount, with the combined total used in the CSHC income test.

Deeming will only apply to account-based-income steam(s) and not any other financial assets they own.

If the customer is eligible, they will be presented with an option to claim 'just for myself' or 'for both myself and (their partner’s name)' as a Commonwealth Seniors Health Card combined partner claim.

The option to submit a combined partner online claim will only appear where the following criteria is met:

• claim is not being submitted by a Nominee (Correspondence or Third Party Organisation)
• customer does not indicate they are in crisis (domestic violence, humanitarian visa entrant, natural disaster and recent jail release) in the claim
• partner is already linked in the system before starting the claim
• customer does not change current relationship status within the claim. The customer must not be single or in a relationship where they are unable to live together
• both customer and partner are subscribed to electronic messaging before starting the claim
• partner is eligible to lodge a claim for a Commonwealth Seniors Health Card
• partner is not already receiving an Income Support Payment
• the customer has answered yes to the question 'Can you provide accurate information regarding your partner's circumstances to support your claim?'
• partner has a payment destination account in their name either jointly or solely
• partner does not have a draft Commonwealth Seniors Health Card claim

The customer must not try to submit a claim more than 12 weeks after starting the claim. There needs to be enough time for partner to complete the partner tasks before the claim will automatically cancel online due to time lapse. If eligible for a combined partner claim, the partner must complete and confirm the claim task within 3 days of being notified, otherwise the claim will revert back to an individual Commonwealth Seniors Health Card claim for the customer only.

Confirm details

A summary of all the information provided by the customer is displayed so they can check what they have entered is correct.

If changes are required, the customer can select the Update button relevant to the answers requiring change. This will take them back to the relevant section of the claim to review/update the particular claim questions and responses.

Combined partner claim option

At this stage, if applicable, customers/nominee can select to apply for either a single claim or a combined partner claim. Selecting the relevant claim type will then present further tasks.

Declaration

Once all information is correct, the customer must accept the declaration by ticking the box. Completing the declaration means a signed claim form is not required.

Acknowledgement

The customer must accept the acknowledgement by ticking the box. Completing the acknowledgement means the customer understands and agrees to the terms of their claim.

Confirm Information

The customer must select the Confirm Information button to save all the information provided in the claim. Answers in the claim cannot be changed once this button is selected.

The Next steps page advises the customer of any further information or documentation required for them to submit their claim.

Customers must provide all required documents and verify their identity (when a Confirmed Identify status has not been achieved) to submit their claim. Exceptions will be made for some vulnerable customers.

To be assessed from the earliest possible date, customers need to provide all required information and supporting documents and submit the claim as soon as possible. The date the claim is submitted will generally determine the claim start date. Customers can access their saved claim for 13 weeks. After 13 weeks the claim will expire. See Online claim or ACC expired after 13 weeks for more information.

Customers can access their started online claim using their Centrelink online account or the Express Plus Centrelink mobile app to upload the required documents to submit their claim.

In the Next steps section, there is an Upload documents button next to most listed tasks, that will launch the Upload documents service and change the Task status to ‘Done’ once documents have been provided or actions completed.

If necessary, Service Officers can scan the documents and submit the claim for the customer:

• Scan the documents
• Run the Request and Manage Customer Tasks guided procedure in Customer First to submit the claim, or
• Task can be marked as ‘provided’ by accessing the Tasks icon in Process Direct. See the Process Direct – managing tasks table for more information

To submit their claim, customers must:

• answer all mandatory questions
• provide all their required documents
• verify their identity (when a confirmed Identity Confirmation status has not been achieved)

Exceptions may apply for vulnerable customers to submit their claim without providing all documents.

They cannot submit their claim if the Required tasks are not completed.

Once the relevant tasks are completed, the Submit button will become available so the customer can submit their claim.

Claims not submitted within 13 weeks will expire. See the Online claim or ACC expired after 13 weeks table for more information.

Note: the customer must not try to submit a combined partner claim more than 12 weeks after starting the claim. There needs to be enough time for partner to complete the partner tasks before the claim will automatically cancel online due to time lapse.

'Channel hopping' allows:

• the customer to start a claim online and have it continued by a Service Officer, or
• a Service Officer to help a customer with starting a claim, which would then be completed by the customer online (an active Centrelink online account is required)

Online claims and ACCs can also be started and submitted by customers or their nominees.

Note: nominees acting on behalf of their principals cannot submit a Commonwealth Seniors Health Card combined partner online claim.

For more information, see Table 2.

Once a claim for CSHC is submitted, the claim is assessed to determine eligibility. See Assessing Commonwealth Seniors Health Card (CSHC) claims.

If required update the customer’s personal details via the Change in Contact Details workflow including interpreter details, as ACC does not ask for them.

If ACC was started before the updates were made, the claim can be exited and the updates made outside the claim before submitting it. The updates will appear on the Review page in ACC.

Electronic messaging and letters

Customers who provide a mobile phone number or email address should be told that they will automatically be subscribed to Electronic Messaging (EM) services unless they have previously declined EM. They will be asked to nominate a preferred contact method (SMS or email) for electronic messages. They will receive messages via their preferred contact method to complete all Required tasks, see Electronic Messaging (EM) - Targeted notifications.

Where the customer no longer has online access or wishes to change their preferred contact method, See Centrelink letters, messages and notifications online.

Partner to claim

Establish whether the customer has a partner. If partner is eligible, clarify the partner’s intent. If specific criteria are met, a Commonwealth Seniors Health Card combined partner online claim can be completed. Alternatively, and if partner is:

• available, a separate ACC can be started with the partner
• unavailable, use the FCSO workflow to issue the appropriate claim to the partner

Staff access ACC through the ACC desktop icon.

ACC replicates the questions in the online claim.

Service Officers can run ACC when:

• the customer is available and able to answer the questions in the claim, and
• a customer is unable or unwilling to claim online, or
• helping a customer with starting the online claim

Note: if both members of a couple wish to claim through ACC (and do not meet the specific criteria for CSHC combined partner claim), complete an ACC for both members of the couple.

Claims started via ACC can be submitted by the customer in their online account (an active Centrelink online account is required).

When running ACC, tell the customer of any documents they need to provide or action they need to take to submit their claim. The customer will need to:

• answer all mandatory questions
• including verbal declaration or CDF signed by the customer (where applicable)
• provide all required documents, and
• verify their identity if a Confirmed Identify status is not recorded

Some customers may not be able to complete all of their 'Required' tasks before submitting their claim. Exceptions apply for some vulnerable customers.

To submit the claim via ACC, all mandatory questions must be answered and all required documents provided, including verbal declaration or CDF signed by the customer (where applicable) and identity documents where a confirmed Identity Confirmation status has not been achieved. Exceptions will be made for some vulnerable customers.

Once all required tasks are completed, or the claim can be submitted under a claim submission exception, the Submit button is displayed so the claim can be submitted.

The Claim submission details page will display:

• Submitted date
• Claim ID
• Estimated Completion Date Range (ECDR), a date range that can be given to the customer
• A 'view claim history' button
• A 'view claim answers' button
• Tabs that link to Claim history and Claim answers

Note: a claim started using ACC will expire after 13 weeks if not submitted. See Circumstance Change Monitor for more information.

Once all information is correct, the declaration must be read to the customer and accepted by ticking the box. Completing the declaration means a Customer Declaration Form (CDF) is not needed.

Once a verbal declaration is accepted and the ACC submitted, a DOC containing this information will be displayed in:

• Process Direct notes
• Customer First Super Case
• the Customer Claim Summary

If the customer is identified as vulnerable and the claim is submitted with outstanding documents:

• Check the customer knows what they need to provide
• Record on a DOC

If a customer is unable or declines to make a verbal declaration, the Service Officer must:

• invite the customer to log on to their online services, accept the declaration and submit their claim, or
• print a CDF using the template in the Resources page

The claim must not be submitted without the CDF being completed and signed:

• Send a Q004 to the customer with the printed CDF from the Resources page, as this cannot be added as a required document on Next steps
• Record a detailed Note on the customer’s record stating the Q004 and CDF was issued, include the expected due date. This must be signed and returned before the claim is assessed

Reminder: if a partner is eligible, available, and also wishes to claim CSHC, run ACC with the partner in their own record.

Once a claim for CSHC has been submitted, the claim is then assessed to determine eligibility. See Assessing Commonwealth Seniors Health Card (CSHC) claims

If the customer lodges a paper claim SA296 or SA443 Claim for Commonwealth Seniors Health Card, ensure the claim is complete and accepted. See Claim lodgement of Centrelink claims

If the customer lodges an SA296 or SA443, check:

Question 7 - Do you have a partner?

• Yes, check that the customer and partner have provided personal and income details.
• No, go to Step 4

The Resources page contains links to the CSHC claim forms.

If the customer lodges an SA296 or SA443, check:

Question 8 - Is your partner also claiming the Commonwealth Seniors Health Card?

• Yes, they must also meet Identity Confirmation requirements and have signed the claim form
• No, identity confirmation and signature is not required for partner but income details are

Check for the following documents for both the customer and partner (if applicable):

• CSHC claimants need a confirmed identity status. They will need to provide documents to prove their identity if there is no ICI recorded. Original documents must be sighted, recorded and returned
• Proof of age (must be age pension age at the time of claim lodgement)
• Tax File Number (TFN) for Commonwealth Seniors Health Card (CSHC)
• Other supporting documents. For example:
• ATO Notice of Assessment
• Tax Return
• Payment summary/ATO income statement
• Details of income stream product (SA330) or a similar schedule

For additional details see:

• Documents required for Centrelink new claims
• Commonwealth Seniors Health Card (CSHC) income test and reference tax year, and
• Lodgement of the Notice of Assessment (NOA) and other evidence of income for Commonwealth Seniors Health Card (CSHC)

Ensure the customer provides Identity and proof of age for their partner, if they are claiming CSHC on the same claim form.

Code the customer's identity documents. For more information, see Coding identity documents.

Check that all forms issued via FCSO have been lodged. Customers will get a letter and list the documents they will need to support their claim.

Record details on a DOC:

• if the system does not allow the coding of the proof of age document. For example, due to system limitations, or
• the customer is unable to provide one

Scan documents if there is a need for verification.

See:

• Coding identity documents
• Sighting, recording and returning original documents

When a CSHC paper claim or documents for an online or ACC claim are received:

• scan the paper claim and/or supporting documents to the customer’s record.
• Do not select Scan to Store as the automatic creation of a SHC new claim Social Online Application (SOA) and work item are required for Workload Management (WLM) allocation

Documentation provided separately, for example, after an online claim or ACC has been started or submitted:

• run the Request and Manage Customer Task guided procedure in Customer First. For an online claim or ACC, the Summary page will display Tasks (documents) requested at Next steps
• mark the corresponding Task as 'Provided' or task can be marked as ‘Provided’ by accessing the Task Icon in Process Direct
• scan to the customer’s record
• select appropriate unstructured (UNS) form type if required

Note: if the customer provided the documentation for their online or ACC claim in person, the Service Officer should advise the customer to submit the claim, or do it for them.

For customers grandfathered for Energy Supplement, bank account details (SHC) must be recorded.

If the customer is claiming within 42 days of an income support payment cancellation:

• Update the Payment Destination Details (PAD) screen (SHC) with bank account details coded for the cancelled income support payment on the Payment Destination Summary (PAS) screen
• The 'E008SH - Code SHC payment destination or ES NOT grandfathered status' warning will appear on the Assessment Warning and Error (AWE) screen when there are no bank account details recorded

For customers who have a payment nominee, record the bank account of the Payment Nominee on the PAD screen before linking the Nominee. Note: CSHC customers cannot get the Energy Supplement if their bank account details are set as cheque.

Check to ensure the correct relationship status is coded on the Marital Status (MS) screen. This ensures that the customer is paid the correct entitlement of Energy Supplement (partnered or single rate) if they want to get this payment.

Press [Enter], and complete all personal details.

Once a claim for CSHC is submitted, it is assessed to determine eligibility. See Assessing Commonwealth Seniors Health Card (CSHC) claims