Assessing Commonwealth Seniors Health Card (CSHC) claims 065-06030000

To qualify for a CSHC, a customer must satisfy all the eligibility criteria. See Eligibility for Commonwealth Seniors Health Card.

If any eligibility criteria are not met, the claim must be rejected. There is no requirement to verify details that will not change the outcome of the assessment.

Service Officers must stream claims on the day they are received or allocated via Workload Management.

Claims are to be checked to make sure all required information has been provided to allow the claim to be finalised

If the claim cannot be finalised, the progress of claim DOC/note must be annotated with a detailed explanation of why the claim cannot be finalised.

If documentation is required, this is displayed at Next Steps within the online claim.

Documents required for customers submitting paper claims will be identified from checklist of SA296, SA296A or identified documents of SA443. See Documents required for Centrelink new claims for more information.

When customers provide documents in person to support their claim, accept and scan documents as required. Customers can supply further information or documents for their claim via Upload documents service.

Verification of Income for CSHC

All customers claiming CSHC must provide evidence of their declared income for the relevant financial year plus evidence of any account based income streams. For detailed information see:

• Commonwealth Seniors Health Card income test and reference tax year
• Lodgement of NOA and other evidence of income for Commonwealth Seniors Health Card

If a customer is not required to lodge a tax return, then they should be encouraged to test their eligibility for an Age Pension.

Customers advising in their claim of a child entering care need to provide a completed 'Details of your child's care arrangement (FA012)' before submitting their online claim.

If the claim is processed in Process Direct, an Assessment of Care Arrangements Referral work item will be generated and the assessment must be completed before the claim can be finalised.

A Families Service Officer will complete the Assessment of Care for the child.

After the Service Officer completes the care assessment, Commonwealth Seniors Health Card processing staff can assess and finalise the claim.

Customers who have had their CSHC cancelled, it may be restored, require a re-claim or a full new claim. See Claiming Commonwealth Seniors Health Card (CSHC).