Residence assessment for customers claiming Commonwealth Seniors Health Card (CSHC) 065-06040010
This document outlines how to assess if a claimant for a CSHC satisfies the residence requirements. The assessment includes whether the customer is residentially qualified to lodge a legal claim and if they are required to serve the Newly Arrived Resident's Waiting Period (NARWP).
On this page:
Residence requirements for CSHC
Assessing if a customer has served or is exempt from the NARWP
Residence requirements for CSHC
Table 1
Step |
Action |
1 |
Residence requirements for CSHC + Read more ... To qualify for a CSHC the customer must meet all the following:
Ensure the customer's country of birth and any travel documents are recorded. The system will automatically link to immigration information and update the customer's visa and movement information. For more details, see Activating the Department of Home Affairs datalink and contingency procedures if datalink is unavailable. To activate the Immigration Datalink, go to the Immigration Enquiry (RSIMME) screen. |
2 |
Check residence details provided by immigration + Read more ... Check the following screens:
If the customer is:
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3 |
Customer is not in Australia + Read more ... The customer can only lodge a legal claim for a CSHC 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?
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4 |
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. |
5 |
Customer is not an Australian resident or is an SCV holder who is not residing in Australia + Read more ...
The customer may be entitled to some of the following. Offer to the customer if appropriate:
Procedure ends here. |
Assessing if a customer has served or is exempt from the NARWP
Table 2
Step |
Action |
1 |
Check citizenship + Read more ... A customer who is an Australian citizen has an automatic exemption from the NARWP. Citizenship must be verified. To determine if a customer is an Australian citizen, see Proof of Australian citizenship. Service Officers must code country of citizenship details on the Legal Residence Details (RSLEG) screen. Is the customer an Australian citizen?
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2 |
Check if the customer has served the NARWP + Read more ... If the customer was granted their first permanent residence visa:
Check the Periods of Australian Presence (RSPAP) screen. This screen displays the periods the customer has physically been in Australia while an Australian resident. For SCV holders, check the Residency Results Explanation (RSREX) screen. This displays periods of Australian residence as an SCV holder. Has the customer been an Australian resident or the holder of an SCV living in Australia for at least 2 years (104 weeks) or 4 years (208 weeks?
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3 |
Check visa subclass 852 + Read more ... A customer who holds, or has held, 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. Is the customer the holder (or former holder) of a visa subclass 852?
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4 |
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 evidenced on the RSLEG screen or from their passport, contact Centrelink International Services (CIS): In Process Direct, create an International Services referral. This will place the online claim On Hold pending the outcome of the referral:
Is the customer a refugee or former refugee?
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5 |
Family member of a refugee or former refugee + Read more ... 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?
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6 |
Check if the customer was the family member of a refugee or former refugee when they arrived in Australia + Read more ... Note: the customer must also currently be the family member of that person, or if that person has died, they must have been a family member when that person died. Was the customer a family member of a refugee or former refugee at the time that the refugee or former refugee arrived in Australia?
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7 |
Check if the customer is currently the family member of a refugee or former refugee + Read more ... Note: the customer must also have been the family member of that person at the time the refugee first arrived in Australia. If the family member is now an Australian citizen, they are no longer considered to be a refugee (they are a former refugee) but the customer can still be covered by this exemption provision. Is the customer currently the family member of a refugee or former refugee?
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8 |
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 also have also been the family member of that person at the time the refugee first arrived in Australia. Was the customer the family member of a refugee or former refugee when the refugee or former refugee died?
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9 |
Continue to assess the claim + Read more ... If the customer has served the NARWP:
If the customer has not served the NARWP:
Is the customer residentially qualified for CSHC?
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10 |
Options for customers who are not residentially qualified for CHSC + Read more ... The customer may still be entitled to some of the following. Offer to the customer where appropriate:
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