Register children (including children in care) for Medicare Safety Net 011-43080070
This document outlines how to register children, including children in care, for Medicare Safety Net. Note: from 1 July 2016, Norfolk Island is covered under Medicare provisions.
National consistency for dependant (child) registration for Medicare Safety Net
This information provides national consistency for situations where a dependant child is being registered for the Medicare Safety Net.
Definition of a child dependant
For Medicare Safety Net purposes a dependant is defined as:
- a child who is:
- less than 16 years of age, and
- in custody, care and control of the family contact or their spouse/de facto partner
- a full-time student who is:
- less than 25 years of age, and
- in custody, care and control of the family contact or their spouse/de facto partner
A child can be registered in a maximum of two Medicare Safety Nets provided the families share custody and decision making concerning the daily care and control of the child.
If a child is registered on two Medicare Safety Nets, the out-of-pocket expenses associated with any service the child receives is attributed to the Medicare Safety Net family of the family who incurred the expense.
As each family approaches the Safety Net threshold, the family is asked for confirmation of the family composition. If there are any changes to the family composition these must be updated. This may involve removing the child from an earlier registered family, if the child is no longer in their custody, care or control.
No existing Medicare Safety Net family registration
Do not create a new Medicare Safety Net family registration without the customer’s consent where a request is received by Services Australia to enrol a child in Medicare and either:
- there is no existing Medicare Safety Net family registration, and/or
- the Medicare Safety Net question has been left blank on the form
Register a child for the Medicare Safety Net after Medicare enrolment
A child must be registered in a Medicare Safety Net family registration from the calendar year in which the child became eligible and enrolled in Medicare. For example, if a child was born in December, but not enrolled in Medicare until the following calendar year (Medicare enrolment will be back dated to date of birth), they must be added to the existing Medicare Safety Net family registration for both the current and previous calendar years.
If the customer requests a child be added to their Medicare Safety Net family and the child is enrolled in Medicare but has not been registered in an existing Medicare Safety Net family and was:
- born in Australia, then the child is added to the registration from the calendar year in which the child was born
- born overseas, then the child is added to the registration from the date the child became eligible for Medicare
Note: if the date the child is being added to the Medicare Safety Net family registration is greater than 12 months from the date the child was born, the enquiry must be emailed to MPS Assessing for determination.
See Family registration and confirmation for Medicare Safety Net to:
- add a child to an existing registration
- register a new Medicare Safety Net Family
End of year carry-over of Medicare Safety Net registrations
The end of the year roll-over allows for all Medicare Safety Net registrations to be carried over to 1 January the following year. This means that families already registered do not need to re-register for the Medicare Safety Net for the following calendar year however they need to confirm the family when reaching the threshold.
Any queries about additional Medicare Safety Net benefits being payable for the child must be referred to MPS Assessing.
Medicare Safety Net Registrations and newborns
For families who have a newborn and have not previously registered as an MSN family, the registration date will be the newborn’s date of birth.
Adjust Service Lines where Medicare Safety Net threshold has been reached
Adjustments to Medicare claims need to be made to service lines if:
- there was an existing Medicare Safety Net family registration and the child was not registered in the Medicare Safety Net family at the time of enrolment, or
- a new registration should have been created at the time of the child's enrolment for example mother and child, and
- claims for Medicare benefits have been processed for the child since the date of enrolment
See Medicare Safety Net threshold has been reached.
Record the contact details of the customer and their situation on the Medicare Safety Net query form and email the form along with any other relevant scanned documents the customer may have provided for example birth certificate to MPS Assessing.
The Resources page contains a link to the Medicare Safety Net query form.
Register children in care in a family Medicare Safety Net family
This policy covers the situation where a family caring for a child in care, state ward or a child under a care/guardianship order or in kinship care requests the addition of the child/ren to their Medicare Safety Net family registration.
Children in care are considered 'dependant children' provided they fulfil the conditions of 'dependant'. See Definition of a child dependant.
Any queries regarding the registration of children in care are to be directed to MPS Assessing. See Child protection agencies - Medicare card number requests for children and young people in out-of-home care (OOHC).
Children in care registered in two Medicare Safety Nets families
When a request has been made to add a child/ren who is in care to a Medicare Safety Net family and child/ren are already registered on two Medicare Safety Nets, the customer must provide proof that the child/ren are in their full custody, care and control.
This evidence should be either a court order or documentation from a state child protection agency. For:
- NSW Department of Communities and Justice
- VIC Department of Human Services
- QLD Department of Communities (Child Safety)
- SA Department of Health and Aged Care and Human Services
- WA Department of Child Protection
- ACT Office for Children, Youth and Family Support, Care and Protection
- NT Department of Health and Aged Care and Families
Applications from agencies such as Barnardos, Catholic Care and Anglicare are acceptable providing all required documents are provided.
Once evidence has been provided that the child/ren are in full custody of the foster parent or guardian, the child/ren are to be removed from two existing Medicare Safety Net family registrations (provided and added to the foster parent/guardians Medicare Safety Net family
Reimbursement of medical costs by state departments or agencies
Medicare benefits are not payable for services (reimbursement of medical costs) to children in care. That is, if the carer has a financial agreement with a:
- state department, or
- agency
The Resources page has:
- contact details for the Assessing and Benefits team
- a link to the VG4 form
- the Medicare Safety Net query form PP041
- a link to the Medicare Safety Net escalation form
- the Medicare Safety Net Registration and Amendment for Couples and Families form (MS016)
Related links
Escalation process for Medicare Eligibility
Family registration and confirmation for Medicare Safety Net
Indicators, codes, modifiers and control lines for claims processing in Medicare
Latter day adjustments (LDA) and HELD payments for patient claims