Applicants for permanent residency eligibility for Medicare 011-44020000

Customers must provide the following documents for each person listed on the Medicare enrolment form (MS004) or listed in their Digital Medicare enrolment (DME) application:

• Current passport or valid ImmiCard, and
• Proof of a valid visa with permission to work, and
• Proof from the Department of Home Affairs that they have applied for permanent residency. Evidence must include the:
• application ID
• visa subclass applied for, and
• date of lodgement of visa application (this can be accepted when sent from a Migration Agent)

If a customer/s:

• does not have permission to work, go to Step 4
• MS004 is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information
• DME documents are incorrect, see Digital Medicare enrolments (DME) and the MEE Portal

Note: Service Officers must not save customer documents and letters to their desktop or personal H: drive.

To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal.

Note: if a customer submits a DME application, DVS is completed in the MEE Portal. See Digital Medicare enrolments (DME) and the MEE Portal.

Service Officers must complete a Visa Entitlement Verification Online (VEVO) check for all customers listed on the MS004 form.

If the customer has submitted their enrolment through DME, see Digital Medicare enrolments (DME) and the MEE Portal.

Does the VEVO check confirm the customer is onshore?

• Yes, proceed with the enrolment
• No, customer is offshore:
• reject the application, and
• send Applicant Still Overseas letter
• Procedure ends here

If a customer has no work rights, they must provide evidence of a relationship to a child, partner, or parent who is either:

• an Australian citizen
• a permanent resident of Australia, or
• a New Zealand citizen that lives in Australia

Service Officers do not have permission to access customer records to confirm the eligibility of the:

• Australian citizen
• permanent resident of Australia, or
• New Zealand citizen that lives in Australia

Service Officers must record the relationship documents in CDMS. If relationship documents have been supplied with a previous application and recorded in CDMS under eligibility documents, relationship documents are not required to be re-supplied.

Note:

• if only one person in the family has permission to work, only that person can enrol in Medicare
• if there is a dash (-) in entitlement (DIAC link) when enrolling a customer and VEVO states permission to work, continue the enrolment process as VEVO has the most current information from Home Affairs

Register the customer for Medicare using the entitlement details below and record all documents provided.

To enrol the customer under applicant for permanent residency:

• Entitlement Type - Conditional Migrant
• Country of relevance - previous country of residence before arriving in Australia
• Start Date - use the date the customer:
• lodged their visa application (onshore)
• entered Australia to live (if visa application lodged offshore)
• End Date - 12 months from the start date
• End reason - entitlement ceased

When keying the entitlement end date of 12 months, only the years needs to change. For example, a start date of 01/01/2023 would mean the end date is keyed as 01/01/2024.

If the entitlement end date is close to expiry (less than 31 days from the date of processing), the entitlement can be manually extended for 12 months from date of processing.

Service Officers must key all required eligibility documents provided under each applicant's Entitlement tab in CDMS. See Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS).

• Select Documents tab
• Select or key the details of each of the customer's eligibility documents:
• Eligibility Document (mandatory)
• Residency Document (if applicable)
• Reference Text - number or text of the document (mandatory)
• Reference Date (mandatory)
• Select Add
• Repeat above to key all documents provided separately

See Document types for Medicare eligibility and enrolment for document details to be recorded in CDMS.

Customers must provide their change of name documents.

For an initial enrolment when the customer's name differs between the passport and visa:

• Search for the name recorded with Home Affairs
• Link the customer to their Home Affairs record (DIAC link). See Table 6
• When the DIAC link is complete, change the customer's name (to the passport or change of name document)

Any changes from Home Affairs will update in CDMS.

If there is no DIAC link, the customer's name may be changed once the initial enrolment has been completed.

For a previously enrolled customer, change the customer's name if they are currently enrolled under the name held by Home Affairs.

For details about acceptable change of name documents see Change legal name on Medicare record.

Customers must provide the following documents for each person listed on the Medicare enrolment form (MS004) or listed in their Digital Medicare enrolment (DME) application:

• MS004 or DME, and
• Current passport or valid ImmiCard, and
• Proof of valid visa with permission to work, and
• Proof from the Department of Home Affairs they have applied for permanent protection. Evidence must include the:
• application ID
• visa subclass applied for, and
• date of lodgement of visa applicant (this can be accepted when sent from a Migration Agent)

For refugees who do not have photo ID

Refugee customers who do not have photo identification can provide a statement by an authorised referee. It must include the:

• customer's full name
• customer's date of birth
• referees relationship to the customer, and
• length of time the referee has known the customer

A referee may be a:

• case/social worker
• minister of religion
• police officer, or
• member of the legal profession

This only applies to applicants or holders of permanent protection visas. All other enrolments must provide photo identification.

If a customer/s:

• does not have permission to work, go to Step 4
• MS004 is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information
• DME documents are incorrect, see Digital Medicare enrolments (DME) and the MEE Portal

Service Officers must not save customer documents and letters to their desktop or personal H: drive.

To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal.

Note: if a customer submits a DME application, DVS is completed in the MEE Portal. See Digital Medicare enrolments (DME) and the MEE Portal.

Service Officers must complete a VEVO check for all customers listed on the MS004 form.

If the customer has submitted their enrolment through DME, see Digital Medicare enrolments (DME) and the MEE Portal.

Does the VEVO check confirm the customer is onshore?

• Yes, proceed with the enrolment
• No, customer is offshore:
• reject the application, and
• send Applicant Still Overseas letter
• Procedure ends here

If a customer has no work rights, they must provide evidence of a relationship to a child, partner, or parent who is either:

• an Australian citizen
• a permanent resident of Australia, or
• a New Zealand citizen that lives in Australia

Service Officers do not have permission to access other customer records to confirm the eligibility of the:

• Australian citizen
• permanent resident of Australia, or
• New Zealand citizen that lives in Australia

Record the relationship documents in CDMS.

If relationship documents have been supplied with a previous application and recorded in CDMS under eligibility documents, relationship documents are not required to be re-supplied.

Note:

• if only one person in the family has permission to work, only that person can enrol in Medicare
• if there is a dash (-) in entitlement (DIAC link) when enrolling a customer and VEVO states permission to work, continue the enrolment process as VEVO contains the most current information from Home Affairs

Register the customer for Medicare using the entitlement details below and record all documents provided.

To enrol the customer under an applicant for permanent protection:

• Entitlement Type - Application for Permanent Protection (866 visa)
• Country of relevance - previous country of residence before arriving in Australia
• Start Date - use the date that the application was lodged in Australia with Home Affairs
• End Date - 12 months from the start date
• End reason - entitlement ceased

The Resources page has an allowable extension period table.

When keying the entitlement end date of 12 months, only the years needs to change. For example, a start date of 01/01/2023 would mean the end date is keyed as 01/01/2024.

If the entitlement end date is close to expiry (less than 31 days from the date of processing), the entitlement can be manually extended for 6 months from date of processing.

Service Officers must key all required eligibility documents provided under applicant's Entitlement tab in CDMS. See the Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS)

• Select Documents tab
• Select or key the details of each of the customer's eligibility documents:
• Eligibility Document (mandatory)
• Reference Text - number or text of the document (mandatory)
• Reference Date (mandatory)
• Select Add
• Repeat above to enter all documents provided separately

See Document types for Medicare eligibility and enrolment for document details to be recorded in CDMS.

Customers must provide change of name documents.

For an initial enrolment when the customer's name differs between the passport and visa:

• Search for the name recorded with Home Affairs
• Link the customer to their Home Affairs record (DIAC link). See Table 6
• When the DIAC link is complete, change the customer's name to the passport or change of name document

All changes from Home Affairs update in CDMS.

If there is no DIAC link, the customer's name can be changed once the initial enrolment has been completed.

For a previously enrolled customer, change the customer's name if they are currently enrolled under the name held by Home Affairs.

See Change legal name on Medicare record.

A customer may have their visa application refused by Home Affairs. The customer can appeal this decision with the Administrative Review Tribunal (ART).

Note: Prior to 14 October 2024 the ART was known as the Administrative Appeals Tribunal (AAT).

The customer is eligible for Medicare while appealing the decision.

Has the customer lodged an appeal with the ART or AAT for their visa refusal?

• Yes, go to Step 2
• No, the customer is ineligible for Medicare. Procedure ends here

Customers who have lodged an appeal of their visa refusal cannot lodge a re-enrolment application online through Digital Medicare Enrolments (DME).

To extend their eligibility customers must provide:

• a completed Medicare Enrolment form (MS004), and
• a current passport or ImmiCard, and
• a valid visa with permission to work which can be viewed in VEVO, see Step 4, and
• a Home Affairs notice for the refused visa which includes details about the category of visa subclass, application ID and date of lodgement, and
• Evidence of an appeal. The customer must provide one of the below:
• AAT or ART document, or
• Federal Court or High Court document, or
• Ministerial Intervention document or Visa Entitlement Verification Online (VEVO) to confirm Ministerial Intervention has commenced

If evidence of an appeal has not been provided, Service Officers must:

• attempt to contact customers to request evidence of an appeal
• not reject or refuse an application if a customer cannot provide evidence of an appeal. See Escalation process for Medicare Eligibility

If the customer's identity document has expired:

• see Expired Identity documents on the Background page
• and previously recorded in CDMS but cannot be verified in DVS, the customer can supply a current Australian driver's licence

Note: the customer must be appealing the refusal of a Medicare-eligible visa category to be eligible for Medicare during the appeals process.

Administrative Review Tribunal (ART) documents

• The letter must be dated within the last 2 years at the date of processing
• If it is over 2 years old, ask the customer to provide a current letter. It must show that the appeal is ongoing
• The Appeals Tribunal document can be from the Administrative Appeals Tribunal (AAT) or the ART

Federal Court or High Court documents

Federal Court documents must include one of the following:

• a court hearing date, or
• advice that a court hearing date will be provided in the future or a date yet to be advised

This document must identify the customer by name. If only a pseudonym is present, ask the customer to provide an additional letter that has the:

• customer's name, and
• customer is referred to by the pseudonym

Note: this additional letter can be the covering letter the customer initially got from the Court notification or from the customer's Migration Agent.

See Escalation process for Medicare Eligibility if:

• it cannot be determined the appeal is ongoing, or
• the customer cannot provide evidence of an appeal, or
• the customer cannot provide a letter confirming their pseudonyms

Ministerial Intervention documents

Customers can apply for a Ministerial Intervention through the Department of Home Affairs Minister's office.

Service Officers must escalate all Ministerial Intervention applications through PaNDA to ME_Escalations, LPS will escalate through PaNDA to the Medicare Consumers Program Support Team.

Ministerial Intervention documents must include one of the following:

• Document confirming a Ministerial Intervention is in place, or
• VEVO confirming Ministerial Intervention has commenced

See Escalation process for Medicare Eligibility

A customer’s VEVO check result will display a 'No' answer to the 'Applicant for Permanent Residency' question when their Permanent Residency visa application has been refused.

Service Officers must complete a VEVO check for all customers listed on the Medicare enrolment (MS004) form.

Has the customer provided evidence of an appeal?

• Yes, go to Table 4
• No, request evidence of a valid appeal from the customer. If the customer has:
• not lodged an appeal the customer is ineligible for Medicare. Procedure ends here
• lodged an appeal but cannot provide evidence see Escalation process for Medicare Eligibility

To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal

Note: if a customer submits a DME application, DVS is completed in the MEE Portal. See Digital Medicare enrolments (DME) and the MEE Portal.

Service Officers must complete a VEVO check for all customers listed on the Medicare enrolment (MS004) form.

If the VEVO check confirms the customer is:

• onshore, go to Step 3
• not onshore:
• reject the application, and
• send Applicant Still Overseas letter
• Procedure ends here

• If a customer has no work rights, they must provide evidence of a relationship to a child, partner, or parent who is either:
• an Australian citizen
• a permanent resident of Australia, or
• a New Zealand citizen that lives in Australia
• Service Officers do not have permission to access customer records to confirm the eligibility of the:
• Australian citizen
• permanent resident of Australia, or
• New Zealand citizen that lives in Australia
• Service Officers must record the relationship documents in CDMS
• If relationship documents have been supplied with a previous application and recorded in CDMS under eligibility documents, relationship documents are not required to be re-supplied.

Note:

• if only one person in the family has permission to work, only that person can enrol in Medicare
• if there is a dash (-) in entitlement (DIAC link) when enrolling a customer and VEVO states permission to work, continue the enrolment process as VEVO contains the most current information from Home Affairs
• If the customer has submitted their enrolment via DME, see Digital Medicare enrolments (DME) and the MEE Portal

• Select Amend Consumer Details
• Key the customer's Medicare card number in ID Number field
• Select Group

A Medicare Payment Integrity (MPI) restriction may be on the record. This prevents any changes. If this occurs, see the Comments in Group, check Unauthorised Medicare activity or contact Medicare and Aged Care - Local Peer Support (LPS).

Note: sensitive or safety concern messages may display on the record. Service Officers must acknowledge these warnings, failing to check indicators may cause serious harm or distress to customers.

Service Officers must check that the existing entitlement in CDMS matches the entitlement in the documents submitted by the customer.

Select Entitlement.

Does the Entitlement Type in CDMS match with the visa name/subclass on the customer’s Home Affairs notice?

• Yes, select Amend DIAC Link button, go to Step 6
• No, contact Medicare and Aged Care - Local Peer Support (LPS)

If the Client Status shows:

• Lodged - go to Step 7
• Granted - see Table 8 in Medicare eligibility for customers with permanent resident status
• Refused - see Table 3
• Withdrawn - contact Medicare and Aged Care - Local Peer Support (LPS)

Note: the Immigration Clients tab cannot be selected if there is no information available from Home Affairs regarding the customer’s client status.

Service Officers must key all required eligibility documents provided under each applicant’s Entitlement tab in CDMS. See the Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS)

• Select Documents tab
• Select or key the details of each of the customer's eligibility documents:
• Eligibility Document (mandatory)
• Reference Text - number or text of the document (mandatory)
• Reference Date (mandatory)
• Select Add
• Repeat to enter all documents provided under each applicant's entitlement separately

Do not record the same document details if they are already correctly recorded in eligibility documents.

Note: when relationship documents have been previously submitted and recorded in CDMS and are still relevant, do not request these again.

The Resources page has details about extension periods.

Once eligibility is established, extend the entitlement details.

Select the Card Request tab.

In the Group Eligibility end date field:

• Key the extended date
• Select the checkbox to replace the current card
• Select the Replacement Reason from the dropdown menu
• Select the checkbox if a Duplicate Replacement card is also required
• Select the Card Request Source from the dropdown menu
• Select Comments and key the below if the visa is refused
  'Appeals Tribunal letter dated [dd/mm/yy], [case number], extended for 12mths'
• Select Validate, Validate, Update

An information message displays stating if the details were acceptable or not. Select OK to acknowledge the message. If not acceptable, make changes as required.

Do not change the Group Eligibility Start Date.

• Select the Amend Consumer Details
• Key the customer's Medicare card number in the ID number field
• Select Personal
• Scroll down and select External IDs

Home Affairs linked records display under Recorded External IDs. The issuing party displays as IMMIGR.

Note: the Recorded External IDs does not display for records not linked.

• Select Amend Consumer Details
• Key the customer's Medicare card number in the ID number field
• Select Entitlement

• In Consumers, select the radio button of the customer
• In Eligibility Status, select Amend DIAC link (Home Affairs)
• In Immigration Clients, the following displays:
• currently linked client details
• exact and/or possible matches
• If there are no matches, no details display
• To unlink the record, go to Step 3.
• To unlink and link the record, go to Step 4.

Select Unlink.

The following warning messages display:

• 00645 message - 'the details are acceptable'
• Select OK to acknowledge the message
• 01879 message - 'Home Affairs link will be removed from the currently linked customer. You have not selected a customer to be re-linked. If you want to re-link to a listed immigration client, you must click the "Amend DIAC link" again'
• Select OK to acknowledge the message
  Note: Service Officers must check that they only unlink an incorrect match
• Scroll down and select Validate [Alt+V]
• Check the Confirm Amend Medicare Entitlement Details screen to see the changes, and
• correct the details if necessary
• To update and finalise the record, go to Step 5.

• Under Exact and possible matches, select the radio button of the customer that matches to the customer's link
• Select Unlink & Link
• The following message displays
  00645 message - 'details are acceptable'
• Select OK to acknowledge the message
• Scroll down and select Validate [Alt+V]

• Select Update [Alt+U]
  A message displays advising the entitlement details have been added
• Select OK