Applicants for permanent residency eligibility for Medicare 011-44020000

Customers must provide the following documents:

• A completed Medicare Enrolment form (MS004), or
• Digital Medicare enrolment (DME), and
• Current passport or valid ImmiCard, and
• Proof from the Department of Home Affairs (DIAC) they have applied for permanent residency:
• Must have details about the category of visa subclass, application ID and date of lodgement
  Note: this can be accepted when sent from a Migration Agent, and
• Proof of a valid visa with permission to work

If a customer does not have permission to work, see Step 5.

These documents must be provided for each person listed on the enrolment form or listed in their Digital Medicare enrolment (DME) application.

If the Medicare enrolment form (MS004) is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information:

• attempt to contact the customer once to advise what is required
• pend for future release (for example, 7 days) and add a processing note in PaNDA detailing requested documents/information

If contact is unsuccessful:

• issue a Z0139 Enrolling in Medicare letter
• Service Officers must delete any saved letters, and
• pend for future release (for example, 28 days) and add a processing note in PaNDA detailing requested documents/information

If the DME documents are incorrect, see Digital Medicare enrolments (DME) and the MEE Portal.

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

Does the VEVO check confirm the customer is onshore?

• Yes, proceed with the enrolment, go to Step 3
• No, customer is offshore:
• reject the application, and
• send Applicant Still Overseas letter. Procedure ends here

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

• To verify documents for enrolments, see Table 1 in Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal
• If a customer fails the DVS check and attends a service centre, see Table 3 in 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.

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

To enrol the customer under applicant for permanent residency (including subclass 191):

• Entitlement Type - Conditional Migrant
• Country of relevance - this is the 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 (customer receives a blue Medicare card)
• 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.

Note: the customer does not have permission to work if the Entitlement Type shows a dash (–) or non-alpha on the CDMS link unless VEVO shows permission to work. Go to Step 5.

If the customer does not have permission to work, they must show evidence of one of the following.

A relationship with a parent, de facto, spouse, or child who lives in Australia, who is:

• an Australian citizen
• a permanent resident of Australia, or
• a 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.

Record all documents in CDMS when registering a customer's Medicare entitlement.

• 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 (mandatory) (number or text of the document)
• Reference Date (mandatory)
• Select Add
• The New Medicare Entitlement Details screen displays
• Select Document tab
• 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. This will help match the customer to Home Affairs
• Link the customer to their Home Affairs record (that is the visa). See Table 6
• When the 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 Home Affairs 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.

See Change legal name on Medicare record.

Customers must provide the following documents:

• A completed Medicare Enrolment form (MS004), or
• Digital Medicare enrolment (DME), and
• Current passport or valid ImmiCard, and
• Proof from Home Affairs (DIAC) they have applied for permanent residency:
• Must have details about the category of visa subclass, application ID and date of lodgement
  Note: this can be accepted when sent from a Migration Agent, and
• Proof of a valid visa with permission to work

If a customer does not have permission to work, see Step 5

Service Officers must:

• do a Visa Entitlement Verification Online (VEVO) check and upload VEVO to the relevant PaNDA work item, and
• record all documents in CDMS when registering a customer's Medicare entitlement

These documents must be provided for each person listed on the enrolment form or listed in their Digital Medicare enrolment (DME) application.

If the Medicare enrolment form (MS004) is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information:

• attempt to contact the customer once to advise what is required
• pend the work item for future release (for example, 7 days) and add a processing note in PaNDA detailing requested documents/information

If contact is unsuccessful:

• issue a Z0139 Enrolling in Medicare letter
• Service Officer must delete any saved letters, and
• pend for future release (for example, 28 days) and add a processing note in PaNDA detailing requested documents/information

If the DME documents are incorrect, see Digital Medicare enrolments (DME) and the MEE Portal.

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 below, 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.

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

Does the VEVO check confirm the customer is onshore?

• Yes, proceed with the enrolment, go to Step 3
• No, customer is offshore:
• reject the application, and
• send Applicant Still Overseas letter. Procedure ends here

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

• To verify documents for enrolments, see Table 1 in Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal
• If a customer fails the DVS check and attends a service centre, see Table 3 in 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.

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 - this is the 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 (customer receives a blue Medicare card)
• 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.

Record all documents in CDMS when registering a customer's Medicare entitlement.

Note: the customer does not have permission to work if the Entitlement Type shows a dash (–) or non-alpha on the CDMS link unless VEVO shows permission to work. Go to Step 5.

If the customer does not have permission to work, they must show evidence of one of the following.

A relationship with a parent, de facto, spouse, or child who lives in Australia, who is:

• an Australian citizen
• a permanent resident of Australia, or
• a 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 is in real time and the most current information from Home Affairs

Record all documents in CDMS when registering a customer's Medicare entitlement.

• 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 (mandatory) (number or text of the document)
• Reference Date (mandatory)
• Select Add
• The New Medicare Entitlement Details screen displays
• Select Document tab
• 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/ImmiCard and visa:

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

All changes from Home Affairs update in CDMS.

If there is no Home Affairs 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.

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 Administrative Review Tribunal 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

To re-enrol, customers need to provide a completed Medicare Enrolment form (MS004), and:

• proof of an appeal. The customer must provide one of the below:
• Appeals Tribunal document (AAT or ART)
• Federal Court or High Court document
• Ministerial Intervention document or Visa Entitlement Verification Online (VEVO) to confirm Ministerial Intervention has commenced
  Note: see Step 5 for a list of the proof of an appeal requirements
• a valid visa with permission to work:
• in the form of a travel document, or
• an email or a letter from Home Affairs
• an identification document:
• passport
• travel document
• ImmiCard, or
• Current Australian driver's licence (only if the passport, travel document or ImmiCard was previously recorded in CDMS as the initial enrolment identification)

Service Officers must complete a VEVO check. Customers must hold a bridging visa with permission to work. If the customer does not have permission to work, they must supply relationship documents to be eligible for Medicare.

Re-enrolment of customers who have lodged an appeal of their visa refusal cannot lodge online through Digital Medicare Enrolments (DME) applications.

If the customer's identity document has expired, see Expired Identity documents on the Background page.

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

Does the VEVO check confirm the customer is onshore?

• Yes, proceed with the enrolment, go to Step 4
• No, customer is offshore:
• reject the application, and
• send Applicant Still Overseas letter. Procedure ends here

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

• To verify documents for enrolments, see Table 1 in Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal
• If a customer fails the DVS check and attends a service centre, see Table 3 in 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.

AppealsTribunal 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 still ongoing.

The Appeals Tribunal document may be from the Administrative Appeals Tribunal (AAT) or the Administrative Review Tribunal (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 received from the Court notification or from the customer's Migration Agent.

Do not reject or refuse an application if a customer cannot provide evidence of an appeal.

Service Officers must attempt to contact customers to request evidence of appeal.

Escalate application through PaNDA to ME_Escalations, Medicare and Aged Care - Local Peer Support (LPS) will escalate to the Medicare Consumers Program Support Team (if required) if:

• it cannot be determined the appeal is ongoing
• the customer cannot provide evidence of an appeal
• the Service Officer cannot:
• determine if there is a letter confirming the person's pseudonyms, or
• obtain VEVO confirmation

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, Medicare and Aged Care - Local Peer Support (LPS) who will escalate 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

Do not reject or refuse an application if a customer cannot provide evidence of an appeal.

Service Officers must attempt to contact customers to request evidence of an appeal.

Record all documents in CDMS when registering a customer's Medicare entitlement.

• 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 (mandatory) (number or text of the document)
• Reference Date (mandatory)
• Select Add
• The New Medicare Entitlement Details screen displays
• Select Document tab
• Repeat above to enter all documents provided separately

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

• 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, for example:

'CHECK INDICATORS ON THE SENSITIVE INFORMATION TAB'

'DO NOT DISCLOSE INFORMATION ABOUT END DATE MEMBERS'

Service Officers must acknowledge these warnings as failing to check indicators may cause serious harm or distress to customers.

The Resources page has details about extension periods.

Once eligibility is established, extend the entitlement details.

Select the Card Requests tab.

In the Group Eligibility end date field:

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

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

This date displays in Entitlement. A new entitlement date does not need to be added or amended.

Do not change the Group Eligibility Start Date.

Service Officers must key all additional documents provided under Entitlement tab in CDMS, that is, identity, visa, VEVO.

Note: when updating CDMS after the customer's initial enrolment, try to locate the immigration data link and add it to the Medicare record. This will ensure immigration updates display in CDMS.

Go to Step 3.

On CDMS home page:

• Select Amend Consumer Details
• Key the customer's Medicare card number in ID Number field
• Select Entitlement
• Select the radio button against any entitlement entry line
• Select Amend
• Select Documents tab

The Eligibility and Residency Documents screen displays.

Document Types

• Select or key the details of each of the customers eligibility documents:
• Eligibility Document (mandatory)
• Residency Document (if applicable)
• Reference Text (number or text of the document). (See the Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS))
• Reference Date (See the Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS))
• Select Validate
• Repeat for all other documents to be added (if required)
• Select Return, Validate and Update

The documents will display in Document References.

It is not a requirement to record the same document details if they are already recorded in CDMS documents. For example, the same passport submitted in the new application to extend a Medicare card.

Note: when relationship documents have been previously submitted and recorded in CDMS and are still relevant, it is not a requirement to request these again.

• 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:
• Correct the details if required

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