Lifetime Health Cover (LHC) eligibility in Medicare 011-44080000

An eligible person can request an LHC letter by any of the following:

• Over the telephone the caller must pass a public security check
• In person at a service centre
• the caller must pass a
• pass a public security check
• Written request with:
• name
• Medicare number, and
• signature
• Medicare enrolment form (MS004)
• The Medicare enrolment application form (MS004) can be used to request an LHC letter at the same time as enrolling in Medicare
• Digital Medicare enrolment (DME)
• Customers can request an LHC letter as part of their DME application
• Service Officers must create LHC letters requested as part of a DME application in the MEE Portal. See Digital Medicare enrolments (DME) and the MEE Portal for the process

Note:

• the letter should only be given to the person requesting it
• if there are multiple persons on the one card that require the letter, each individual over 14 years should request one separately
• if an enrolment application is received and persons under 14 years are included with the request for a LHC letter, these persons can be included on the LHC letter of the applicant
• if all persons are present or on the phone and request to be on the same letter:
• get the individual's consent for the letter and complete a security check
• add comments to the Personal tab to record that the customer consented to be on the same letter as the requestor
• LHC letters do not apply to:
• diplomats, and
• customers of Reciprocal Health Care Agreement (RHCA) countries

Note: if the Production Control address is recorded on the customer’s record, the customer’s Group address must be updated:

• before sending an LHC letter update to a valid postal address, and
• after successful completion of a security check and appropriate confirmation of identity

See:

• Amend address in the Consumer Directory Maintenance System (CDMS) for Medicare
• the Resources page for Medicare entitlement types and eligibility for LHC letter

On CDMS home page, select inquire on consumer details.

• key the Medicare card number in the ID Number field
• select Personal

On Personal Detail Inquiry screen:

• select the consumer using the radio button
• scroll to bottom of page and select Summary
• select History from dropdown box

On Consumer History Summary screen:

• select Program Entitlement from the All Events dropdown box
• select Filter Results

All events that have a program entitlement will display.

Select the radio button of any event that has Program MCARE.

Select History details tab.

The History detail – Program Entitlement screen will show all previous, current and deleted program entitlement details.

See the Reference column to find the Medicare registration date (applicable date for LHC letter).

If a person has multiple entitlements, go to Step 4.

If a person has Medicare entitlement type/s) of:

• Migrant (only)
• LHC date = date of registration (processing date)
• Conditional migrant (only)
• LHC date = date of registration (processing date)
• Ministerial order
• LHC date = date of registration (processing date)

Conditional migrant and RHCA

• LHC date = date on which the Conditional migrant was registered (processed date)
• Conditional migrant and Migrant
• LHC date = date on which the Conditional migrant was registered (processed date)
• RHCA and Migrant
• LHC date = date on which the Migrant was registered (processed date)
• Australian citizen newly arrived and not previously enrolled
• LHC date = date on which the Australian citizen was registered (processed date)
• if the person was previously enrolled and has been absent from Australia and recently returned, see the Medicare entitlement types and eligibility for LHC letter table on Resources page
• New Zealand citizen newly arrived and not previously enrolled
• LHC date = date on which the New Zealand citizen was registered (processed date)
• if the person was previously enrolled and has been absent from Australia and recently returned, see the Medicare entitlement types and eligibility for LHC letter table on Resources page

Choose the appropriate letter. See the Medicare entitlement types and eligibility for LHC letter table on the Resources page.

• Z0138 Lifetime Health Cover - applicable date
• Z2780 LHC – Unable to confirm applicable date - International Movement Record may be required
• Z2781 Your request for a Lifetime Health Cover Letter

Use the options available in the Standard Letter Template (SLT) to create a letter.

To complete the Address and Signatory tab:

• for a person with only one name, key the name in the mandatory first name field in Addressee Details of the letter
• use the customer’s first name and last name recorded in the Personal tab in CDMS
• there is a blank option in the title field dropdown box
• use the address recorded in the Group tab in CDMS

To complete the Details of People Covered tab (only in the Z0138 letter):

• key the customer’s first name/s, middle initial (if they have one) and last name recorded in the Personal tab in CDMS
• for a person with only one name, key the name in the first name field
• add one of the following comments in the Personal tab in CDMS:
• Z0138 - LHC letter for date of registration <insert date> and (if applicable). Customer consented to be included in the same letter as the applicant
• Z2780 - Unable to confirm applicable date in Medicare letter sent or
• Z2781 - Your request for a Lifetime Health Cover letter – unable to provide LHC due to entitlement type letter sent

Note: when completing the letter Z2780 or Z2781, use the PID field for the PaNDA work item ID or the DME ID. Leave the Work ID field blank.

Once completed:

• upload the letter with PaNDA work item ID if LHC was requested in writing (Medicare enrolment form MS004 or email request)
• refer the letter for quality assurance, see Preparing, quality and peer to peer checking of Medicare external mail

Once approved by the delegate, give (if in person) or mail the letter to the customer.