Medicare cards 011-44150000

Service Officers must check the customer:

• is over 15 years of age
• is listed on the card, and
• has been authenticated

Service Officers can re-issue a replacement card if the card has an expiry date of less than 6 months.

If the expiry date in CDMS is greater than 6 months, see Table 2 for more details.

The customer must be registered for a Medicare account online.

Customers can order a maximum of 2 replacement Medicare cards online in a 12-month period. If the customer needs more than 2 replacement cards, they must:

• call the Medicare general enquiry line, or
• visit a service centre

The customer must provide identity documents. See Document types for Medicare eligibility and enrolments for more details.

If the customer cannot provide identity documents, Service Officers must authenticate the customer. See Authenticating a Medicare customer.

Note: a person requesting a Medicare card must be over 15 years of age and be listed on the card.

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

On CDMS Home page:

• select Inquire Consumer Details
• key the customers Medicare card number in ID Number field
• select Group
• select Current Issue Details

Has a new card issued?

• Yes, go to Step 3
• No, go to Step 7

Select Interactions tab to show when a Medicare card was sent, and to what address.

Is the address the card was issued to different to what is recorded in CDMS?

• Yes, see Table 3
• No, the address is the same and needs updating, see Amend address in the Consumer Directory Maintenance System (CDMS)

On CDMS Home page:

• Select Inquire Consumer Details
• Key the customers Medicare card number in ID Number field
• Select Group
• Select Address Details tab

This displays in the field Type of Mail Returned.

Is the return mail indicator present?

• Yes:
• confirm the address recorded in CDMS is correct
• see Table 10 in Amend address in the Consumer Directory Maintenance System (CDMS) for Medicare to remove a return mail indicator. Update this before issuing a Medicare card
• No, go to Step 5

On CDMS Home page:

• Select Inquire Consumer Details
• Key the customers Medicare card number in ID Number field
• Select Personal
• Select Personal Details tab

Is a consumer end date with the end reason 'residing overseas' present?

• Yes, go to Step 8
• No, go to Step 7

On the customer’s Personal Details Inquiry in CDMS select Entitlement.

Is there an entitlement end date on the customer’s record?

• Yes, the customer must provide evidence to re-enrol in Medicare. See Medicare eligibility for enrolments
• No, go to Step 7

If the Medicare card has been expired for:

• less than 6 months, and the customer does not need to re-enrol in Medicare, issue a replacement card. See Table 3
• more than 6 months, go to Step 8

If a customer has been residing outside of Australia for:

• less than:
• 5 years for Australian citizens, or
• 12 months for permanent resident or New Zealand citizen:
  Customers are regarded as a resident for Medicare purposes.
  See Table 3 and record the date of departure in the comments field at Personal level
• more than:
• 5 years for Australian citizens, or
• 12 months for permanent resident or New Zealand citizen.
  Determine if the customer has returned to Australia to reside. See Medicare eligibility enrolments.
  The customer must provide evidence to re-enrol in Medicare.
  Service Officers must not update any personal details held in CDMS until the customer has lodged an enrolment application through an MS004 or DME

See:

• Table 4 in Australian citizens eligibility for Medicare
• Medicare eligibility for New Zealand citizens, or
• Medicare eligibility for customers with permanent resident status

Australian Government employee or a member of the Australian Defence Force

Where the customer is a government employee or a member of the Defence Force, and has been absent from Australia for more than 5 years:

• they stay eligible for medical benefits incurred in Australia
• Defence Force personnel must provide documentation to enrol or re-enrol in Medicare
• See Australian citizens eligibility for Medicare

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

Before issuing a new or replacement Medicare card for a customer, check all CDMS Group comments to identify if a BI flag comment exists.

• If no comment exists, go to Step 3
• If a comment exists, see Suspected Medicare fraud and Business Integrity (BI) flags

On CDMS home page:

• Select Amend Consumer Details
• Key the customers Medicare card number in ID Number field
• Select Group

Note: Suspected Medicare fraud and Business Integrity (BI) flags may be present, preventing amendments. If this occurs, contact a Medicare and Aged Care - Local Peer Support (LPS) for help, if required.

Customers can request a:

• replacement card if their current card is lost or stolen, or
• duplicate card if there is more than one person over the age of 15 years enrolled on the card

Select Card Requests tab:

• Tick the required checkbox to request:
• replace current card
• duplicate current card, or
• duplicate replacement card
• Select Replacement Reason from the dropdown box. Duplicate card requests do not need a replacement reason.
• Select Card Request Source from the dropdown box
• Select Validate, Validate, Update to confirm the details displayed

Note: if an error message shows Replacement not Allowed, see Table 10 in Amend customer details in the CDMS for Medicare.

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

Before issuing a new or replacement Medicare card for a customer, check all CDMS Group comments to identify if a BI flag comment exists.

• If no comment exists, go to Step 3
• If a comment exists, see Suspected Medicare fraud and Business Integrity (BI) flags

Service Officers must confirm the customer's address is current.

Is the address different to the address recorded in CDMS?

• Yes, see Amend address in the Consumer Directory Maintenance System (CDMS) before issuing a replacement Medicare card
• No, issue a replacement Medicare card. See Table 3

In CDMS:

• Select the address is a production control address checkbox
• Issue a replacement Medicare card, noting a card will not be sent
• Tell the customer they may need to re-enrol in Medicare. See Reciprocal Health Care Agreements (RHCA) eligibility for Medicare and Pharmaceutical Benefits Scheme (PBS) for the relevant country

If the enquiry is by phone or in a service centre, tell the customer that a Medicare card will not be sent.

If the RHCA Medicare card has expired:

• The customer must provide evidence to re-enrol in Medicare
• Service Officers must not update any personal details held in CDMS until the customer has lodged an enrolment application through a Medicare enrolment (MS004) form or Digital Medicare Enrolments (DME)

See Reciprocal Health Care Agreements (RHCA) eligibility for Medicare and Pharmaceutical Benefits Scheme (PBS) for the relevant country.

If the:

• Service Officer has created a duplicate Consumer ID (no programs attached) go to Step 2
• customer is already enrolled and a duplicate PIN has been created, go to Step 3
• card has been issued in error and the customer is eligible for Medicare, go to Step 4
• customer has been enrolled in error and is not eligible for Medicare, go to Step 5

See Duplicate Medicare enrolment and Consumer IDs in Medicare for more details.

Contact the Medicare and Aged Care - Local peer Support to request the Consumer ID be deleted.

See Duplicate Medicare enrolment and Consumer IDs in Medicare process for details.

If a card is issued in error, extract the card by completing a card extraction form no later than 12 noon (AEST) the following day. The form is available on the Resources page.

The extracted card will not need to be returned to the Service Officer as the error must be rectified immediately.

If the cut-off time of 12 noon has passed, a Medicare card will issue and send to the customer. In this case the Service Officer must:

• phone the group contact of the Medicare card impacted
• apologise for the error related to the enrolment and tell the group contact they will get an incorrect Medicare card
• tell the group contact they must:
• not use this card
• destroy the card, and
• tell any other members about the card
• if contact attempts are unsuccessful, record a comment in Personal in CDMS stating:
• the error that has occurred, and
• contact attempts were unsuccessful

The customer must have a customer end date keyed and a comment recorded in Personal CDMS. Extract the card by completing a card extraction form no later than 12 noon (AEST) the following day. The form is available on the Resources page.

If the Service Officer identifies the error after the card extraction timeframe, contact the group card holder to tell them they:

• will get a card, and
• are not eligible

If contact attempts are unsuccessful, record a comment in Personal in CDMS stating:

• the error that has occurred, and
• contact attempts were unsuccessful

The stopping of Medicare cards should only occur in extreme circumstances, as it affects the ability to claim benefits for all customers listed on the card.

Service Officers must:

• contact Medicare and Aged Care - Local Peer Support (LPS) to confirm actions needed to prevent the card from being issued before stopping a card
• enter detailed comments in the Group Comments field in CDMS, as all stop cards appear on a daily report

If a customer is eligible for Medicare but has been enrolled in Medicare without providing sufficient documents, and it is too late to request a card extraction, Service Officers must:

• stop the Medicare card
• add detailed comments in the Group Comments field in CDMS, to outline the documentation required to remove the stop

On CDMS Home page:

• Select Amend Consumer Details
• Key the Medicare card number in the ID Number field
• Go to the Card Request tab > Group
• Tick the Stop Card indicator
• Select Validate, Validate, Update to confirm the details shown

The Medicare card will not be issued until the customer provides the required documents. See Medicare eligibility and enrolments request for information.

Once the customer has provided the required documents, Service Officers must assess the customer's eligibility and remove the stop on the Medicare card if eligible.

On CDMS Home page:

• Select Amend Consumer Details
• Key the Medicare card number in the ID Number field
• Go to the Card Request tab > Group
• Untick the Stop Card indicator
• Select Validate, Validate, Update to confirm the details shown

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

On the CDMS Home page:

• Select Amend Consumer Details
• Key the customers Medicare card number in ID Number field
• Select Group
• Select Name/Address tab

In the Contact Name, change the details of the group contact as required.

Is the group contact associated with the card?

• Yes:
• select the Group Association checkbox
• key the reference number of the customer in Contact Reference Number
• select Get Details
• The mailing address automatically populates in the address fields
• No:
• untick the Group Association checkbox
• remove the reference number
• key customer's name in the Contact Name field (Surname, comma, title, initial, for example, Smith,Mr J)
• complete all required Address fields

Make other amendments in the remaining fields, as required:

• Scroll down and select Validate. An information message will show to advise if the amendments were accepted or not accepted
• Select OK to acknowledge the message. If not acceptable, update the amendments as required
• Scroll down and select Validate
• When the details are correct, select Update

The Confirm Amended Card Details screen displays the updated details.

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, procedure ends here

On CDMS Home page:

• Select Amend Consumer Details
• Key the customers Medicare card number in ID Number field
• Select Group

Note: Suspected Medicare fraud and Business Integrity (BI) flags may be present, preventing amendments. If this occurs, contact a Medicare and Aged Care - Local Peer Support (LPS).

Select:

• Card Requests tab
• Display Medicare Card
• Print

Does the service centre have a digital secure bin on site?

• Yes, go to Step 2
• No, go to Step 3

Service Officers must place the Medicare card in the digital secure bin to be disposed securely.

Service Officers must:

• put the cut-up Medicare card in a sealed envelope
• address the envelope to a Services Australia mailroom
• add the envelope to the site's outgoing mail