Re-claim for a Commonwealth Seniors Health Card (CSHC) 065-06010010

Was the customer's CSHC cancelled within the last 26 weeks?

• Yes, go to Step 2
• No, the customer will need to complete a full claim for CSHC, see Claiming Commonwealth Seniors Health Card (CSHC). Procedure ends here

If the CSHC has been cancelled for less than 13 weeks (with the exception of cancelled due to income or portability) the customer's CSHC may be able to be restored. For more details, see Restoration of Commonwealth Seniors Health Card (CSHC).

Can the card be restored?

• Yes, see Restoration of Commonwealth Seniors Health Card (CSHC). Procedure ends here
• No, go to Step 3

When the CSHC was cancelled reason O19 (overseas more than 19 weeks) customers can complete a verbal re-claim for CSHC upon their return if:

• their CSHC has been cancelled due to a temporary overseas absence exceeding their maximum portability period, and
• they have returned to Australia and have contacted within 13 weeks of their CSHC being cancelled, and
• they have previously provided income details from their Tax Notice of Assessment from either of the previous 2 financial years or they are 'not required to lodge' an income tax return. For more details, see Commonwealth Seniors and Health Card (CSHC) income test and reference tax year, and
• any account-based income streams owned by the customer (and partner) are coded with a balance within the last 12 months on the Pension/Annuities Summary (SUPS) screen

Have all of the above criteria been met?

• Yes, for:
• Process Direct see Table 2
• Customer First, see Table 3
• No, go to Step 4

Note: for these claims the CSHC date of claim will be automatically taken as the immigration advised date of return if:

• the customer lodges a CSHC re-claim within 14 days of the date of return to Australia, and
• the date of return is less than 13 weeks since their CSHC cancellation date

Advise the customer they may complete a paper re-claim form:

• the Re-claim for a Commonwealth Seniors Health Card (SA296A) can be downloaded directly from the Services Australia website
• customised Claim for a Commonwealth Seniors Health Card (SA443) is issued by running the First Contact Service Offer (FCSO) workflow

The Resources page contains links to the SA296A and SA443.

Where customers are eligible to re-claim it may be more suitable to complete a full new CSHC claim via online channels. See Claiming Commonwealth Seniors Health Card (CSHC).

In circumstances where a customer advises that they are unable or unwilling to complete an online claim offer an Assisted Customer Claim.

From 1 July 2018, eligible customers will be assessed for payments or concession cards from the date they actually submit a complete claim with all relevant supporting documentation.

For more information, see:

• Identity Confirmation
• Lodgement of the Notice of Assessment (NOA) and other evidence of income for Commonwealth Seniors Health Card (CSHC)

Note: different processes apply for customers in vulnerable circumstances, see Intent to claim and vulnerable customers.

• Select SOA Shell from the Process Direct Landing page
• Complete the following fields:
• Benefit Type: Commonwealth Seniors Health Card
• Customer's CRN
• Date of Receipt: use the date of contact
• Select Create Claim

• Ask the customer if they consent to use the previously provided Tax File Number for themselves and their partner (if relevant) and update as required
• Check the correct relationship status is coded on Marital Status table and Links Summary
• Check the Telephone Details (TDS) screen to ensure contact details are correct
• Check Energy Supplement Grandfather Status
• The Grandfathering Summary (GFS) screen displays the grandfathering type '2016 Energy Supplement' applicable to CSHC holders
• If the CSHC customer is grandfathered for Energy Supplement they will be entitled to quarterly supplement
• If the customer is eligible for quarterly supplement check the Payment Destination (PAD) screen to ensure correct details are recorded if the customer wishes to receive quarterly supplement

Check the Immigration Advised Movements (RSIM) screen. Is the customer's latest return date recorded?

• Yes, go to Step 4
• No, key the customer's return to Australia, go to Step 4

Is there a temporary overseas address recorded in the Address Details Summary (ADS) screen?

• Yes, go to Step 5
• No, go to Step 6

Select the temporary address line on the ADS screen and update the following:

• Select Edit
• Address End Date: insert the date of return to Australia
• Select Save

Is the customer and/or partner not required to lodge a tax return?

• Yes, ensure that 'not required to lodge' is recorded on the Seniors Health Card income summary and details (SHIS) screen for 1 of the 2 previous financial years.
  For more information, see Commonwealth Seniors Health Card (CSHC) income test and reference tax year:
• If not recorded, go to Step 7
• If recorded, go to Step 8
• No, go to Step 8

Update the SHIS screen if this did not previously indicate the customer was not required to lodge a tax return.

• Select Add in the Income Details table
• Complete the following fields:
• Date of event: date of contact
• Reference tax year: record the relevant financial year (1 of the previous 2 financial years. The current financial year cannot be used)
• Income type: NRL (Not required to lodge)
• Taxable income ($): the customer's income
• Select Save

The income must be declared even if the lodgement threshold is below the tax threshold.

Customers who are partnered must provide income details for themselves and their partner for the same financial year.

If the customer is partnered, select to add the partner's income details.

After saving updates:

• return to the SWE screen to view errors, warnings and messages in the Message Log
• select ? to launch the Digital Assistant. This will populate details of any error presented on the screen it is launched from
• for help, see Using Digital Assistance Roxy in Process Direct

Some circumstances will require the claim to be handed over from Process Direct for processing in Customer First or Customer Record.

Is a handover is required? (Note: handover should only be completed after raising an incident in Roxy as advised):

• Yes, go to Step 9
• No, go to Step 10

• Select > Handover to CF/CR
• Select a reason for requesting handover on Change Status
• When Handover is completed a warning will display advising the claim has been handed over to Customer First/Customer Record for processing
• The status of the claim will change to On Hold - Handover to Customer First/Customer Record
• A new claim activity will be created in ISIS
• The claim can no longer be accessed in Process Direct, unless the claim is handed back from Customer First/Customer Record to Process Direct
• Procedure ends here

Select Assess:

• Ensure the claim outcome is correct on the Entitlement (ELD) screen
• Check the SHIS screen, to view refreshed deemed income

Is the claim to be rejected, as the customer is not eligible for CSHC?

• Yes, see Rejecting a claim for CSHC. Procedure ends here
• No, go to step 11

If a customer has died before their claim was finalised, extra coding is needed to end Electronic Messaging (EM) subscription:

• Select Finish
• Add additional comments or information about the claim outcome if required
• Select Finalise

Note: all scans associated with the claim must be actioned once the claim is finalised.

When a CSHC claim is finalised using Process Direct, an automatic Note is created on the customer's record to reflect the outcome.

Check that the Note meets:

• Recording reasons for decisions
• Online Document Recording (ODR)

If a customer already holds a Low Income Health Care Card (LIC) the CSHC will not be automatically issued as the LIC is a higher priority card than the CSHC. If the customer wants the CSHC issued manually issue a non-priority concession card. For more information, see Preferences for concession cards.

Procedure ends here.

Once the customer record has been found or created key the following claim details on the name Search (IN) screen:

• Service reason: 'SHC' (Seniors Health Card)
• Source: 'FRE' (File record)
• Activity: 'NCL' (New claim)
• Date of receipt: date of contact

Note: the verbal claim for a CSHC is a re-claim and not a restoration of CSHC entitlement. Where the customer is eligible the verbal claim may be granted from the date of customer contact.

As of 6 December 2014 CSHC date of claim will be taken as the immigration advised date of return if the customer lodges a claim within 14 days of the date of return to Australia. This will include CSHC on-line claims, customised claims, paper claim received by mail, DLS, or in office and verbal re-claims. New claims are not included.

See Indexing, re-indexing and cancelling claim activities.

Is the customer's partner also re-claiming?

• Yes, key 'SHC' in the Part SvRn: field on the National Index Person Details PED screen during the indexing process to allow both parties to be re-granted a CSHC from the activity. Go to Step 2
• No, leave Part SvRn: field blank, go to Step 2

• Ask the customer if they consent to use the previously provided Tax File Number for themselves and their partner (if relevant) and update as required
• Check the Telephone Details (TD) screen to ensure contact details are correct
• Check Energy Supplement Grandfather Status
• Check the Energy Supplement Summary (CESSUM) page
• Select the View Energy Supplement Grandfathering status hyperlink. The Grandfathering Summary (GFS) screen displays the grandfathering type '2016 Energy Supplement' applicable to CSHC holders
• If the CSHC customer is grandfathered for Energy Supplement they will be entitled to quarterly supplement
• If the customer is eligible for quarterly supplement check the Payment Destination (PAD) screen to ensure correct details are recorded if the customer wishes to receive quarterly supplement
• Check the correct relationship status is coded on the Marital Status (MS) screen to ensure correct rate of quarterly supplement is paid

Check the Immigration Advised Movements (RSIM) screen. Is the customer's latest return date recorded?

• Yes, go to Step 4
• No, key the customer's return to Australia, go to Step 4

Is there a temporary overseas address recorded in the Address Details Summary (ADS) screen?

• Yes, go to Step 5
• No, go to Step 6

Select the temporary address line on the ADS screen and update the following:

• Address End Date: insert the date of return to Australia
• Action: key 'I' (insert)
• Press [Enter]

Is the customer and/or partner not required to lodge a tax return?

• Yes, ensure that 'not required to lodge' is recorded on the SHID screen for 1 of the 2 previous financial years. For more information, see Commonwealth Seniors Health Card (CSHC) income test and reference tax year
• If not recorded, go to Step 7
• If recorded, go to Step 8
• No, go to Step 8

Update the SHID screen if this did not previously indicate the customer was not required to lodge a tax return.

Key the following details:

• Date of Event: date of contact
• Reference Tax Year: record the relevant financial year (1 of the previous 2 financial years. Note: the current financial year cannot be used)
• Income Type: 'NRL' (Not required to lodge)
• Taxable Income: the customer's and/or partner's income

The income must be declared even if the lodgement threshold is below the tax threshold.

Note: customers who are partnered must provide income details for themselves and their partner for the same financial year.

Access the Activity Results (AR) screen and finalise the activity.

Create a Fast Note. Select Auto text, use Concession Cards > Claims > Commonwealth Senior Card (CSHC) NCL Grant/Reject.

If the customer's partner is reclaiming, record details on a DOC on the customer and partner's records.