Restoration of Commonwealth Seniors Health Card (CSHC) 065-06060030

If the reason for cancellation was:

• O19 - due to an overseas absence (portability cancellation) and the customer has been outside Australia for less than the maximum portability period applicable to the customer, the CSHC can be restored. Go to Step 7
• WUK - whereabouts unknown, go to Step 2
• INC - income, go to Step 8
• FRR - Failing to return the review form or provide information as part of the review, go to Step 4
• FRC/FSD - Failed to reply to correspondence or failed to supply documents, go to Step 5
• NTB - Customer and partner failed to advise Tax File Number (TFN), go to Step 6
• NTC - Customer failed to advise TFN, go to Step 6
• NTP - Partner failed to advise TFN, go to Step 6
• Any other reason, go to Step 9

A customer’s CSHC can be restored if:

• they contact within 13 weeks after the cancellation decision
• have continued to meet the eligibility criteria for CSHC during the entire period of cancellation, and
• provide their new address or evidence of their current address if their address has not changed

If the customer:

• Has changed address, or the address was recorded in error:
• update the address, and
• reissue returned correspondence
• Has not changed address they must provide evidence that they still live at the recorded address. That is, unless they can provide a satisfactory explanation and this is the first time mail has been returned from that address. Verification may be required before the CSHC can be restored. If mail is returned from an address which the customer advises is correct, further mail sent to the same address is also likely to be returned

Is the customer required to provide any information or documentation before the CSHC can be restored?

• Yes, do not restore on initial contact:
• tell the customer about the documentation required before restoration can occur
• record details on a DOC of advice given to the customer
• book an enquiry (ENQ) appointment at the service centre
• go to Step 3
• No, go to Step 7

Has the customer supplied required information?

• Yes, if the address details before cancellation are still current, but has been end dated:
• remove the end date coding
• reissue returned correspondence, and
• restore the CSHC
• go to Step 7
• No, tell the customer that CSHC cannot be restored until the required action has been taken. Procedure ends here

If the customer returns the form:

• within 13 weeks:
• process the review form
• restore the customer's CSHC if ongoing eligibility is determined
• go to Step 7
• between 13 and 26 weeks of cancellation, the customer must re-claim CSHC. Procedure ends here
• after 26 weeks of cancellation, the customer must complete and lodge a full new claim. Procedure ends here

If a customer replies to correspondence and provides requested information:

• within 13 weeks of cancellation:
• restore the customer's CSHC
• go to Step 7
• between 13 and 26 weeks of cancellation the customer must re-claim CSHC. Procedure ends here
• after 26 weeks of cancellation the customer will need to complete and lodge a full new claim. Procedure ends here

Where a customer's CSHC is being reviewed and/or their partner's TFN has not previously been provided, the TFN must be provided for the CSHC to remain current. See Tax File Number (TFN) for Commonwealth Seniors Health Card (CSHC) for more details.

If TFN(s) provided:

• within 13 weeks of cancellation:
• record the TFNs
• restore CSHC
• go to Step 7
• after 13 weeks of cancellation the customer must re-claim CSHC. Procedure ends here
• after 26 weeks of cancellation the customer must complete and lodge a full new claim. Procedure ends here

For all CSHC customers that 'return to Australia' make sure the processes at Return to Australia procedures for service centre and Smart Centre staff for non-pension payments and cards have been followed and completed before any CSHC restoration action.

If a CAN WUK customer has confirmed their address details are still current, but have been end dated, remove the end date coding before restoration.

• Update the Benefit Action (BA) screen fields as follows:
• Sys: field, code 'SHC'
• Svc Rsn: field, code 'SHC'
• Action: field, code 'RES'
• Reason: field, leave blank
• Effect Date: field, defaults to date of cancellation
• Source Code: field, PHO or INT
• Receipt Date: field, See Date of receipt or Record the correct date of receipt for customers returning to Australia
• Record details on a DOC, including the Social Security (Administration) Act 1999 (SSAA) reference for CSHC restoration. See References for a link
• Finalise the activity

Procedure ends here.

CSHC can only be restored if income was coded incorrectly.

• Update the Benefit Action (BA) screen fields as follows:
• Svc Rsn: field, code 'SHC'
• Action: field, code 'RES'
• Reason: field, leave blank
• Effect Date: field, defaults to date of cancellation
• Source Code: field, PHO, INT or LET
• Receipt Date: see Date of receipt
• Go to the Seniors Health Card income summary and details (SHID) screen
• Correct the required income fields
• Record details on a DOC, including the Social Security (Administration) Act 1999 (SSAA) reference for CSHC restoration. See References for a link
• Finalise the activity

In all other instances if the cancellation occurred:

• within the last 26 weeks, the customer can complete a re-claim for a Commonwealth Seniors Health Card
• more than 26 weeks ago and the customer's circumstances have changed, they must lodge a new claim for assessment of their entitlement to the CSHC

Procedure ends here.

A verbal CSHC reclaim may be actioned if:

• the CSHC was cancelled with reason code 'O19' due to their temporary absence overseas exceeding the maximum portability period applicable to the customer, and
• the customer has contacted within 13 weeks of the cancellation

See Verbal re-claim of a non-income tested Commonwealth Seniors Health Card (CSHC-NOI).

If the CSHC was cancelled for any other reason:

• within the last 26 weeks, the customer can complete a re-claim for a Commonwealth Seniors Health Card
• more than 26 weeks ago, the customer must lodge a new claim for CSHC