Essential Medical Equipment Payment (EMEP) 008-01040000

EMEP is paid to eligible customers with medical needs (or their carers who live at the same residence) to help cover the additional costs of running:

• each item of essential medical equipment, and/or
• medically required heating/cooling

Customers will not have to lodge a new claim every 12 months to continue to receive the payment.

Note: if further qualifying medical equipment is obtained after the initial grant, the customer will need to lodge a claim for the new equipment.

EMEP is:

• automatically paid every 12 months on the grant date anniversary
• subject to the Consumer Price Index (CPI). On 1 July each year, EMEP rates increase in line with the CPI. All payments made on or after this date will receive the applicable rate of EMEP
• paid until the customer loses qualification (including when there is a change of circumstances)
• paid via direct credit to customers bank account

To be eligible for EMEP, a customer must be a:

• person with medical needs (equipment user) who must:
• use essential medical equipment (see the Resources page for alternative names), and/or medically required heating/cooling, and
• hold or be listed on a qualifying concession card, or
• carer of the eligible equipment user who must:
• live at the same residential address as the equipment user
• provide care and attention on a regular and ongoing basis for the eligible equipment user
• hold or be listed on a qualifying concession card

To qualify for payment, a customer must also:

• provide proof of medical needs
• be responsible, either wholly or partly, for meeting energy costs associated with running equipment and/or heating/cooling
• not exceed 2 EMEPs in a Financial Year
• not be a dependent child
• reside in Australia on the:
• Date of lodgement of the EMEP claim, and
• 12 month anniversary date of EMEP
• live in a valid residence/s
• not claim for shared equipment at same residence with another EMEP customer

For new claims, proof is required that the equipment user:

• requires essential medical equipment, and/or
• has a medical condition that means they cannot regulate their body temperature and medically requires heating/cooling in their home

Medical information provided for the initial claim cannot be more than 2 years old.

The Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation (SA449) is the preferred form of medical evidence from a Treating Health Professional (THP) for new claims to verify that the equipment user requires specified essential medical equipment, unless the customer has evidence that the person with medical needs, or their carer, currently qualifies for assistance for the same equipment (excluding heating/cooling) under a state or territory government schemes.

Medical evidence for medically required heating/cooling from a THP must include a signed SA449.

This medical confirmation declaration form (SA449) is:

• provided as a link to customers who submit an online EMEP claim
• combined with the SA440 and SA451 for paper claims
• available for download on the Services Australia website

Once eligibility for EMEP is established, proof of medical needs is not required again if:

• the customer changes address but the claim is for the same person with the same medical equipment/requirements
• a new carer claims, with no other changes to medical requirements

Note: Medical evidence that is provided for a different Social Security payment (for example, Disability Support Pension or Carer Payment) cannot be used as evidence for an EMEP claim.

See the Resources page for scenarios.

To be eligible for an EMEP at the current residence where the essential medical equipment and/or medically required heating/cooling is being used:

• equipment users must:
• have a recent energy account in their (or their partner's) name, or
• state they contribute to payment of the energy account used to run essential medical equipment and/or medically required heating/cooling
• carers must:
• provide a recent energy account in the equipment user’s name, or
• state they contribute (full or in part) for the energy costs associated with running essential medical equipment and/or medically required heating/cooling used by the equipment user
• If an energy account is not available (or does not name the equipment user, their partner or the carer), the energy account holder can sign a declaration that the customer, their partner or the equipment user contributes to paying part or all of the energy account.

Approved energy forms are:

• electricity
• natural or liquid petroleum gas
• diesel
• heating oil
• petrol, or
• kerosene

Evidence is not required for an EMEP claim except where an unacceptable proof of energy account was provided in an earlier energy account review. Acceptable proof must be provided if later requested.

EMEP is not payable if, in the previous 12 months of the Financial Year, the customer has received:

• an EMEP for the same medical equipment or for medically required heating/cooling at the same residence, or
• two EMEPs for the same medical equipment or for medically required heating/cooling at 2 separate residences

If replacing an item of equipment, for example, a new respirator for an old one, the person is considered to be using the same item of medical equipment.

If an EMEP is not payable due to the lodgement of a duplicate EMEP claim outlined in this step, the duplicate claim cannot be granted. See Processing Essential Medical Equipment Payment (EMEP) claims.

If the customer changes residential address, EMEP will automatically cancel and the customer will need to lodge a new claim to receive EMEP for the new residence. If the carer of the person using the same medical equipment, or the customer uses the same medical equipment at the new address, they will not need to provide medical evidence with the new claim. If another EMEP is granted, a new anniversary date is created and EMEP is automatically paid on their anniversary date at 12 month intervals.

An EMEP is not payable if the person making the claim is a dependent child as defined under social security law. The claim will automatically reject if the customer is recorded as a dependent child.

If the person with medical needs (equipment user) is:

• a dependent child:
• their carer can make a claim for EMEP
• is not affected by percentage of care
• not a dependent child, the carer must obtain consent from the equipment user to claim their EMEP using the Essential Medical Equipment Payment – Equipment User Declaration (SA450) form.

To be eligible for an EMEP, the customer must be physically present in Australia on the:

• date the EMEP claim was lodged, and
• 12 month anniversary date of their initial EMEP grant

The residence where the essential medical equipment and/or medically required heating/cooling is being used must also be in Australia.

The EMEP claim will automatically reject (or cancel on the anniversary date) if the customer is recorded as not in Australia on the relevant dates.

The equipment user or carer must meet the Australian residence requirements for the qualifying concession card.

For EMEP, a valid residence can be a private residence (including a term address) in Australia, and includes:

• public housing
• share housing, or
• a residential address with no commercial care arrangements

A residential care facility is not a valid residence for EMEP and is not payable if the equipment user is ‘in residential care’ and submit a claim. Examples include:

• approved residential care (such as aged care facilities)
• hospitals and/or other medical facilities
• residential rehabilitation or treatment centres
• prisons or any place in which a person may be lawfully detained while under sentence for conviction of an offence and not on release on parole or licence
• detention centres

EMEP is also not payable if the equipment user is ‘in residential care’ on their 12 month anniversary date.

Up to a maximum of 2 EMEPs can be paid every 12 months for each item of essential medical equipment and/or for medically required heating/cooling at separate residences.

A separate claim must be lodged for each residence and the equipment user must reside at the address on the date the claim is lodged or on the EMEP anniversary date.

A change of address will automatically cancel EMEP. If an EMEP is paid for the new residence, a new anniversary date is set.

If the equipment user is a dependent child, and a shared care arrangement means the child resides at separate residence during the year, separate claims must be made in relation to each residence.

Note: in these cases, separate anniversary dates will be set up according to the date the EMEP is paid for each residence. An EMEP can continue to be paid every 12 months for the equipment and/or medically required heating/cooling being used at each residence.

See the Resources page for scenarios.

All EMEP online and paper claims are processed using the Staff Process Claim workflow. After completing the workflow, the customer's eligibility for payment is assessed. Any further processing is completed manually to finalise the claim.

To access the EMEP system and view details in Customer First:

• open the customer’s record. In the Next field, key SVMEP
• view EMEP assessment details via Payments & Services > Energy Payments > Medical equipment task selector
• for EMEP system service reason, key MEP

EMEP is:

• non-taxable
• exempt income under social security, family assistance and veterans' law
• payable to payment nominees
• not an eligible payment for:
• an urgent payment
• Centrepay deductions
• not subject to income management, including Voluntary Income Management
• not automatically used to offset or recover any debt, but customers can elect to use their EMEP to repay an outstanding debt
• not a recoverable debt unless activity is found that relates to serious non-compliant behaviour such as fraud

EMEP is paid in relation to the customer’s current residential address. Customers only need to claim EMEP once for their current residence and qualifying essential medical equipment.

Once an eligible customer receives their initial EMEP payment for an item of essential medical equipment and/or medically required heating/cooling being used at a given residence, they do not need to lodge another claim to receive the subsequent 12 month EMEP for the same item(s) of equipment being used at that residence.

Eligibility for the payment will be confirmed on the 12 month anniversary date of the initial grant date of EMEP.

If the customer has lost qualification or a change of circumstances causes them to lose qualification (such as a change of residential address), EMEP will automatically cancel.

If a new EMEP claim is lodged for the new residence and the customer is eligible to be paid another EMEP, a new anniversary date is set in relation to the latest grant.

See the Resources page for scenarios.

A customer can apply for a formal review of a decision at any time. If they apply more than 13 weeks after the rejection notice, the payment may be affected by the date of effect rules. See Customer initiated review of decision.

Customers can request a reassessment of their rejected or cancelled EMEP.

EMEP claims may be reassessed where all outstanding requested documents have been provided within 13 weeks of the rejection notice. SO’s should consider the new information being supplied to determine if the claim outcome can be reassessed and the outcome will be fully favourable.

EMEP is paid under social security law.

The Resources page contains links to the intranet and Services Australia website, EMEP forms and customer eligibility scenarios.