Claiming Essential Medical Equipment Payment (EMEP) 008-01040010

An EMEP claim for essential medical equipment or medically required heating/cooling applies to the customer’s current residential address, and can be made by:

• a customer with essential medical needs (equipment user). If the equipment user is a:
• a dependent child, they are not affected by a percentage of care requirement
• a non-dependent adult, they must authorise the carer to claim their EMEP, or
• a person caring for an equipment user. The carer:
• must provide care and attention on a regular and ongoing basis for the equipment user
• does not need to be a formal carer or be receiving Carer Payment and/or Carer Allowance to qualify for EMEP
• must live together with the equipment user at the same address
• does not need to satisfy any formal minimum standards of care requirements to qualify for EMEP

If the customer lives in different residences during the year, separate claims are needed for each residence. EMEP can be paid for the same item(s) of equipment at up to 2 residences every 12 months. For example:

• a dependent child who is in shared care and living alternately with either parent, or
• a non-dependent elderly customer living alternately between 2 residences that belong to their adult children

If lodging a paper claim or supporting documents, go to Step 5.

Tell the customer they can claim online. The Services Australia website has relevant information and a list of medical equipment that qualifies for EMEP.

Note: correspondence nominees cannot claim EMEP online on behalf of a customer and must lodge a paper claim. Go to Step 3.

Does the customer want to claim online?

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

Complete a thorough search for the customer's record before creating a record. See Adding a customer to the system.

Use the Mail forms workflow in Customer First to issue the customer with the relevant forms which include:

• Claim for Essential Medical Equipment Payment (SA440):
• customers must use this form if they use 1 or more items of essential medical equipment
• the SA440 is a combined form with the Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation (SA449) and is available on the Services Australia website
• Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation (SA449):
• medical practitioners must use this form to confirm and certify the customer’s need for essential medical equipment and/or medically required heating or cooling in their home
• the SA449 form is available on the Services Australia website
• Essential Medical Equipment Payment – Equipment User Declaration (SA450):
• this consent form must be signed by the person who uses the essential medical equipment
• the form authorises EMEP to be paid to the person’s carer
• the SA450 form is available on the Services Australia website
• Claim for Essential Medical Equipment Payment - Multiple Claim (SA451):
• customers must use this form to claim for multiple items of essential medical equipment and/or multiple equipment users who live at the same residence
• each equipment user listed on the SA451 is considered an individual claim and each claim is assessed and processed separately
• the SA451 is a combined form (and includes the SA449) and is available on the Services Australia website

As EMEP is an online claim currently available on the legacy platform, Assisted Customer Claim (ACC) cannot be used for EMEP.

Anyone can lodge documents for the customer, except for identity linkage documents.

Identity requirements

Identity Confirmation is required for the customer (and equipment user) if they have not previously confirmed their identity.

Proof of medical needs – initial claim

Medical evidence provided for the initial EMEP claim must not be more than 2 years old. If it is over 2 years old, new medical evidence is required.

Medical evidence from a Treating Health Professional (THP) must include a signed Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation (SA449). This medical confirmation declaration form 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

The SA449 must be used for new claims to verify that the equipment user:

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

Once granted:

• EMEP remains current
• current EMEP customers will:
• be automatically paid every 12 months on the grant date anniversary, and
• continue to get payments until they lose qualification

Proof of medical needs – change in circumstances/new claim required

When there is a change in circumstances (such as a change in residential address):

• the customer loses qualification
• the customer must lodge a new claim
• a new anniversary date is set according to the date of grant of the new claim

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

Medical documents provided for other payments cannot be used for EMEP, for example:

• Medical Report - Disability Support Pension Review (SA012RM), or
• Carer Payment and/or Carer Allowance Medical Report - For a person - 16 years or over (SA332A)

If further evidence or information is required, request information.

Other evidence

Other evidence may be provided (instead of an SA449) to verify that essential medical equipment is required. For example:

• an energy bill showing a rebate or concession under a state or territory scheme
• notification from the Department of Veterans' Affairs

Other evidence cannot be provided for medically required heating/cooling.

Carer consent

When claiming online, the customer should print and keep the SA450 as they may be asked for it during a review. The SA450 is a declaration signed by the equipment user that authorises EMEP to be paid to their carer.

Energy account

Customers do not need to provide energy account evidence for an EMEP claim unless they did not provide proof for an EMEP energy account review.

Check the customer has completed and signed the claim. The equipment user also needs to sign the claim if they are not the customer or a dependent child:

• Staff with no access to Centrelink system:
• photocopy identity documents and other supporting documents. Initial copy and attach to claim. Return original to customer
• Medicare staff, see Handling claims for Essential Medical Equipment Payment received at Medicare service centres
• Other staff:
• scan SA440, SA451, SA450 and/or SA449 to the customer's record
• In Process Direct, go to Identity Confirmation Dashboard, check the customer’s Identity Status, see Identity Confirmation
• code identity documents if provided and/or required

For Smart Centre Processing teams, see Processing EMEP claims.

Lodge all forms generated by the Mail Forms workflow to avoid payment delays.

Do not accept the SA449 on its own as a claim, it must be accompanied by a completed SA440 or SA451. See Processing EMEP claims.

Customers must be registered with an active Centrelink online account to start an online claim.

Once registered, customers can start an online claim for EMEP. Tell the customer to:

• sign in to myGov and access their Centrelink online account
• select Payments and Claims > Claims > Make a claim > Disabled, ill or injured > Get started > Apply for Essential Medical Equipment Payment
• on the What you would like to claim window, select Apply for Essential Medical Equipment Payment
• on the Make a claim (continued) for Essential Medical Equipment Payment page:
• the customer can read about EMEP eligibility, and
• select Continue to start their claim

When a customer starts their online claim, the system:

• allocates a Claim ID to the claim
• creates a DOC on the customer's record, including the Claim ID
• uploads customer contact details from the online claim to their record

Service Officers can view the status of the online claim and its history.

The Resources page contains links to the Services Australia website for EMEP claims.

The Claim Progress window (next to the online claim) displays the following sections of the claim that the customer is required to complete:

• Customer Details:
• must provide Customer Reference Number if known, name(s), date of birth, gender of the equipment user or carer claiming and if they are a dependent child or not
• Address Details:
• must provide their permanent home address and if this is where the medical equipment is used. If not, they must state the type of residence where the equipment is being used (for example, temporary) and the address
• Contact Requirements:
• Interpreter
• Preferred language for written communication
• Nominees
• Preferred service centre
• Telecommunication Details:
• must provide at least 1 number for contact during business hours
• Essential Medical Equipment Payment. If the customer is claiming EMEP as the medical equipment user, they must advise:
• if they use medically required heating/cooling
• each item of essential medical equipment they use
• the energy account is held by them or their partner, or they can show they have to pay toward the account
• the type of energy used to run the medical equipment
• Essential Medical Equipment Payment. If the customer is claiming EMEP as the carer of the medical equipment user, they must advise:
• the care receiver's personal details
• the carer receiver's address details
• if the care receiver uses medically required heating/cooling
• each item of essential medical equipment the care receiver uses
• the energy account is held by the carer or their partner, or they can show they or the carer receiver has to pay toward the account
• the type of energy used to run the medical equipment
• Payment Destination. Customers can choose to:
• use the same account they use for their current payments
• nominate an account by stating the Branch (BSB) number, account number, and name the account is in. it must be in their name or jointly in their name
• provide their account details later
• Review and Submit claim

On the Check your Eligibility for Essential Medical Equipment Payment page, the customer must answer the streaming questions to check they are eligible to the payment based on their circumstances. Eligibility questions include:

• Are you claiming an Essential Medical Equipment Payment, as either:
• the person with medical needs who is a user of 1 or more pieces of qualifying essential medical equipment, and/or medically required heating/cooling, in your current residence, or
• the carer of the person with medical needs, who you currently live with, or
• none of the above?
• Are you currently in Australia?
• Are you a dependent child of another person?
• Are you the holder of, or are listed on a qualifying Commonwealth concession card?
• For the residence where the energy is used to operate the essential medical equipment or medically required heating/cooling, are you:
• the energy account holder, or
• the partner of the energy account holder, or
• contributing towards payment of the energy account?
• Have you already received an Essential Medical Equipment Payment from Centrelink or the Department of Veterans' Affairs, for the same piece of medical equipment, or medically required heating/cooling, at the same residence this financial year?
• Has anybody else received an Essential Medical Equipment Payment from Centrelink or the Department of Veterans' Affairs, for the same piece of medical equipment, or medically required heating/cooling, at the same residence this financial year?
• Is the essential medical equipment, and/or medically required heating/cooling, you are claiming for being used in the residence you are claiming at?

On the You may be eligible to receive Essential Medical Equipment Payment page, customers are asked if they want to continue to Make a claim.

After selecting Claim, the Continue button navigates the customer to the Claim navigation page which displays:

• a claim progress window (next to the claim question set)
• claim options (including a ‘save and exit claim’ option and ‘Help index’), and
• sections of the claim that are required to be completed

Customers must complete each section containing relevant questions by selecting the ‘Save and Continue’ button in order to go to the next section.

A green tick indicates the question set for each page is complete. On each question page, the customer can select:

• Back to go to the previous question
• Save to save the claim at the current stage
• Save and Continue to progress to the next set of questions
• Save and Exit option from the Claim Progress window to save their answers and continue later with their started claim
• Help Index to access help text about the questions on the current page. Help text will open in a separate window and can be printed

Access a started claim

Tell the customer to:

• sign in to myGov and select their Centrelink online account
• select Apply for a Payment > View your Online Claims > incomplete EMEP claim status > select:
• Continue claim, or
• Cancel claim. Note: once confirmed, customers cannot view or continue the online claim and no claim information is recorded. Customers can start a new online claim

Information may pre-populate from the customer’s Centrelink record and can be updated in the claim if it is not correct.

The customer must answer the questions marked with an asterisk (*) before they can continue. They must complete all questions sets to submit their claim.

Draft claims are claims that the customer has started online but has not submitted.

Incomplete claims require additional information from the customer and submission before they will be processed. Available Actions allow the customer to:

• Continue with their claim, or
• Cancel their claim. Once the customer cancels the claim and confirm this, they cannot view or continue the EMEP online claim and no claim information goes on their record. Customers can start a new online claim

Submitted claims are claims waiting to be processed and cannot be edited by the customer. Available Actions allow the customer to:

• Withdraw their claim. Withdrawn claims are submitted claims that the customer does not want to pursue. Customers are advised before withdrawing their online claim that:
• after it is withdrawn, this claim cannot be reinstated
• they cannot apply for a formal review of this decision

Note: as EMEP is a legacy online claim, the Withdraw claim option is only available if the submit date was within the past 14 days. If the submit date is more than 14 days, the customer cannot be contacted and asked to withdraw their claim.

The Review your claim page contains a summary of all of the information provided by the customer so they can check what they have entered is correct.

The customer can go back by selecting the Back button or change their details by selecting the link to the question set.

If all of the information is correct, the customer can select Continue.

Submit your claim page

Declaration

The customer must accept the declaration before they can submit the claim.

If the person with medical needs is not the customer and is over 16 years, they need to give consent. The customer must tick the box confirming they have written consent from the equipment user that they are aware the customer is claiming EMEP.

Once they accept the declaration, select Submit button.

The What you must do page:

• confirms the customer has submitted the claim
• displays their claim number, and
• lists documents the customer must provide for their claim, including medical and identity confirmation information. This can include proof of medical needs, such as Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation (SA449) to confirm and certify the customer’s need for essential medical equipment and/or medically required heating or cooling in their home. Note: medical information lodged with the initial claim must not be more than 2 years old
• tells the customer they need to provide identity documents at a later stage. If customer identity has not been confirmed, Skill tagged Processing Services staff must request identity documents from the customer. These must be provided before finalising the claim

For their claim, the customer does not need to provide evidence they meet energy account requirements. This may need to be provided later.

Customers can upload documents online. Note: scannable documents exceptions apply and are not to be used for processing.

Options from this page include:

• View your Online Claim
• Print this page
• return to the online account menu
• view a summary of all Your online claims
• links to payments and support services (if they indicated they are in a crisis)

After a customer has submitted an online claim, they cannot update the online claim details, except to withdraw their claim online.

Customers must contact Services Australia to add or change details for the claim .

When a customer submits their online claim, the system automatically:

• indexes a new claim activity or creates a manual follow-up activity on their record. Day 1 processing includes indexing the claim if necessary
• creates a DOC
• uploads customer contact details

View information the customer has provided in their online claim in the Review Claim section.

Messages and notifications

Customers who provide a mobile phone number or email address will be:

• advised they will automatically be subscribed to the Electronic Messaging (EM) service unless they have previously declined
• asked if they want to nominate a preferred contact method (SMS or email) for notifications
• subscribed to receive their Centrelink mail online. These will be delivered through their myGov Inbox, and
• advised they can opt out of these services at any time

See Processing Essential Medical Equipment Payment (EMEP) claims when a current customer lodges another EMEP claim for the same essential medical equipment less than 12 months from the most recent payment of EMEP and has not had a change of circumstances.