Processing Essential Medical Equipment Payment (EMEP) claims 008-01040030

EMEP claims are assessed 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 and/or medically required heating/cooling. If the customer acquires further qualifying medical equipment, they will need to lodge a new claim for a new assessment.

Once it is 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

When there is a change in circumstances, for example 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

Note: medical evidence/information provided for the initial EMEP claim cannot be more than 2 years old.

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

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

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.

Granting a claim for a customer who is already EMEP current without a change in circumstances:

• resets the anniversary date, and
• causes the customer to receive an incorrect payment before the 12 month anniversary date

Staff must not overpay EMEP.

If a current customer lodges another EMEP claim for the same essential medical equipment less than 12 months from the most recent payment of EMEP, Service Officers must only grant the claim if the customer has:

• claimed for another item of essential medical equipment they are not currently being paid EMEP for
• had a change of circumstances, or
• lost qualification, for example by moving address

Service Officers must cancel the EMEP new claim activity (not the EMEP payment).

This includes if a customer lodges a new claim in a new financial year, the customer is not entitled to receive another EMEP for the same essential medical equipment less than 12 months after their previous EMEP has been paid.

The Resources page contains eligibility scenarios.

Initial processing includes searching for submitted online claim activities, indexing the claim where this has not occurred, and checking that all required information and supporting documentation has been requested.

The workflow is used to index the claim if necessary and to upload claim information into the indexed MEP NCL activity

Encourage customers to claim online. When they submit the claim, the What you must do page lists the supporting documents needed.

There are multiple benefits for claiming online including less information to provide. Any information that has previously been provided by the customer is pre-populated (from their Centrelink record) into their online claim.

EMEP is a legacy online claim currently available in Centrelink online account. It is only accessible in Customer First. Assisted Customer Claim cannot be used for EMEP.

Nominees cannot claim EMEP online for a customer. Issue a paper claim to correspondence nominees.

If the customer is unable or unsuitable to complete an online claim, they can lodge a paper claim for EMEP:

• Claim for Essential Medical Equipment Payment (SA440):
• customers must use this form if they use one or more items of essential medical equipment
• the SA440 is a combined form (and includes the Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation (SA449))
• the SA440 form 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 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)
• the SA451 form is available on the Services Australia website

Use the Staff Process Claim workflow to:

• index the EMEP new claim activity in Customer First
• key claim data from the scanned SA440, SA451 and/or SA449
• upload claim information into the indexed EMEP new claim activity

An automatic letter will be sent to the customer to advise the outcome of their claim. If the claimant has died since lodging the claim a manual grant or rejection letter must be issued.

Customers can apply for a review of the decision to reject or cancel EMEP.

EMEP is paid under social security law.

Note: EMEP claims may be reassessed where all outstanding requested documents have been provided within 13 weeks of the rejection notice.