Processing newborn child enrolments in Medicare 011-19042338

Services Australia plays a critical role in providing support to people with family and domestic violence concerns. The agency gives access to the services and support people may need. Family and domestic violence can pose a serious risk to the safety and wellbeing of our customers. It is important to discuss all options with the customer.

When a customer contacts the agency by phone about their application, suitably skilled Service Officers must attempt first contact resolution. Service Officers not skilled in this work type should follow the Escalation process for Medicare Eligibility.

Note: all Financial hardship and vulnerable customer claims, must be processed at first point of contact. Service Officers not skilled in this work type, must escalate to a Local Peer Support (LPS) for help.

The partner can complete the Centrelink online claim and submit the Medicare enrolment application (MS004) form and request for their newborn to be enrolled in Medicare.

• If both parents are on the same Medicare card, then enrol the newborn on the parent's family card
• If the partner is on their own Medicare card and wants to enrol the child on their card, the Service Officer must:
• sight evidence of the partner's parental relationship with the child (birth certificate or other legal documentation), or
• sight or obtain verbal consent from the birth mother to enrol the child on the partner's card

If the partner is the applicant and on the same card as the birth mother, it is okay to enrol newborn without obtaining verbal consent from the birth mother as long as parental relationship documents are sighted or mother's signature is on the FA081 form.

The below options are deemed acceptable for a partner to provide evidence of their parental relationship to the newborn child to enrol the newborn onto their Medicare card:

Online claim

The partner can complete the online claim and submit:

• the back page of the FA081 form along with evidence of their parental relationship with the child (birth certificate or other legal documentation), or
• all 4 pages of the FA081 form including their details, the birth mother's details and both their signature and the birth mother's signature

If the partner has completed the online claim and:

• both parent's details and signatures are on the form the newborn can be enrolled on both Medicare cards
• only submitted the back page of the FA081 form, if both parents are on the same Medicare card, the newborn can be enrolled

Newborn enrolment using Medicare online accounts

The partner can enrol their newborn/s using Medicare online accounts. If the partner is on their own Medicare card and wishes to enrol the child on their card, the Service Officer must:

• sight evidence of the partner's parental relationship with the child (birth certificate or other legal documentation), or all pages of the completed Child Declaration (FA081), or
• sight or obtain verbal consent from the birth mother to enrol the child on the partner's card

If the partner has completed:

• Medicare enrolment form and both parent's details and signatures are on the form the newborn can be enrolled on both Medicare cards
• the online claim and only submitted the back page of the FA081 form, provided both parents are on the same Medicare card, the newborn can be enrolled

MS004 form

• the partner can complete and submit Part C of the MS004 form along with evidence of their parental relationship to the child (birth certificate or other legal documentation), or
• if the nominated partner in Part C of the MS004 form is the birth mother and she also signs the form, the form can be submitted along with the back page of the FA081 form or the doctor/midwife's declaration of birth

If both parent's details and signatures are on the form and they have ticked 'yes' to adding the newborn to their Medicare card, the newborn can be enrolled on both Medicare cards.

The child cannot be enrolled until adequate evidence is provided. If the Service Officer is unable to make immediate contact with the partner or the birth mother, the standard letter template must be completed.

The Resources page contains a links to the standard letter templates.

The group members on a Medicare card must be checked prior to enrolling a newborn.

If a customer presents a Medicare card number that includes their ex-partner, the customer must be contacted and transferred to a new Medicare card before enrolling the newborn child.

See Errors and exceptions with newborn child enrolments in Medicare for more information.

Identification documents must be verified in the Medicare Document Verification Service (DVS) Portal before processing the application. Table 9 on the Process page contains details on how to verify and record this information.

From 14 October 2023, the consent statement for using DVS was included in all newborn enrolment applications submitted through Medicare online account (MOA) and Centrelink online account (MAENROL). For applications submitted before this date, verbal consent is necessary before verifying documents.

Services Australia can enrol a newborn child when they have not yet been named. This may occur when the newborn requires urgent medical treatment following their birth and they require access to Medicare.

When registering a newborn child not yet named, Service Officers must key 'Newborn' as the child's first name when entering their personal details.

For a multiple birth, the newborns must be enrolled by order of birth. 'Newborn 1', 'Newborn 2', 'Newborn 3', etc. must be keyed as the first name.

Newborns are not to be enrolled using any other term except for the above, and their last name.

When notified of the child's legal name, documentation must be provided before it can be updated and a new Medicare card issued.

See Change of name on Medicare record.

An 'only name' enrolment occurs where the newborn has only one name - there is no separate last name and first name.

When enrolling a newborn with an only name, Service Officers must enter the name in the last name field only and select the Only Name Indicator box.

If a legal name is a long name, it usually requires enrolment of the person on their own Medicare card. Medicare allows names to be shortened so all family members can be enrolled on the same Medicare card.

A name is considered long when any of the following apply:

• the person's last name contains more than 18 characters
• their first given name contains more than 12 characters, or
• the combination of their first name, initial and family name have more than 25 characters, (including spaces between the names)

If a newborn has a long name, a parent has 2 options, the newborn child/'s:

• can be enrolled on their own Medicare card, or
• name can be shortened to enable enrolment on the family Medicare card

The Service Officer must contact the applicant to get advice on which option they prefer.

If contact cannot be made with the mother, the newborn must be enrolled on their own Medicare card. A long name record must be created to make sure the correct name is embossed on the card and the birth mother as the group contact.

The Process page contains more details.

If the applicant chooses to shorten the newborn child's name, it must only be made at Group level. The legal name of the child is still held at Personal level.

If a name is hyphenated and the applicant wants to remove one of the names, this is considered a name change, not shortening a name. It would require documentation. See Change legal name on Medicare record.

If the applicant submits an enrolment on Medicare online accounts and the child has a long name, they will be presented with 2 options, the newborn child/'s:

• can be enrolled on their own Medicare card, or
• name can be shortened to enable enrolment on the family Medicare card

When processing an enrolment submitted through Medicare online accounts, contact with the applicant to confirm how they want to treat the long name is not required. See Process newborn child enrolment (MOA) from CDMS Provisional Registration screen table.

Parent with long name

If the parent has a long name, the child cannot be added to their Medicare card. The newborn must be enrolled on their own card with the parent as the group contact and a comment placed in Group in CDMS.

Parents/guardians cannot use their Medicare online account to make a Medicare claim for a newborn on their own card.

See Process newborn child enrolment for newborn with long name table.

My Health Record preferences are processed in the Medicare entitlement screens in the Consumer Directory Maintenance System (CDMS). The following conditions must be met for the applicant to be eligible to answer the My Health Record question(s):

• question is on the form
• applicant provides appropriate evidence of parental responsibility (outlined for each form below), and
• applicant has completed the question(s)

If any of the conditions are not met, select: Question is not on form or not answered.

Do not select Consumer does not want a My Health Record if any of the conditions are not met.

If all of the conditions are met, the applicant's My Health Record choice should be processed as one of the following:

• Consumer does not want a My Health Record
• Consumer does want a My Health Record

Conditions are slightly different for each form.

See also Processing My Health Record options – tips and error reporting.

Newborn Child Declaration FA081

If all of the conditions below are met, the Service Officer can process the applicant's My Health Record preference:

• Question is on the FA081
• The birth mother is the applicant or has signed as the partner on the form, and
• Applicant has completed question

The birth mother's parental responsibility evidence is the proof of birth page.

Express Plus Centrelink mobile app and Online claim

The birth mother can complete the My Health Record questions online. The My Health Record toggle does not appear for other applicants.

• My Health Record toggle I do not want a My Health Record for my newborn child is included in the questions, and
• Applicant uploads Proof of Birth page

The birth mother's parental responsibility evidence is the proof of birth page.

If the applicant is not the birth mother, select Question is not on form or not answered in CDMS.

Medicare enrolment application form (MS004) - Part C - Enrolling a newborn child

If all of the conditions below are met, the Service Officer can process the applicant's My Health Record preference:

• Questions are on the MS004
• Applicant has provided evidence of parental responsibility, and
• Applicant has completed the My Health Record question

The birth mother's parental responsibility evidence is the proof of birth page. Other applicants can also provide the Proof of Birth page if the birth mother has signed as the partner.

If the birth mother has not signed the MS004 as the partner, other applicants must provide a birth certificate, adoption papers or court orders.

Note: if Service Officers are unable to select the customer to register for a My Health record in CDMS, see Processing My Health Record options - tips and error reporting.

The Resources page contains a link to the My Health Record Website for information on applying in other ways for a My Health Record on behalf of a child.