Errors and exceptions with newborn child enrolments in Medicare 011-19042341

Services Australia (the agency) plays a critical role in providing support to people with family and domestic violence concerns. The agency gives access to the services and support they 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.

Privacy implications require Service Officers to take action to rectify the error if they identify that a newborn has been added to an incorrect Medicare card, including:

• initial (new) enrolment
• copy or transfer
• newborn has been enrolled twice on the same Medicare card

Note: the newborn may also be incorrectly registered on the wrong Medicare Safety Net family registration.

The Process page contains more information.

Before enrolling a newborn, Service Officers must check the applicant's (parent) Medicare card in the CDMS to confirm if the parent is still enrolled on their original family card (with their parents).

If it is identified that the parent is still enrolled on their original family card, the Service Officer must not enrol the newborn on this card unless there are exceptional circumstances.

Every effort must be made to contact the parent to seek their consent to be transferred from their original family card to another Medicare card (for example, their own or their partner's). If contact can be made with the parent and consent is given, the parent can be transferred to another Medicare card and the newborn can be enrolled onto this card with the parent.

If contact is unsuccessful with the parent, the newborn is required to be enrolled on their own Medicare card with the birth mother as the group contact and a comment placed in Group in CDMS.

The Process page contains more information.

Unless exceptional circumstances apply, it is not usually acceptable to have a grandparent, parent and child on the same Medicare card together. Situations when it may be considered are:

• birth mother under 15 years of age (the Process page contains more information)
• grandparent has guardianship for both the mother and grandchild

If exceptional circumstances apply, Service Officers must escalate to a Medicare and Aged Care - Local Peer Support (LPS).

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.

The Process page contains the process to follow when the applicant is required to transfer to a new Medicare card.

Ways to identify if ex-partner is still on the Medicare card

Check the question on the lodged FA081 or a MS004 that asks if the customer has a partner.

If the yes answer is selected, Service Officers must check the partner’s details match the existing Medicare records.

If the no answer is selected, and there is another adult on the same Medicare card, it might mean their ex-partner is still listed on that card.

Service Officers must be aware of any sensitive indicators that may have been applied.

If a Service Officer is unsure if a person listed on the Medicare card is the ex-partner, they must seek advice from LPS before contacting the customer or enrolling the newborn.