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Medicare eligibility for enrolments 011-23032034

This document contains information to assist in determining eligibility in Medicare for overseas enrolments.

Establishing Medicare eligibility

This table helps Service Officers to determine eligibility for Medicare. This information can also be viewed in a flowchart.

Step	Action
1	Reason for coming to Australia + Read more ... Ask the customer why they have come to Australia? If they have: come for a holiday, go to Step 2 come for work/study, marriage/de facto relationship, refugee, go to Step 3 migrated here, go to Step 4 returned to live in Australia, go to Step 5
2	Holiday visit + Read more ... Ask the customer are they from a Reciprocal Health Care Agreement (RHCA) country? If the customer responds: Yes, they may be eligible for Medicare No, they are not eligible for Medicare A list of the RHCA countries and processing information can be found on Reciprocal Health Care Agreements (RHCA) eligibility for Medicare and Pharmaceutical Benefits Scheme (PBS).
3	In Australia for work/study, marriage, refugee or for an extended period + Read more ... Ask the customer if they have applied for permanent residency or a permanent protection visa? If the customer responds: Yes, the customer is eligible for Medicare. See Applicants for permanent residency No, check if they are eligible under a Ministerial order. See Ministerial orders and Medicare eligibility Is the customer eligible under a Ministerial order? Yes, see Ministerial orders and Medicare eligibility No, ask if they are from a RHCA country. Go to Step 2 Note: there are some occasions when Ministerial orders may determine Medicare eligibility for visa subclasses. See the Resources page for a list of commonly found visa subclasses.
4	Migrated to Australia + Read more ... Ask the customer if they are residing in Australia and: have permanent residency, or have applied for permanent residency, or are a New Zealand citizen If the customer responds: Yes, see: Medicare eligibility for customers with permanent resident status Applicants for permanent residency eligibility for Medicare Medicare eligibility for New Zealand citizens No, they are not eligible to enrol in Medicare. The customer may be eligible for RCHA. Go to Step 2
5	Citizens/ residents returning after extended periods + Read more ... For customers who are returning to Australia, ask if they are: Australian citizens, or permanent residents/New Zealand citizens Returning Australian citizens who have been absent for: less than 5 years - remain eligible for Medicare and are not required to provide documents. Note: the 5 year period does not recommence when an Australian citizen returns to Australia for a visit (that is, not to reside) more than 5 years – must: complete a Medicare enrolment form or Digital Medicare Enrolment (DME), and provide their passport and 2 residency documents See: Ministerial orders and Medicare eligibility Australian citizens eligibility for Medicare New Zealand citizens and permanent residents who have been absent greater than 12 months, see: Medicare eligibility for New Zealand citizens Medicare eligibility for customers with permanent resident status