Australian citizens eligibility for Medicare 011-44010000

This document outlines information about Medicare eligibility for Australian citizens.

Step	Action
1	Documents needed to enrol Australian citizens enrolling for the first time in Medicare must prove their identity and residency by providing: a Medicare enrolment form (MS004) or Digital Medicare Enrolment (DME), and a valid Australian passport or Australian birth certificate or foreign passport and Australian citizenship certificate 2 residency documents dated within the last 6 months If the Australian citizen cannot provide residency documents after 6 months they can submit a Commonwealth statutory declaration. In some cases, a statutory declaration can be made available to an Australian citizen within 6 months from their arrival date. See Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS). If the MS004 is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information. If the digital Medicare enrolment application is incomplete, or documents are incorrect or missing, Service Officers must request information. See Digital Medicare enrolments and extensions in the MEE Portal. For children 0-14 years born: in Australia, see Child born in Australia enrolling in Medicare overseas, see Child born overseas enrolling in Medicare
2	Document Verification Service (DVS) To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal. Note: if a customer submits a digital Medicare enrolment application, DVS is completed in the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal.
3	Register a new customer See Table 1 in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS).
4	Enter the entitlement details After registration of a new customer: Select Entitlement on the Registration Type screen The New Medicare Entitlement Details screen will show: Entitlement Type - Australian citizen Country of Relevance - (Australia or previous country of residence) Entitlement Start Date - date of arrival Entitlement End Date not applicable - open Medicare card
5	Record each customer's eligibility documents Select Documents tab Select or key the details of each of the customer's eligibility documents: Eligibility Document (mandatory) Residency Document (if applicable) Reference Text (mandatory) Reference Date (mandatory) Select Add Repeat above to enter all eligibility documents provided Note: if this is part of a digital Medicare enrolment application, Service Officers must record document details in CDMS from the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal.
6	Issue the Medicare card Select Group tab - Group Details tab on Amend Medicare Card Details screen will show Select Name/Address tab Confirm the Group mailing address is correct Select Card Request tab Confirm the Group Eligibility Start Date is correct Remove Group Eligibility End Date Tick the required checkbox to request: Replace Current Card, and Duplicate Replacement Card, if required Select: Replacement Reason - Card Information is Outdated Card Request Source - Medicare Enrolment Form Select Validate, Update to finalise the enrolment transaction See Medicare cards.

Australian citizenship by birth on child's 10th birthday

Table 2: this table details how to enrol a child born in Australia who has gained citizenship on their 10th birthday.

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Step	Action
1	Documents needed to enrol A child born in Australia, who has resided in Australia for 10 years, automatically becomes an Australian citizen on their 10th birthday regardless of the parents status. The following documents are required to enrol or update a child's entitlement to Australian citizen: completed Medicare enrolment form (MS004) child's birth certificate, and child's Australian citizenship certificate If the MS004 is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information.
2	Document Verification Service (DVS) To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal.
3	Register a new customer If the child has not previously been enrolled in Medicare see Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS). Note: a parent must be listed as the group contact on the child's new Medicare card.
4	Add entitlement details After registration of a new customer: Select Entitlement on the Registration Type screen The New Medicare Entitlement Details screen will show: Entitlement Type - Australian citizen Country of Relevance - Australia Entitlement Start Date - date citizenship was granted Entitlement End Date not applicable - open Medicare card If the child has previously been enrolled in Medicare: Select Amend Consumer Details on the CDMS Home page Key the child's Medicare card number in ID Number field Select Entitlement The New/Additional Medicare Entitlement Details screen will show: Entitlement Type Australian citizen Country of Relevance Australia Entitlement Start Date - date citizenship was granted Entitlement End Date not applicable - open Medicare card ' Note: if the child's Australian citizen entitlement is different to the parent/s' Medicare entitlement, transfer the child to a new Medicare card. An Application to copy or transfer from one Medicare card to another form (MS011) is not required. If help is required to change the child's entitlement type to Australian citizen see Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS).
5	Record the child's eligibility documents Select Documents tab Select or key the details of each of the customer's eligibility documents: Eligibility Document (mandatory) Reference Text (mandatory) Reference Date (mandatory) Select Add Repeat above to enter all eligibility documents provided
6	Issue the Medicare card Before issuing a Medicare card, Service Officers must check that consumer end dates have been removed if they are no longer applicable. After the entitlement has updated: Select Group tab - Group Details tab on Amend Medicare Card Details screen will show Select Name/Address tab Confirm the Group mailing address is correct Select Card Request tab Confirm the Group Eligibility Start Date is correct Remove Group Eligibility End Date Tick the required checkbox to request: Replace Current Card, and Duplicate Replacement Card, if required Select: Replacement Reason - Card Information is Outdated Card Request Source - Medicare Enrolment Form Select Validate, Update to finalise the enrolment transaction See Medicare cards.

Amending entitlement from Permanent Resident to Australian Citizen

Table 3

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Step	Action
1	Documents needed to amend entitlement to Australian citizen Customers updating their Medicare entitlement from Permanent Resident to Australian citizen must provide a: Medicare enrolment form (MS004) or digital Medicare enrolment application, and valid Australian passport or Australian citizenship certificate Customers must provide these documents for each person listed on the enrolment application or listed in their digital Medicare enrolment application. If the: MS004 is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information digital Medicare enrolment application is incomplete, or documents are incorrect, Service Officers must request information. See Digital Medicare enrolments and extensions in the MEE Portal
2	Document Verification Service (DVS) To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal. Note: if a customer submits a digital Medicare enrolment application, DVS is completed in the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal.
3	Complete mandatory detailed search in CDMS See Table 1 in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS).
4	Enter the entitlement details Once eligibility is established, enter the new entitlement details. On CDMS Home page: Select Amend Consumer Details Key the customer's Medicare card number in ID Number field Select Entitlement The New/Additional Medicare Entitlement Details screen will show: Entitlement Type Australian citizen Country of Relevance (previous country of residence) Entitlement Start Date - date Australian citizenship was granted or Australian passport issue date Entitlement End Date not applicable - open Medicare card Note: if the customer is amending their entitlement after returning from residing overseas their entitlement start date is their date of arrival. Two residency documents dated within 6 months of date of lodgement are required to prove residency in Australia.
5	Record each customer's eligibility documents Select Documents tab Select or key the details of each of the customer's eligibility documents: Eligibility Document (mandatory) Residency Document (if applicable) Reference Text (mandatory) Reference Date (mandatory) Select Add Repeat above to enter all eligibility documents provided Note: if this is part of a digital Medicare enrolment application, Service Officers can record document details in CDMS from the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal.
6	Issue the Medicare card Before issuing a Medicare card, Service Officers must check that consumer end dates have been removed if they are no longer applicable. After the entitlement has updated: Select Group tab - Group Details tab on Amend Medicare Card Details screen will show Select Name/Address tab Confirm the Group mailing address is correct Select Card Request tab Confirm the Group Eligibility Start Date is correct Remove Group Eligibility End Date Tick the required checkbox to request: Replace Current Card, and Duplicate Replacement Card, if required Select: Replacement Reason - Card Information is Outdated Card Request Source - Medicare Enrolment Form Select Validate, Update to finalise the enrolment transaction See Medicare cards.

Citizens returning to Australia to reside

Table 4: this table details how to amend Australian citizen eligibility for citizens returning to Australia after a break in entitlement.

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Step	Action
1	Documents needed to enrol Returning Australian citizens who have been absent from Australia for 5 years or more must: complete a Medicare enrolment form (MS004) or digital Medicare enrolment, and provide their current passport and 2 residency documents dated within 6 months from date of lodgement Note: only 2 residency documents are needed for a family enrolment application if all members are enrolling at the same time. If the: Australian citizen cannot provide residency documents after 6 months they can submit a Commonwealth statutory declaration. In some cases, a statutory declaration can be made available to an Australian citizen within 6 months from their arrival date. See Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS) MS004 is incomplete or documents are missing, Service Officers must request information. See Medicare eligibility and enrolments request for information digital Medicare enrolment application is incomplete, or documents are incorrect, Service Officers must request information. See Digital Medicare enrolments and extensions in the MEE Portal Note: if the Australian citizen has not returned to reside and has been absent from Australia for 5 years or more, they are not eligible for Medicare unless they are visiting from an RHCA country. See Reciprocal Health Care Agreements (RHCA) eligibility for Medicare and Pharmaceutical Benefits Scheme (PBS).
2	Document Verification Service (DVS) To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal. Note: if a customer submits a digital Medicare enrolment application, DVS is completed in the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal.
3	Amend entitlement details Once eligibility is established, add the new entitlement details. On CDMS Home page: Select Amend Consumer Details Key the customer's Medicare card number in ID Number field Select Entitlement The New/Additional Medicare Entitlement Details will show: Entitlement Type - Australian citizen Country of Relevance - (previous country of residence) Entitlement Start Date - date of arrival Entitlement End Date - not applicable - open Medicare card Note: the Group Eligibility Start Date for Australian citizens has not changed, this remains the citizen's original eligibility start date. If an Australian citizen has been absent from Australia for 5 years or more: the previous entitlement must be end-dated 5 years after the date of departure (if known) and the exact date of departure is not known, the end-date is 5 years from the end of the known departure year. That is, 5 years from 31 December of the advised year of departure
4	Record each customer's eligibility documents Select Documents tab Select or key the details of each of the customer's eligibility documents: Eligibility Document (mandatory) Residency Document (mandatory) Reference Text (mandatory) Reference Date (mandatory) Select Add Repeat above to enter all eligibility documents provided Note: if this is part of a digital Medicare enrolment application, Service Officers can record document details in CDMS from the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal.
5	Issue the Medicare card Before issuing a Medicare card, Service Officers must check that consumer end dates have been removed if they are no longer applicable. After the entitlement has updated: Select Group tab - Group Details tab on Amend Medicare Card Details screen will show Select Name/Address tab Confirm the Group mailing address is correct Select Card Request tab Confirm the Group Eligibility Start Date is correct Remove Group Eligibility End Date Tick the required checkbox to request: replace current card, and duplicate replacement card, if required Select: Replacement Reason - Card Information is Outdated Card Request Source - Medicare Enrolment Form Select Validate, Update to finalise the enrolment transaction See Medicare cards.

Australian citizens returning to Australia from conflict overseas (Middle East)

Table 5: this table details how to amend Australian citizen eligibility for citizens returning to Australia from conflict overseas not intending to reside permanently in Australia. For example:

Lebanon
Israel
Palestine

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Step	Action
1	Documents needed to enrol Returning Australian citizens who have been absent from Australia for 5 years or more and intend to return to previous country of residence when it is safe to do so, must provide: a Medicare enrolment form (MS004) valid Australian passports for all customers listed on the MS004 a statutory declaration stating their intent to reside in Australia for the foreseeable future due to the conflict. Service Officers can approve statutory declarations If the MS004 is incomplete or documents are missing, Service Officers must escalate the application to Local Peer Support. See Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS). Where some members enrolled on a Medicare card have been absent from Australia for 5 years or more and other members have not, the members who have been absent for 5 years or more must be transferred to a new Medicare card. This is because they have an entitlement end date. An Application to copy or transfer from one Medicare card to another form (MS011) is not required in this instance. Note: if Australian citizens returning from conflict overseas have previously been enrolled under this agreement and have been residing in Australia for more than 12 months, they: meet residency requirements, and do not need to supply additional documents to remove the entitlement end date in CDMS
2	Document Verification Service (DVS) To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal. Note: if a customer submits a digital Medicare enrolment application, DVS is completed in the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal.
3	Amend entitlement details Once eligibility is established, add the new entitlement details. On CDMS Home page: Select Amend Consumer Details Key the customer's Medicare card number in ID Number field Select Entitlement The New/Additional Medicare Entitlement Details will show: Entitlement Type - Australian citizen Country of Relevance - (previous country of residence) Entitlement Start Date - date of arrival Entitlement End Date - 12 months from date of arrival Note: the Group Eligibility Start Date for Australian citizens has not changed, this remains the citizen's original eligibility start date. If an Australian citizen has been absent from Australia for 5 years or more: the previous entitlement is required to be end-dated 5 years after the date of departure (if known) and the exact date of departure is not known, the end-date is 5 years from the end of the known departure year. That is, 5 years from 31 December of the advised year of departure
4	Record each customer's eligibility documents Select Documents tab Select or key the details of each of the customer's eligibility documents: Eligibility Document (mandatory) Residency Document (mandatory) Reference Text (mandatory) Reference Date (mandatory) Select Add Repeat above to enter all eligibility documents provided
5	Issue the Medicare card Before issuing a Medicare card, Service Officers must check that consumer end dates have been removed if they are no longer applicable. After the entitlement has updated: Select Group tab - Group Details tab on Amend Medicare Card Details screen will show Select Name/Address tab Confirm the Group mailing address is correct Select Card Request tab Confirm the Group Eligibility Start Date is correct Remove Group Eligibility End Date, if applicable Tick the required checkbox to request: Replace Current Card, and Duplicate Replacement Card, if required Select: Replacement Reason - Card Information is Outdated Card Request Source - Medicare Enrolment Form Select Validate, Update to finalise the enrolment transaction See Medicare cards.

Defence Force personnel

Table 6: this table details how to enrol or re-enrol Defence Force personnel.

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Step	Action
1	Eligibility for Medicare Defence Force personnel remain Australian residents for the purposes of the Health Insurance Act 1973. They are not required to satisfy the standard process for residency. This includes if they have been absent from Australia for more than 5 years.
2	Documents needed to enrol Defence Force personnel must provide the following to enrol or re-enrol in Medicare: Completed Medicare enrolment form (MS004) Identification, which can include one of the following: current Australian driver's licence Australian birth certificate valid Australian passport Residency document, which can include one of the following: discharge papers evidence of employment a completed statutory declaration to support their enrolment application where documents cannot be provided
3	Document Verification Service (DVS) To verify documents for enrolments, see Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal.
4	Enter entitlement details Entitlement details if not previously enrolled in Medicare: Entitlement type - Australian Citizen Country of Relevance - Australia Entitlement Start date - can be one of the following: date of birth if date of birth is prior to 01/02/1984 use this date 01/02/1984 date citizenship was granted Entitlement End date - not applicable - open Medicare card
5	Record each customer's eligibility documents Select Documents tab Select or key the details of each of the customer's eligibility documents: Eligibility Document (mandatory) Residency Document (mandatory) Reference Text (mandatory) Reference Date (mandatory) Select Add Repeat above to enter all eligibility documents provided
6	Issue the Medicare card Before issuing a Medicare card, Service Officers must check that consumer end dates have been removed if they are no longer applicable. After the entitlement has updated: Select Group tab - Group Details tab on Amend Medicare Card Details screen will show Select Name/Address tab Confirm the Group mailing address is correct Select Card Request tab Confirm the Group Eligibility Start Date is correct Remove Group Eligibility End Date Tick the required checkbox to request: Replace Current Card, and Duplicate Replacement Card, if required Select: Replacement Reason - Card Information is Outdated Card Request Source - Medicare Enrolment Form Select Validate, Update to finalise the enrolment transaction See Medicare cards.

Operational Information

Australian citizens eligibility for Medicare 011-44010000

On this page:

Australian citizens enrolling in Medicare

Australian citizenship by birth on child's 10th birthday

Amending entitlement from Permanent Resident to Australian Citizen

Citizens returning to Australia to reside

Australian citizens returning to Australia from conflict overseas (Middle East)

Defence Force personnel