Applicants for permanent residency eligibility for Medicare 011-44020000

Customers can apply for permanent residency or a protection visa and can do this either:

• offshore (outside of Australia)
• onshore (in Australia)

There are different types of permanent residency visas including protection visas. The legislation states that an applicant for a permanent resident visa must hold a valid temporary visa. It does not specify the type of visa.

Customers can enrol in Medicare if they meet all the criteria. When the customer enrols, they will get a blue interim Medicare card. Blue interim Medicare cards display the expiry date in DD/MM/YYYY format.

Customers must supply documents to enrol in Medicare.

A customer is eligible to enrol if they:

• apply for a permanent residency or protection visa
• are onshore, and
• have a current visa that shows they have permission to work

This does not apply to customers who have applied for a Parent visa. While Parent visas are a type of permanent residency visa application, they are subject to different Medicare eligibility requirements. See Visa subclasses and Medicare eligibility on the Resources page in Medicare eligibility for enrolments.

Note: Visa Entitlement Verification Online (VEVO) shows if the customer is onshore, their visa type and if they have permission to work.

If customers do not have permission to work, they are only eligible for Medicare if they:

• have a relationship with a child, partner or parent who resides in Australia and:
  • is an Australian citizen
  • is a New Zealand citizen, or
  • holds a permanent resident visa
• were residing in a Reciprocal Health Care Agreement (RHCA) country immediately before coming to Australia, and meet the criteria of that country, they can enrol under RHCA

Customers who are seeking judicial review or ministerial intervention of their refused permanent residency or permanent protection visa are not eligible for Medicare. See Customers appealing a visa refusal below.

The Process page contains more details.

If the customer's:

• visa details are shared through an electronic data link (DIAC) with the Department of Home Affairs, the system automatically extends eligibility using the allowable card extension periods. The Resources page contains more details
• Medicare eligibility did not automatically extend, manually extend using the allowable extension periods. The customer must continue to meet the visa application criteria. A customer is eligible to extend their entitlement if:
  • their visa application has not been refused, and
  • they have permission to work

If the customer does not have permission to work, they are only eligible to extend if they have a relationship with a child, partner or parent who resides in Australia and:

• is an Australian citizen
• is New Zealand citizen, or
• holds a permanent resident visa

The customer must supply documents to extend their eligibility for Medicare. The Process page contains more details.

The Process page also contains steps to follow when a customer's visa has been refused.

Customers with different entitlement end dates cannot be on the same Medicare card. If a Medicare card has customers with different entitlement end dates, any card requests will automatically cancel. A cancelled card will not be issued and the customer will not have an active Medicare card.

The Department of Home Affairs have made changes to several visas to support customers affected by family and domestic violence (FDV). Under the new changes, if the Department of Home Affairs refuses a primary applicant's visa because of their role as a perpetrator of FDV, the additional applicants may still be eligible to have their visa granted.

These changes will only apply to the additional visa applicants so that customers affected by FDV do not need to stay in a dangerous situation to be granted a permanent visa.

The Resources page contains a list of the visas included in this change.

If an enrolment application is received:

• to enrol or extend Medicare entitlement for a listed visa
• there is advice of FDV, and
• the enrolment application does not include children under 15 years

Service officers must:

• make sure they process the enrolment application safely and correctly. See:
  • Separating safely - protecting personal details
  • Family and domestic violence
  • Sensitive Information Indicators in CDMS
• follow the process in Applicants for permanent residency eligibility for Medicare to enrol or extend the customer
• confirm with Visa Entitlement Verification Online (VEVO) the customer is an additional customer, if applicable
• follow Table 2 in Copy or transfer a person or child to another Medicare card if the enrolment application includes children under 15 years

Service officers:

• do not need to escalate customers enrolling for the first time with children under 15 years
• must escalate to Local Peer Support, if they need help. See Tier 0 technical support - self-sufficiency.

LPS follow the Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS) if they need more help.

Tell customers to contact the Department of Home Affairs for more details about the visa changes.

Note: the updated letter from the Department of Home Affairs and the VEVO Entitlement Details screen should not show the primary holder visa details.

A customer may have their visa application refused by the Department of Home Affairs. If a visa application is refused, the Department of Home Affairs will issue the customer with a notice telling them of the decision. The customer's Medicare entitlement will end, and Services Australia will issue a system generated letter to inform the customer about the change in Medicare entitlement.

After a visa refusal, the customer may choose to:

• seek review through the Administrative Review Tribunal (ART)
• seek judicial review through a court, such as the Federal Circuit and Family Court
• request Ministerial Intervention

For Medicare eligibility purposes, these pathways are treated differently.

Customers may be eligible for Medicare while their refused visa decision is being considered by the Administrative Review Tribunal (ART), if all other Medicare eligibility requirements are met.

In some cases, a court may find a legal error in the visa refusal decision and set the decision aside. The matter may then be remitted to the ART or the Department of Home Affairs for reconsideration. If the matter is remitted for reconsideration, the customer may be eligible for Medicare for the duration of that review process, provided the visa application being reconsidered is for a Medicare-eligible visa and the customer continues to meet all other Medicare eligibility requirements.

Customers are not eligible for Medicare if they are seeking:

• judicial review, or
• Ministerial Intervention

Note: before 14 October 2024, the ART was known as the Administrative Appeals Tribunal (AAT).

For more information, see:

• Administrative Review Tribunal (ART) review of a refused visa
• Judicial review and Ministerial Intervention after a refused visa

A customer may be eligible for Medicare while their refused visa decision is being considered by the ART if all other Medicare eligibility requirements are met.

The customer must be appealing the refusal of a Medicare-eligible visa category to be eligible for Medicare during the ART appeal process. To enrol or re-enrol in Medicare, the customer must provide:

• a completed Medicare enrolment form (MS004)
• evidence of a current ART appeal, dated within the last 12 months (from date of lodgement)
• a valid visa with permission to work
• a passport or ImmiCard

For customers who have an adverse outcome with their Permanent Residence (Skilled Regional) subclass 191 visa see Ministerial orders and Medicare eligibility.

Child born in Australia to parent/s who have lodged an appeal with the Administrative Review Tribunal (ART)

For a child born in Australia to parent/s who have lodged a visa refusal appeal with ART before the child's birth, see Child born in Australia enrolling in Medicare.

ART remit letters

An ART remit letter means the customer's matter has been referred back to the Department of Home Affairs for further consideration.

Where an ART remit letter is provided:

• the customer is no longer considered to be under ART review
• the customer remains eligible for Medicare as an applicant for permanent residency or permanent protection visa
• there is no break in Medicare entitlement

Service officers must not create a new entitlement line, the customer's original entitlement start date remains valid.

If entitlement requires extension, see Extending Medicare eligibility above.

ART supports Medicare eligibility

Under section 3 of the Health Insurance Act 1973, a person may be considered an Australian resident while their application for permanent residency or permanent protection has not been finally determined.

For Medicare purposes, eligibility:

• ends if the customer does not lodge an ART appeal within the required timeframe
• ends if the ART affirms (upholds) the refused visa decision
• may continue while a refused visa decision is being reviewed by the ART, if all other Medicare eligibility requirements are met
• may continue if the ART remits the matter back to the Department of Home Affairs for reconsideration, if all other Medicare eligibility requirements are met

Judicial review and Ministerial Intervention requests do not support Medicare eligibility.

This is because these processes happen after the visa application and ART review processes and do not form part of the Medicare-eligible visa review pathway.

Customers are not eligible for Medicare if they are seeking:

• judicial review through a court or request
• Ministerial Intervention

Unauthorised Maritime Arrivals (UMA)

Customers may remain eligible for Medicare as a UMA if they hold:

• a valid Bridging Visa E (BVE 050), and
• a valid ImmiCard

Note: customers who hold (or have held) a passport are not eligible to be enrolled as an UMA, as they have travelled to Australia using a passport or other valid travel document.

See Ministerial orders and Medicare eligibility.

Reciprocal Health Care Agreements (RHCA)

Customers may remain eligible for Medicare under a Reciprocal Health Care Agreement, if they:

• hold a valid visa
• hold a valid passport
• meet RHCA residency requirements

See Reciprocal Health Care Agreements (RHCA) eligibility for Medicare and Pharmaceutical Benefits Scheme (PBS).

As part of the Medicare eligibility policy clarification, Services Australia is undertaking a customer review activity for two groups of customers (Stream A and Stream B) who may be affected by the clarified policy. The review activity has the reference number JRMI26.

Customers in these streams have been identified because their Medicare eligibility or pending enrolment application may be based on documents relating to judicial review and Ministerial Intervention following a refused permanent residency or permanent protection visa decision.

Stream A - Existing Medicare customers

Stream A includes customers with a current Medicare entitlement identified as potentially no longer eligible for Medicare under the clarified policy.

As part of the review activity, customers:

• may have received an outbound phone call, letter, or both
• are asked to provide evidence of Medicare eligibility under another eligibility pathway
• have 28 days to respond from the date on the JRMI letter

If the customer:

• does not respond within 28 days from the date on the JRMI letter, their Medicare entitlement will end
• responds, but is not eligible under another Medicare eligibility pathway, their Medicare entitlement will end

Stream B - Pending enrolment applications

Stream B includes customers whose Medicare enrolment applications were placed on hold while the policy clarification was being finalised.

As part of this activity, customers will receive a letter advising:

• the policy has been clarified
• judicial review and Ministerial Intervention documents do not support Medicare eligibility following a refused visa decision
• they have 28 days, from the date on the JRMI letter to provide evidence of another visa pathway or circumstance that may support Medicare eligibility

If the customer does not provide evidence that supports Medicare eligibility, their pending enrolment application will be rejected.

JRMI26 references

Customers who have been included in this activity may:

• refer to a letter containing the reference JRMI26
• have comments recorded in CDMS (either in Group or Personal) referencing JRMI26
• have JRMI26 processing notes recorded against an open or pended PANDA or Digital Medicare Enrolment or Extension (DME/DMX) application

If a customer refers to a JRMI26 letter, or a JRMI26 comment is identified in CDMS, PANDA or MEE Portal, go to Process page > Table 7.

New Zealand citizens living in Australia are eligible for Medicare and can apply for permanent residency.

Service officers must not add an immigration data link to these enrolments. This incorrectly changes or ends the customer's Medicare eligibility.

New Zealand citizens enrolled in Medicare as an applicant for permanent residency may have their application refused. In these cases, update the customer's Medicare entitlement to reflect their New Zealand citizen eligibility. Do not refuse a Medicare card in these cases.

For more details see Amending a New Zealand entitlement type.

From 1 July 2023, New Zealand citizens who have been living in Australia for 4 years or more, are eligible to apply directly for Australian citizenship:

• They no longer need to first apply for and be granted a permanent visa
• These changes apply to New Zealand citizens holding a Special Category (subclass 444) visa (SCV) that arrived in Australia after 26 February 2001

The Department of Home Affairs introduced 2 new pathways for permanent residency. Customers are eligible for Medicare as a Conditional Migrant if they have lodged:

• Permanent Residence (Hong Kong) (Regional) subclass 191, commenced 5 March 2022
• Permanent Residence (Skilled Regional) subclass 191, commenced 16 November 2022

For customers who have been refused their Permanent Residence (Skilled Regional) subclass 191 visa, see Adverse outcome visa subclass 191 in Ministerial orders and Medicare eligibility.

The Red Cross helps people who have arrived in Australia with limited financial means.

The customer is:

• subject to constant review by the Red Cross, and
• must provide immigration documents to enrol in Medicare

Medicare eligibility of these customers is no different to other customers from overseas.

The Process page contains more details for refugees who do not have photo identification (ID).

Service officers must escalate all enrolment applications received under Asylum Seekers Assistance Scheme and Red Cross Refugees. The Medicare Customer Eligibility Support team assess and finalise all enrolment applications for this group.

For escalations to the Medicare Customer Eligibility Support team:

• Service officers, see Tier 0 technical support - self-sufficiency
• Local Peer Support, see Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS)

The Department of Home Affairs shares details with Services Australia for customers who:

• are Migrants (includes customers who have a permanent resident status before or after arriving in Australia)
• are Conditional Migrants (includes customers who have a temporary resident visa and have applied for a permanent visa. For example, a spouse of an Australian citizen)
• live in Australia and have applied for a permanent resident visa
• have applied under a Ministerial order and the visa has been granted

The shared details are through an electronic data link (DIAC), and shows the status of the customer's visa application with the Department of Home Affairs:

• Lodged
• Withdrawn
• Refused, or
• Granted

Service officers can access the above in CDMS. The Department of Home Affairs link (DIAC) is used when enrolling or amending a customer's record.

The Department of Home Affairs link (DIAC) may not be present on CDMS. This is often because it has been a short time since the customer:

• first arrived in Australia, or
• has lodged their visa application

The details the Department of Home Affairs sends through an electronic data link (DIAC) may change a customer's Medicare entitlement.

When the Department of Home Affairs refuses an application for permanent residency or a protection visa, Medicare entitlement ends. CDMS automatically issues a letter to the customer to inform them about their Medicare entitlement.

For example, a customer has a Conditional Migrant status with Medicare. The Department of Home Affairs shares a data link (DIAC) advising the customer is now a permanent resident. This automatically updates the customer's Medicare record.

If a customer's data link is not on the system, they can still enrol in Medicare.

Service officers must access VEVO when processing enrolment applications. This includes:

• initial enrolments
• extensions, and
• change of entitlement type from Conditional Migrant to Migrant

See Access Visa Entitlement Verification Online (VEVO) program.

• Identification documents must be verified for all customers enrolling and re-enrolling in Medicare using the Medicare DVS Portal
• If an enrolment application is received and processed in a service centre, Medicare DVS is only required if the service officer is not satisfied with the validity of the documents

For more details 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 (DME) or Digital Medicare Extension (DMX) application, DVS is completed in the MEE Portal. See Digital Medicare Enrolments and Extensions in the MEE Portal.

For Medicare eligibility some expired identity documents can be accepted if they can be successfully verified through the Medicare DVS Portal.

Commonly accepted expired documents can include:

• Foreign passport linked to a current Australian visa
• ImmiCard that has not been cancelled

For more details on acceptable identity documents, including all expired identity documents see, Medicare identity documents A to Z.

See Medicare eligibility for customers with permanent resident status.