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Applicants for permanent residency eligibility for Medicare 011-44020000

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This document explains Medicare eligibility for customers who have lodged an application for permanent residency or a protection visa with the Department of Home Affairs.

On this page:

Applicant for permanent residency

Applicant for a permanent protection visa

Appealing a visa refusal

Extend a Medicare card

Check if a Medicare enrolment is linked to the Department of Home Affairs

Unlink and link a current record

JRMI26 - Customer review activity and mail out

Stream A - Customer Review Activity JRMI26

Stream B - Customer Review Activity JRMI26


Applicant for permanent residency

Table 1: this table describes how to enrol or extend a customer as an applicant for permanent residency (Conditional Migrant) in CDMS.

Expand table

Step

Action

1

Documents needed to enrol

Customers must provide all the following documents for each person listed on the Medicare enrolment form (MS004) or listed in their Digital Medicare Enrolment (DME) or Digital Medicare Extension (DMX) application:

  • Current passport or valid ImmiCard
  • Proof of a valid visa with permission to work:
    • if the customer has not provided proof of a valid visa with the enrolment application, service officers can use the VEVO check as proof
  • Proof from the Department of Home Affairs that they have applied for permanent residency. Evidence must include the:
    • application ID
    • visa subclass applied for, and
    • date of lodgement of visa application (this can be accepted when sent from a Migration Agent)

Note: if the customer supplies a bridging visa letter which includes the visa subclass applied for and the application ID, the customer's date of visa application can be confirmed through either:

  • VEVO
  • Electronic data from the Department of Home Affairs (DIAC) link

Service officers must use the information from VEVO if the information from the DIAC link and VEVO do not match.

For example, if the DIAC link indicates that the visa has been refused but VEVO indicates that the visa has been lodged, use the information from VEVO. If unsure, Service officers must contact Medicare and Aged Care - Local Peer Support (LPS) for support.

Service officers must not save customer documents and letters to their desktop or personal H: drive.

If the:

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 DME/DMX application, DVS is completed in the MEE Portal. See Digital Medicare Enrolments and Extensions in the MEE Portal.

3

VEVO

Service officers must complete a Visa Entitlement Verification Online (VEVO) check for all customers listed on the MS004 form.

If the customer has submitted their enrolment through DME/DMX application, see Digital Medicare Enrolments and Extensions in the MEE Portal.

Does the VEVO check confirm the customer is onshore?

4

Customer does not have permission to work

If a customer does not have permission to work, they must provide evidence of a relationship to a child, partner, or parent that resides in Australia and is either:

  • an Australian citizen
  • a permanent resident of Australia, or
  • a New Zealand citizen that lives in Australia

Service officers do not have permission to access customer records to confirm the eligibility of the:

  • Australian citizen
  • permanent resident of Australia, or
  • New Zealand citizen that lives in Australia

Service officers must record the relationship documents in CDMS. If relationship documents have been supplied with a previous enrolment application and recorded in CDMS under eligibility documents, relationship documents are not required to be re-supplied.

Note:

  • if only one member in the family has permission to work, only that member can enrol in Medicare
  • if there is a dash (-) in entitlement (DIAC link) when enrolling a customer and VEVO states permission to work, continue the enrolment process as VEVO has the most current details from the Department of Home Affairs
  • service officers do not have permission to access customer records to confirm the eligibility of the child, partner or parent

5

Register the customer and enter the entitlement details

Register the customer for Medicare using the entitlement details below and record all documents provided in CDMS.

To enrol the customer under applicant for permanent residency:

  • Entitlement Type - Conditional Migrant
  • Country of relevance - previous country of residence before arriving in Australia
  • Start Date - use the date the customer:
    • lodged their visa application (if the visa application was lodged onshore), or
    • entered Australia to live (if the visa application was lodged offshore)
  • End Date - 12 months from the start date
  • End reason - entitlement ceased

When keying the entitlement end date of 12 months, only the year needs to change. For example, a start date of 01/01/2023 would mean the end date is keyed as 01/01/2024.

If the entitlement end date is close to expiry (less than 31 days from the date of processing), the entitlement can be manually extended for 12 months from date of processing.

Note: if a customer has requested judicial review (through courts) or Ministerial Intervention following a refused visa, they are not eligible for Medicare. See Table 3 > Step 7 for more information.

6

Record each customer's eligibility documents

Service officers must key all required eligibility documents provided under each customer's Entitlement tab in CDMS. See the Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS).

  • 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 - number or text of the document (mandatory)
    • Reference Date (mandatory)
  • Select Add
  • Repeat above to key all documents provided separately

See Document types for Medicare eligibility and enrolment for document details to be recorded in CDMS.

7

Issue the Medicare card

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
    • Group Eligibility End Date is correct
  • 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.

8

Change of name on an interim Medicare card

Customers must provide their change of name documents.

For an initial enrolment when the customer's name differs between the passport and visa:

  • Search for the name recorded with the Department of Home Affairs
  • Link the customer to their Department of Home Affairs record (DIAC link). See Table 6
  • When the DIAC link is complete, change the customer's name (to the passport or change of name document)

Any changes from the Department of Home Affairs updates in CDMS.

If there is no DIAC link, the customer's name may be changed once the initial enrolment has been completed.

For a previously enrolled customer, change the customer's name if they are currently enrolled under the name held by the Department of Home Affairs.

For details about acceptable change of name documents see Change legal name on Medicare record.


Applicant for a permanent protection visa

Table 2: this table describes how to enrol or extend a customer as an applicant for a permanent protection visa (866) entitlement in CDMS.

Expand table

Step

Action

1

Documents needed to enrol

Customers must provide all the following documents for each person listed on the Medicare enrolment form (MS004) or listed in their Digital Medicare Enrolment (DME) or Digital Medicare Extension (DMX) application:

  • Current passport or valid ImmiCard
  • Proof of valid visa with permission to work
    • if the customer has not provided proof of a valid visa with the enrolment application, service officers can use the VEVO check as proof
  • Proof from the Department of Home Affairs they have applied for permanent protection. Evidence must include the:
    • application ID
    • visa subclass applied for, and
    • date of lodgement of visa application (this can be accepted when sent from a Migration Agent)

Note: if the customer supplies a bridging visa letter which includes details regarding the visa subclass applied for and the application ID, the customer's date of visa application can be confirmed through:

  • VEVO or
  • Electronic data from the Department of Home Affairs (DIAC) link

Service officers must use the information from VEVO if the information from DIAC link and VEVO do not match.

For example, if the DIAC link indicates that the visa has been refused but VEVO indicates that the visa has been lodged, use the information from VEVO. If unsure, service officers must contact Medicare and Aged Care - Local Peer Support (LPS) for support.

For refugees who do not have photo ID

Refugee customers who do not have photo identification can provide a statement by an authorised referee. It must include the:

  • customer's full name
  • customer's date of birth
  • referee's relationship to the customer, and
  • length of time the referee has known the customer

A referee may be a:

  • case/social worker
  • minister of religion
  • police officer, or
  • member of the legal profession

This only applies to applicants or holders of permanent protection visas. All other enrolments must provide photo identification.

Service officers must not save customer documents and letters to their desktop or personal H: drive.

If the:

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 DME/DMX application, DVS is completed in the MEE Portal. See Digital Medicare Enrolments and Extensions in the MEE Portal.

3

VEVO

Service officers must complete a VEVO check for all customers listed on the MS004 form.

If the customer has submitted their enrolment through DME/DMX application, see Digital Medicare Enrolments and Extensions in the MEE Portal.

Does the VEVO check confirm the customer is onshore?

  • Yes, proceed with the assessment of the enrolment application
  • No, customer is offshore:

4

Customer does not have permission to work

If a customer does not have permission to work, they must provide evidence of a relationship to a child, partner, or parent that resides in Australia and is either:

  • an Australian citizen
  • a permanent resident of Australia, or
  • a New Zealand citizen that lives in Australia

Service officers do not have permission to access other customer records to confirm the eligibility of the:

  • Australian citizen
  • permanent resident of Australia
  • New Zealand citizen that lives in Australia, or

Record the relationship documents in CDMS.

If relationship documents have been supplied with a previous enrolment application and recorded in CDMS under eligibility documents, relationship documents are not required to be re-supplied.

Note:

  • if only one member in the family has permission to work, only that member can enrol in Medicare
  • if there is a dash (-) in entitlement (DIAC link) when enrolling a customer and VEVO states permission to work, continue the enrolment process as VEVO contains the most current details from the Department of Home Affairs

5

Register the customer and enter the entitlement details

Register the customer for Medicare using the entitlement details below and record all documents provided in CDMS.

To enrol the customer as an applicant for permanent protection:

  • Entitlement Type - Application for Permanent Protection (866 visa)
  • Country of relevance - previous country of residence before arriving in Australia
  • Start Date - use the date that the visa application was lodged in Australia with the Department of Home Affairs
  • End Date - 12 months from the start date
  • End reason - entitlement ceased

The Resources page has an allowable extension period table.

When keying the entitlement end date of 12 months, only the year needs to change. For example, a start date of 01/01/2023 would mean the end date is keyed as 01/01/2024.

If the entitlement end date is close to expiry (less than 31 days from the date of processing), the entitlement can be manually extended for 6 months from date of processing.

Note: if an application for a protection visa is refused by the Department of Home Affairs before the customer lodges their enrolment application to enrol with Medicare, the customer:

  • must supply all documents required to enrol
  • must provide evidence of a valid appeal lodged with the Administrative Review Tribunal (ART) dated within the last 12 months from date of lodgement (DOL)
  • start date is the date the visa application for permanent protection was lodged in Australia
  • end date is 12 months from date of processing
  • end reason is entitlement ceased

6

Record each customer's eligibility documents

Service officers must key all required eligibility documents provided under customer's Entitlement tab in CDMS. See the Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS).

  • Select Documents tab
  • Select or key the details of each of the customer's eligibility documents:
    • Eligibility Document (mandatory)
    • Reference Text - number or text of the document (mandatory)
    • Reference Date (mandatory)
  • Select Add
  • Repeat above to enter all documents provided separately

See Document types for Medicare eligibility and enrolment for document details to be recorded in CDMS.

7

Issue the Medicare card

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
    • Group Eligibility End Date is correct
  • 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.

8

Change of name on an interim Medicare card

Customers must provide change of name documents.

For an initial enrolment when the customer's name differs between the passport and visa:

  • Search for the name recorded with the Department of Home Affairs
  • Link the customer to their Department of Home Affairs record (DIAC link). See Table 6
  • When the DIAC link is complete, change the customer's name to the passport or change of name document

All changes from the Department of Home Affairs update in CDMS.

If there is no DIAC link, the customer's name can be changed once the initial enrolment has been completed.

For a previously enrolled customer, change the customer's name if they are currently enrolled under the name held by the Department of Home Affairs.

See Change legal name on Medicare record.


Appealing a visa refusal

Table 3: this table describes document and eligibility requirements for a customer who has appealed the Department of Home Affairs' decision to refuse their visa application.

Expand table

Step

Action

1

Determine the appeal pathway

A customer may have a refused visa decision being reviewed through one of the following pathways:

  • Administrative Review Tribunal (ART)
  • Judicial review (for example: notice of filing, court documents)
  • Ministerial Intervention
  • If the work item includes a letter with the reference JRMI26, or a JRMI26 comment is recorded in the Medicare card group contact's Personal comments or the card Group comments, go to Table 7.

Has the customer provided:

2

Request evidence from the customer

Service officers must attempt to contact the customer to ask for evidence of a current appeal with ART. Only a current ART review supports Medicare eligibility. Judicial review or Ministerial Intervention requests do not support Medicare eligibility and are not acceptable evidence for this purpose.

If the customer cannot provide evidence of a current ART review:

  • If they do not have a copy of their ART letter, advise them to contact the ART to request evidence of their appeal
  • If they have sought judicial review or Ministerial Intervention for their refused visa, advise them they are not eligible for Medicare under this pathway
  • Do not escalate unless there are extenuating circumstances
  • If unable to contact the customer:

See Table 2 in Medicare eligibility and enrolments request for information.

Procedure ends here

3

ART evidence and documents required

Customers must provide all the following documents for each person listed on the Medicare enrolment form (MS004) or listed in their Digital Medicare Enrolment (DME) or Digital Medicare Extension (DMX) application:

  • Current passport or ImmiCard
  • Proof of valid visa with permission to work
    • If the customer has not provided proof of a valid visa with the enrolment application, service officers can use the VEVO check as proof
  • If the customer's visa does not give them permission to work, they may still be eligible for Medicare. See the Background page for more details
  • Evidence of a current ART appeal, dated within the last 12 months:
    • an ART letter dated within the last 12 months from date of lodgement (DOL)
    • other ART documentation confirming the appeal remains active

The customer must be appealing the refusal of a Medicare-eligible visa category to be eligible for Medicare during the appeals process.

A Department of Home Affairs notice for the refused visa must be supplied if the visa subclass is not listed on the customer's:

  • bridging visa notice, or
  • appeals documentation

If the customer's expired identity document:

  • can be verified in Document Verification Service (DVS) proceed with the application, or
  • was previously recorded in CDMS but cannot be verified in DVS, the customer can supply a current Australian driver's licence

See Expired Identity documents on the Background page

Is the ART evidence dated within the last 12 months from DOL?

4

Request updated evidence

Service officers must attempt to contact the customer to ask for evidence of a current appeal with ART:

  • If they do not have any, advise them to contact the ART to request evidence of their appeal
  • Do not escalate unless there are extenuating circumstances
  • If unable to contact the customer:

See Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS) if there are extenuating circumstances that prevent the customer from providing additional evidence to confirm they have an ongoing appeal of their visa refusal with the ART.

When documents are provided go to Step 5.

5

Check documents provided

Has the customer provided all the required documents?

6

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

7

VEVO check result for a refused visa

Service officers must complete a VEVO check for all customers listed on the Medicare enrolment (MS004) form.

A customer's VEVO check result will show a 'No' answer to the 'Applicant for Permanent Residency' question when their Permanent Residency visa application has been refused.

VEVO also shows if the customer has permission to work.

If the VEVO check confirms the customer is:

8

Assess entitlement

If a customer is currently at judicial review or Ministerial Intervention, they are not eligible for Medicare. If the customer has provided evidence of judicial review (notice of filing or court documents) or ministerial intervention, go to Step 9

For customers who do not have a judicial review or Ministerial Intervention, select the appropriate option:

New enrolment

If an applicant for a permanent visa or protection visa is refused by the Department of Home Affairs before the customer lodges their enrolment application with Medicare, the customer:

  • must supply all documents required to enrol
  • must provide evidence of a current appeal lodged with the ART dated within 12 months from DOL
  • eligibility details are:
    • start date is the date the visa application for permanent protection was lodged in Australia
    • end date is the earliest of either 12 months from date of processing or visa expiry date
    • end reason is entitlement ceased

See Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS).

Extension request

If an applicant for a permanent visa or protection visa is refused by the Department of Home Affairs, the customer:

  • must supply all documents required to enrol
  • must provide evidence of a current appeal lodged with the ART dated within 12 months from DOL
  • eligibility details are:
    • start date is the date the visa application for permanent protection was lodged in Australia
    • end date is the earliest of either 12 months from date of processing or visa expiry date
    • end reason is entitlement ceased

See Table 4 to extend their Medicare entitlement.

9

Judicial review and Ministerial Intervention

Judicial review and Ministerial Intervention do not support Medicare eligibility.

Customers are not eligible for Medicare if they are seeking:

  • Judicial review, or
  • Ministerial Intervention

Note: if a customer under judicial review or Ministerial Intervention is an Unauthorised Maritime Arrivals (UMA) or meets RHCA eligibility criteria, they may still be eligible for Medicare.

Determine the enrolment application's date of lodgement (DOL). The process to follow is based on the DOL and applies to both Digital Medicare Enrolments (DME/DMX) and manual enrolment applications.

Go to Step 10.

10

Date of lodgement (DOL)

Do not reject the enrolment application if the DOL is:

  • on or before 28 September 2026, or
  • 29 September 2026 or later and the customer is identified as being in a JRMI26 customer review activity cohort

Choose the appropriate option:

DOL is on or after 29 September 2026 (29/09/2026)

First determine whether the customer is part of a JRMI26 review activity. Customers who are part of a JRMI26 cohort may already have their Medicare eligibility under assessment through the customer review activity. Escalating new work items prevents duplicate processing and helps ensure a consistent outcome is provided to the customer.

See Table 7 for instructions on how to identify if the customer is part of a JRMI26 cohort.

If the customer is part of a JRMI26 customer review cohort, escalate the new work item to Medicare Customer Eligibility Support and go to Step 12.

If the customer is not part of a JRMI26 customer review cohort, go to Step 11.

DOL is on or before 28 September 2026 (28/09/2026)

DOL is on or before 28 September 2026, go to Step 12.

11

DOL is on or after 29 September 2026 (29/09/2026) and are not part of the JRMI26 activity

Select the appropriate option:

Customer has current entitlement in CDMS
  • In CDMS, end their current entitlement:
    • Entitlement End Date: date of processing
    • Entitlement End Reason: Entitlement ceased
  • In PaNDA:
    • Status: Request Rejected
    • Complete Reason: Request Rejected
  • In MEE Portal (if relevant):
    • Status: Rejected
    • Status reason: Not eligible to enrol in Medicare
    • Service officer comments: see below
  • In Digital Messaging Capability:
    • Send a Z0139 Medicare enrolment - unable to process letter.
    • Use the option ‘proof of appeal not accepted’
  • Add comments in PaNDA/DME as per below (depending on the circumstances)
    • Customer is not eligible as they are at JR or MI as per document dated DDMMYY. DMC Letter Z0139 ID XXXX sent.
    • Customer is not eligible as they are at JR/MI as per advice from National Office. DMC Letter Z0139 ID XXXX sent.

Do not record the reference 'JRMI26' in PANDA, MEE Portal or CDMS. This reference is being used to monitor the customer review activity, and the customer groups have already been identified.

Procedure ends here

Customer’s entitlement is expired
  • In PaNDA:
    • Status: Request Rejected
    • Complete Reason: Request Rejected
  • In MEE Portal (if relevant):
    • Status: Rejected
    • Status reason: Not eligible to enrol in Medicare
    • Service officer comments: see below
  • In Digital Messaging Capability:
    • Send a Z0139 Medicare enrolment - unable to process letter
    • Use the option ‘proof of appeal not accepted’
  • Add comments in CDMS Personal as per below (depending on the circumstances).
    • Customer is not eligible as they are at JR or MI as per document dated DDMMYY located in Panda/DME ID XXXXX. DMC Letter Z0139ID XXXX sent.
    • Customer is not eligible as they are at JR/MI as per advice from National Office. DMC Letter Z0139 ID XXXXX sent

Procedure ends here

12

Escalate

Do not reject the enrolment application if the customer's date of lodgement (DOL) is:

  • on or before 28 September 2026, or
  • 29 September 2026 or later and their CDMS record indicates they are part of a JRMI26 customer review activity

If the customer says they have the JRMI26 letter and CDMS confirms they were issued a letter, go to Table 7

Choose the appropriate option:

Manual enrolments

Service officers must:

  • conduct the relevant DVS and VEVO checks before they escalate
  • keep the PaNDA work item 'open' - do not pend
  • add relevant processing note:
    • 'DOL before 29/09/2026 - Judicial Review/Ministerial Intervention', or
    • 'DOL on or after 29/09/2026 - confirmed in JRMI26 cohort'
  • assign the work item to ME_NO_ESCALATION_DCP. If service officers do not have access to this folder:
    • they must escalate to Local Peer Support (LPS)
    • LPS will escalate the application to the folder

Procedure ends here.

Digital Medicare enrolments (DME) and Digital Medicare extensions (DMX)

In the Medicare Eligibility and Enrolments (MEE) Portal:

Service officers must:

  • conduct the relevant DVS and VEVO checks before they escalate
  • escalate to Medicare Customer Eligibility Support through LPS/service officer (SO4)

LPS/SO4 staff must:

  • add a note in the activity log that explains the reason for the escalation
    • 'DOL before 29/09/2026 - Judicial Review/Ministerial Intervention', or
    • 'DOL on or after 29/09/2026 - confirmed in JRMI26 cohort’
  • update the status to On hold - Escalated - National Office
  • unassign and recategorise the work item to folder ME_DME_NO_ESC

Note: if the DME/DMX is not recategorised to ME_DME_ENROLMENT_ESC first, Service officers:

  • cannot recategorise it to ME_DME_NO_ESC
  • must reassign and recategorise it to themselves using work type ME_DME_ENROLMENT_ESC, and
  • then unassign and recategorise to ME_DME_NO_ESC

Procedure ends here


Extend a Medicare card

Table 4: this table describes how to extend an eligible customer's Medicare card.

Note: if a customer has submitted a digital Medicare enrolment application, the Medicare card can be extended in the MEE portal. See Digital Medicare Enrolments and Extensions in the MEE Portal.

Expand table

Step

Action

1

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 DMX application, DVS is completed in the MEE Portal. See Digital Medicare Enrolments and Extensions in the MEE Portal.

2

VEVO

Service officers must complete a VEVO check for all customers listed on the Medicare enrolment (MS004) form or DMX application.

If the VEVO check confirms the customer is:

3

Customer does not have permission to work
  • If a customer does not have permission to work, they must provide evidence of a relationship to a child, partner, or parent that resides in Australia and is either:
    • an Australian citizen
    • a permanent resident of Australia
    • a New Zealand citizen
  • Service officers do not have permission to access customer records to confirm the eligibility of the:
    • Australian citizen
    • permanent resident of Australia
    • New Zealand citizen that lives in Australia
  • Service officers must record the relationship documents in CDMS
  • If relationship documents have been supplied with a previous enrolment application and recorded in CDMS under eligibility documents, relationship documents are not required to be re-supplied

Note:

  • if only one member in the family has permission to work, only that member can enrol in Medicare
  • if there is a dash (-) in entitlement (DIAC link) when enrolling a customer and VEVO states permission to work, continue the enrolment process as VEVO contains the most current details from the Department of Home Affairs
  • if the customer has submitted their DMX enrolment via a digital Medicare enrolment application, see Digital Medicare Enrolments and Extensions in the MEE Portal

4

On CDMS Home page
  • Select Amend Consumer Details
  • Key the customer's Medicare card number in ID Number field
  • Select Group

A Medicare Payment Integrity (MPI) restriction may be on the record. This prevents any changes. If this occurs, see the Comments in Group. If required, contact Medicare and Aged Care - Local Peer Support (LPS).

Note: sensitive or safety concern messages may show on the record. Service officers must acknowledge these warnings, failing to check indicators may cause serious harm or distress to customers.

5

Checking eligibility entitlement is correct in CDMS

Service officers must check that the existing entitlement in CDMS matches the entitlement in the documents submitted by the customer.

Select Entitlement.

Does the Entitlement Type in CDMS match with the visa name/subclass on the customer's the Department of Home Affairs notice?

  • Yes, go to Step 6
  • No, contact Medicare and Aged Care - Local Peer Support (LPS)

6

DIAC link Client Status

Service officers must complete the following for all ART refused enrolment or extension applications.

Select Amend DIAC link button in the Entitlement screen. If the Client Status shows:

  • Lodged - go to Step 8
  • Granted - see Table 8 in Medicare eligibility for customers with permanent resident status
  • Refused - see Table 3 for a list of required documents. If all documents are provided, go to Step 8
  • Withdrawn - contact Medicare and Aged Care - Local Peer Support (LPS)

If Amend DIAC link button does not show, go to Step 7.

Note: the Immigration Clients tab cannot be selected if there are no details available from the Department of Home Affairs about the customer's client status.

7

If Amend DIAC link button is not showing

If service officers do not have the Amend DIAC link button, the customer's Client Status must be checked:

  • Go to CDMS Home page
  • Select Register New Consumer
  • Select New Consumer
  • Select box Tick if Immigration Data Search is Required
  • Key the customer's surname, first name, and date of birth
  • Select Gender
  • Select Search
  • Select 'Yes' on Warning Message 01875
  • Select Immigration Clients tab

The Department of Home Affairs linked records show under Possible Matches.

The Client Status will show:

  • Lodged - go to Step 8
  • Granted - see Table 8 in Medicare eligibility for customers with permanent resident status
  • Refused - see Table 3 for a list of required documents. If all documents are provided, go to Step 8
  • Withdrawn - contact Medicare and Aged Care - Local Peer Support (LPS)

8

Adding documents to CDMS

Service officers must key all required eligibility documents provided under each customer's Entitlement tab in CDMS. See the Resources page in Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS)

  • Select Documents tab
  • Select or key the details of each of the customer's eligibility documents:
    • Eligibility Document (mandatory)
    • Reference Text - number or text of the document (mandatory)
    • Reference Date (mandatory)
  • Select Add
  • Repeat to enter all documents provided under each customer's entitlement separately

Do not record the same document details if they are already correctly recorded in eligibility documents.

Note: when relationship documents have been previously submitted and recorded in CDMS and are still relevant, do not request these again.

See Document types for Medicare eligibility and enrolment for document details to be recorded in CDMS.

9

Extend the entitlement and issue a replacement card

The Resources page has details about extension periods.

Once eligibility is established, extend the entitlement details.

Select the Card Request tab.

In the Group Eligibility End Date field:

  • Key the extended date
  • Select the:
    • checkbox to Replace Current Card
    • Replacement Reason from the dropdown menu
    • checkbox if a Duplicate Replacement Card is also required
    • Card Request Source from the dropdown menu
  • Select Comments and key the below if the visa is refused
    'ART letter dated [dd/mm/yy], [case number], extended for 12mths'
  • Select Validate, Validate, Update

An information message shows stating if the details were acceptable or not. Select OK to acknowledge the message. If not acceptable, make changes as required.

Do not change the Group Eligibility Start Date unless there has been a gap in the customer's entitlement period.

Note:

  • when keying the entitlement end date of 12 months, only change the year. For example, a start date of 01/01/2023, the end date is 01/01/2024
  • if the entitlement end date is close to expiry (less than 31 days from the date of processing), manually extend the entitlement for 12 months from date of processing


Check if a Medicare enrolment is linked to the Department of Home Affairs

Table 5

Expand table

Step

Action

1

On CDMS Home page
  • Select the Amend Consumer Details
  • Key the customer's Medicare card number in the ID number field
  • Select Personal
  • Scroll down and select External IDs

The Department of Home Affairs linked records show under Recorded External IDs. The issuing party shows as IMMIGR. The Recorded External IDs does not show for records not linked.

Note: if a customer has submitted a DME/DMX enrolment application, the link to the Department of Home Affairs can be checked in the MEE portal. See Digital Medicare Enrolments and Extensions in the MEE Portal.


Unlink and link a current record

Table 6: this table describes how to unlink and link a DIAC record for a customer. This process is only for service officers experienced in Medicare Enrolments and Eligibility. For help, contact MEE Local Peer Support (LPS).

Expand table

Step

Action

1

On CDMS Home page
  • Select Amend Consumer Details
  • Key the customer's Medicare card number in the ID number field
  • Select Entitlement

Note: if a customer has submitted a Digital Medicare Enrolment (DME) or Digital Medicare Extension (DMX) application, the link to the Department of Home Affairs can be updated in the MEE Portal. See Digital Medicare Enrolments and Extensions in the MEE Portal.

2

Select the record to unlink

In:

  • Consumers, select the radio button of the customer
  • Eligibility Status, select Amend DIAC link (Department of Home Affairs)
  • Immigration Clients, the following shows:
    • currently linked client details
    • exact and/or possible matches
    • if there are no matches, no details show
  • To unlink the record, go to Step 3.
  • To unlink and link the record, go to Step 4

3

Unlink the record

Select Unlink.

The following warning messages show:

  • 00645 message - 'the details are acceptable'
  • Select OK to acknowledge the message
  • 01879 message - 'Department of Home Affairs link will be removed from the currently linked customer. You have not selected a customer to be re-linked. If you want to re-link to a listed immigration client, you must click the "Amend DIAC link" again'
  • Select OK to acknowledge the message
    Note:     service officers must check that they only unlink an incorrect match
  • Scroll down and select Validate [Alt+V]
    • check the Confirm Amend Medicare Entitlement Details screen to see the changes, and
    • correct the details if necessary
  • To update and finalise the record, go to Step 5

4

Unlink and link the customer
  • Under Exact and possible matches, select the radio button of the customer that matches to the customer's link
  • Select Unlink & Link
  • The following message shows
    00645 message - 'details are acceptable'
  • Select OK to acknowledge the message
  • Scroll down and select Validate [Alt+V]

5

Update and finalise the record
  • Select Update [Alt+U]
    A message shows advising the entitlement details have been added
  • Select OK


JRMI26 - Customer review activity and mail out

Table 7: This table describes how to identify whether a customer is part of a JRMI26 customer review activity

Expand table

Step

Action

1

CDMS comments

Review CDMS comments to determine whether the customer is part of the JRMI26 customer review activity.

Look for JRMI26 comments recorded in CDMS, check both Personal (for the group contact) and Group.

Does Group, or the group contact's Personal CDMS record include a comment with the reference JRMI26?

  • Yes, if the customer has:
    • questions about their enrolment application or a letter they received, go to Step 2
    • submitted an enrolment application for assessment, go to Table 4 > Step 9
  • No, the customer is not part of the customer review activity. Procedure ends here

2

JRMI26 letter type issued

Determine the letter type issued by reviewing the JRMI26 comments in CDMS. Check both:

  • Personal comments for the group contact, and
  • Group comments.

The comment will appear in the following format:

JRMI26 ZXXXX letter sent on MMDDYY

Note: review both Personal and Group comments before determining the letter type, as the JRMI26 comment may be recorded in either location.

Based on the letter code:


Stream A - Customer Review Activity JRMI26

Staff must complete all steps in Table 7 before starting this process. Only continue to this table if directed to do so by Table 7.

Table 8: This table describes what to do if a customer asks about a letter, or when a Medicare card has a CDMS comment containing the reference 'JRMI26' and is identified as part of the Stream A Customer Review Activity.

Expand table

Step

Action

1

Z2348 or Z2352 letters

Customers in the Stream A Customer Review Activity were issued either a Z2348 or Z2352 letter dated 9 October 2026. The letter advises the customer that:

  • a policy clarification has occurred regarding Medicare eligibility
  • their Medicare eligibility may have previously been assessed based on evidence that they had sought judicial review or ministerial intervention following a refused visa decision
  • they have 28 days to provide new information for assessment against another Medicare eligibility category
  • their Medicare entitlement will be end-dated if Medicare eligibility cannot be established under another eligibility category

Customers will be advised of the outcome, in writing, following the 28 day period

For general enquiries, advise that judicial review and ministerial intervention documents do not support Medicare eligibility following a refused visa decision.

For escalated enrolments, advise that the customer's enrolment application is under review and an outcome will be provided in writing.

To help with enquires in Resources see:

If a customer asks:

  • Why they received a letter with reference JRMI26, go to Step 2
  • When their Medicare entitlement will end, go to Step 3
  • About a lost Z2348 or Z2352 JRMI26 letter, go to Step 4
  • To speak to the team assessing their application, go to Step 5
  • Why judicial review and ministerial intervention documents are not accepted as evidence of an appeal, go to Step 6
  • Why they were eligible before, but not now, go to Step 7
  • Why their application has been refused, go to Step 8
  • What to do if more than 28 days have passed since their JRMI26 letter was issued, go to Step 9

2

Customer asks why they received a letter with reference JRMI26

Tell the customer:

'You received a letter because your Medicare eligibility was previously assessed using judicial review or Ministerial Intervention documents.
Services Australia has clarified how Medicare eligibility is assessed in these circumstances and is contacting customers who may be affected by this change.
Your letter gives you 28 days to provide a new Medicare enrolment form (MS004) and supporting document if you believe you may still be eligible for Medicare under a different pathway.
A specialised team will look at any information you give us to assess if you are eligible for Medicare.
If you are eligible, your Medicare entitlement will continue.
If you do not provide information, or the information provided does not demonstrate eligibility for Medicare, your entitlement will end'.

3

Customer asks when or if their Medicare will end

'The letter gives you 28 days to respond if you believe you may be eligible for Medicare under another eligibility pathway.
Judicial review and Ministerial Intervention documents do not support Medicare eligibility. If you remain at the judicial review or Ministerial Intervention stage of your refused visa appeal, you are not eligible for Medicare on that basis.
Providing information within the 28-day period does not automatically maintain Medicare entitlement. The information must demonstrate that you are eligible for Medicare under another eligibility category.
If you do not respond within 28 days, or the information provided does not demonstrate eligibility, your Medicare entitlement will end.
You will be advised of the outcome in writing'.

4

Lost Z2348 or Z2352 JRMI26 letter

Make sure the lost letter is either a Z2348 or Z2352 as the dates provided in this step are relevant to only these two letters.

Select the relevant option:

If the customer contact is on or before 6 November 2026

Tell the customer:

  • to complete an MS004 form and provide documents about their current circumstances
  • judicial review and Ministerial Intervention documents alone do not support Medicare eligibility
  • to email the MS004 form and documents to MPS Eligibility, and include JRMI26 in the Subject line
  • a specialised team will assess their application

Note: the MPS.Eligibility email should only be disclosed for this customer review activity only, where it has been confirmed the customer is part of the JRMI26 activity and the customer is still within the 28 day period.

Staff should explain that submitting a new request does not guarantee eligibility, and the outcome will depend on whether the customer meets all Medicare eligibility requirements.

If the customer contacts us after 6 November 2026

Tell the customer:

  • the 28-day period provided as part of the review has ended
  • do not use the lodgement instruction in the letter
  • to complete an MS004 form or Digital Medicare enrolment, and provide supporting documents about their current circumstances
  • the agency will assess the application based on their current circumstances and the Medicare eligibility requirements

Staff should explain that submitting a new request does not guarantee eligibility, and the outcome will depend on whether the customer meets all Medicare eligibility requirements.

Issue duplicate letter

If a customer requests a copy of their JRMI26 letter:

  • advise that a duplicate letter can be issued within 2-3 business days, but it does not reset their 28 day period
  • ensure the customers address details are current in CDMS
  • escalate to Medicare Eligibility Customer Support, in the email include:
    • JRMI26 duplicate letter request
    • Customer Name
    • Customer Medicare Card Number or note that it is a new enrolment
    • PANDA WID or DME/DMX Application ID (if relevant)
  • Medicare Eligibility Customer Support will arrange for a duplicate copy of the original letter to be issued

Note: the customer's response period is based on the date of the original letter (9 October 2026) and does not reset when a duplicate letter is issued

5

Customer asks to speak to the team assessing their application

If a customer asks to speak to the team assessing their Medicare enrolment application, staff must tell them that:

  • they cannot speak directly to the assessing team
  • the team will
    • assesses enrolment applications in priority order
    • notify them of the outcome in writing

6

Customer asks why judicial review and ministerial intervention documents are not accepted as evidence of an appeal

Tell the customer:

'The policy has been clarified to make sure Medicare eligibility is assessed consistently and according to the law (Health Insurance Act 1973).
Customers who are appealing a refused visa decision through judicial review or a request for Ministerial Intervention are not eligible for Medicare.
As part of this clarification, judicial review and ministerial intervention documents cannot be accepted as evidence of an appeal for Medicare eligibility purposes.'

7

If a customer asks why they were eligible before, but not now

Tell the customer:

'Your Medicare eligibility may have previously been assessed using documents relating to a refused visa decision that is under judicial review or subject to a Ministerial Intervention request.
Judicial review is where a refused visa decision has been appealed through a court.
Services Australia has clarified how Medicare eligibility is assessed to make sure it is applied correctly and consistently according to the law (Health Insurance Act 1973).
Under the clarified policy, requests made through judicial review through a court, or requests for Ministerial Intervention relating to a refused visa decision do not support Medicare eligibility.
Because of this, people who were previously enrolled in Medicare using these documents no longer meet Medicare eligibility requirements.
The legislation has not changed. What has changed is how Medicare eligibility is assessed to make sure decisions are consistent and comply with the law.'

8

What to tell customers whose Medicare enrolment application has been refused

Explain to the customer:

  • Medicare eligibility
    • is set by law and depends on a person’s visa status and where their appeal is being considered
    • must be applied as written in legislation
  • Different appeal pathways have different legal effects on Medicare eligibility
  • Customers do not meet the eligibility requirements for Medicare if they:
    • have lodged an appeal for a refused visa decision with the Federal Circuit and Family Court or the High Court under judicial review, or
    • have requested Ministerial Intervention
  • Only appeals being considered by the Administrative Review Tribunal (ART) can support Medicare eligibility

Tell the customer that depending on their previous country of residence and personal circumstances, they may be eligible under a Reciprocal Health Care Agreement (RHCA). Eligibility under an RHCA is assessed separately and in line with RHCA policy.

9

What to do if more than 28 days have passed since their JRMI26 letter was issued

Tell the customer:

'You can still apply to enrol in Medicare if you believe you may be eligible.
To do this, complete a Medicare enrolment form (MS004) and provide supporting documents that relate to your current circumstances.
As the 28-day response period has passed, you should follow the instructions on the Medicare enrolment form (MS004) for how and where to lodge your enrolment. Do not use the instructions on the JRMI26 letter.
The information you provide will be assessed to determine whether you meet Medicare eligibility requirements.'


Stream B - Customer Review Activity JRMI26

Staff must complete all steps in Table 7 before starting this process. Only continue to this table if directed to do so by Table 7.

Table 9: This table describes what to do if a customer asks about a letter, or when a Medicare card has a CDMS comment containing the reference 'JRMI26' and is identified as part of the Stream B Customer Review Activity.

Expand table

Step

Action

1

Z2349 or Z2353 letters

Customers in the Stream B Customer Review Activity were issued either a Z2349 or Z2353

The letter advises the customer that:

  • a policy clarification has occurred regarding Medicare eligibility,
  • the information provided with their Medicare enrolment application indicates they have sought judicial review or ministerial intervention following a refused visa decision,
  • they have 28 days to provide new information for assessment against another Medicare eligibility category, and
  • if Medicare eligibility cannot be established under another eligibility category, their Medicare enrolment application will be refused

Customers will be advised of the outcome, in writing, following the 28-day period.

For general enquiries, advise that judicial review and ministerial intervention documents do not support Medicare eligibility following a refused visa decision.

For escalated enrolments, advise that the customer's enrolment application is under review and an outcome will be provided in writing.

To help with enquires in Resources see:

If a customer asks:

  • Why they received a letter with reference JRMI26, go to Step 2
  • About a lost Z2349 or Z2353 JRMI26 letter, go to Step 3
  • To speak to the team assessing their application, go to Step 4
  • Why judicial review and ministerial intervention documents are not accepted as evidence of an appeal, go to Step 5
  • Why they were eligible before, but not now, go to Step 6
  • Why their application has been refused, go to Step 7
  • What to do if more than 28 days have passed since their JRMI26 letter was issued, go to Step 8

2

Customer asks why they received a letter with reference JRMI26

Tell the customer:

'You received a letter because your Medicare enrolment application includes documents relating to a judicial review or Ministerial Intervention following a refused visa decision.
Services Australia has clarified how Medicare eligibility is assessed in these circumstances.
Your letter gives you 28 days to provide additional information if you believe you may be eligible for Medicare under a different pathway.
A specialised team will look at any information you give us to assess if you are eligible for Medicare.
If you are eligible for Medicare, your enrolment application can proceed.
If you do not provide additional information, or the information provided does not demonstrate eligibility for Medicare, your enrolment application may be refused.
You will receive the outcome of the assessment in writing.'

3

Lost Z2349 or Z2353 JRMI26 letter

Before providing this advice, make sure the letter issued was Z2349 or Z2353.

Identify the date of the letter by checking CDMS comments. Then determine if 28 days has passed.

Select the relevant option:

If the customer contacts us before their 28 day period is over

Staff must tell them:

  • to complete an MS004 form and provide documents about their current circumstances
  • judicial review and Ministerial Intervention documents alone do not support Medicare eligibility
  • to email the MS004 form and documents to MPS Eligibility, and include JRMI26 in the Subject line
  • a specialised team will assess their application

Note: the MPS.Eligibility email should only be disclosed for this customer review activity only, where it has been confirmed the customer is part of the JRMI26 activity and the customer is still within the 28 day period.

Staff should explain that submitting a new request does not guarantee eligibility, and the outcome will depend on whether the customer meets all Medicare eligibility requirements.

If the customer contacts us after their 28 day period is over

Staff must tell them:

  • the 28-day period provided as part of the review has ended
  • do not use the lodgement instruction in the letter
  • to complete an MS004 form or Digital Medicare enrolment, and provide supporting documents about their current circumstances
  • they can send their completed MS004 form and documents via email to Medicare Enrolment Services, or post them
  • the agency will assess the application based on their current circumstances and the Medicare eligibility requirements

Staff should explain that submitting a new request does not guarantee eligibility, and the outcome will depend on whether the customer meets all Medicare eligibility requirements.

Issue a duplicate letter

If a customer requests a copy of their JRMI26 letter:

  • advise that a duplicate letter can be issued within 2-3 business days, but it does not reset their 28 day period
  • ensure the customers address details are current in CDMS
  • escalate to Medicare Eligibility Customer Support, in the email include:
    • JRMI26 duplicate letter request
    • Customer Name
    • Customer Medicare Card Number
  • Medicare Eligibility Customer Support will arrange for a duplicate copy of the original letter to be issued

Note: the customer's response period is based on the date of the original letter and does not reset when a duplicate letter is issued.

4

Customer asks to speak to the team assessing their application

If a customer asks to speak to the team assessing their Medicare enrolment application, staff must tell them that:

  • they cannot speak directly to the assessing team
  • the assessing team will:
    • assesses enrolment applications in priority order, and
    • notify them of the outcome in writing

5

Customer asks why judicial review and ministerial intervention documents are not accepted as evidence of an appeal

Tell the customer:

'The policy has been clarified to make sure Medicare eligibility is assessed consistently and according to the law (Health Insurance Act 1973).
Customers who are appealing a refused visa decision through judicial review or a request for Ministerial Intervention are not eligible for Medicare.
As part of this clarification, judicial review and ministerial intervention documents cannot be accepted as evidence of an appeal for Medicare eligibility purposes.'

6

No longer eligible

If a customer asks why they were eligible before, but not now

Tell the customer:

'Services Australia has clarified how Medicare eligibility is assessed to make sure it is applied correctly and consistently according to the law (Health Insurance Act 1973).
Under the clarified policy, requests made through judicial review through a court, or requests for Ministerial Intervention relating to a refused visa decision do not support Medicare eligibility.
Because of this, people who were previously enrolled in Medicare using these documents no longer meet Medicare eligibility requirements.
The legislation has not changed. What has changed is how Medicare eligibility is assessed to make sure decisions are consistent and comply with the law.'

7

Medicare enrolment application has been refused

Explain to the customer:

  • Medicare eligibility
  • is set by law and depends on a person’s visa status and where their appeal is being considered
    • must be applied as written in legislation
  • Different appeal pathways have different legal effects on Medicare eligibility
  • Only appeals being considered by the Administrative Review Tribunal (ART) can support Medicare eligibility

Customers do not meet the eligibility requirements for Medicare if they:

  • have lodged an appeal for a refused visa decision with the Federal Circuit and Family Court or the High Court under judicial review, or
  • have requested Ministerial Intervention

Tell the customer that depending on their previous country of residence and personal circumstances, they may be eligible under a Reciprocal Health Care Agreement (RHCA). Eligibility under an RHCA is assessed separately and in line with RHCA policy

8

What to do if more than 28 days have passed since their JRMI26 letter was issued

Tell the customer:

'You can still apply to enrol in Medicare if you believe you may be eligible.
To do this, complete a Medicare enrolment form (MS004) and provide supporting documents that relate to your current circumstances.
As the 28-day response period has passed, you should follow the instructions on the Medicare enrolment form (MS004) for how and where to lodge your enrolment. Do not use the instructions on the JRMI26 letter.
The information you provide will be assessed to determine whether you meet Medicare eligibility requirements.'