Medicare eligibility for New Zealand citizens 011-44050000

New Zealand citizens that live in Australia are covered under the definition of 'Australian resident' in the Health Insurance Act 1973.

New Zealand citizens can enter Australia either:

• on a Special Category visa (SCV) (subclass 444). A SCV is a temporary visa that allows New Zealand citizens to visit, study, stay and work in Australia if they are a New Zealand citizen and meet the eligibility criteria. The SCV is digitally linked to their passport, therefore it is not necessary to see the visa for Medicare purposes, or
• as an applicant for permanent residency visa which allows them to live in Australia
• on an Australian permanent resident visa

New Zealand citizens visiting, that is, who do not live in Australia, are covered by the Reciprocal Health Care Agreement between Australia and New Zealand.

New Zealand citizens who reside in Australia are eligible for Medicare if any of the following apply:

• they intend to reside in Australia
• they have been or will be residing in Australia for 6 months or more

Note: customers need to reside or intend to reside in Australia either continuously or intermittently for a period of at least 6 months in a 12 month period.

The following must be provided with a completed Medicare enrolment form (MS004):

• passport for each person, and
• 2 residency documents proving they live in Australia. Only 2 residency documents are needed for a family, if all family members:
• are New Zealand citizens, and
• arrived in Australia on the same day

See Document types for Medicare eligibility and enrolment for more details.

Record all documents in CDMS when registering customers Medicare entitlement.

Insufficient residency documents

Customers can submit a Commonwealth statutory declaration after 6 months of living in Australia if they are unable to provide any supporting residency evidence. The Commonwealth statutory declaration must be:

• comprehensive, and
• state why the customer could not provide sufficient residency documents

Dependant Student (under 25 years of age in full time study)

Where a dependant student remains in New Zealand to complete their studies before joining their family in Australia, they may not be able to provide 2 residency documents to confirm their residency in Australia. A document from New Zealand stating when they completed their studies is acceptable instead of 2 residency documents.

The dependant student can be added to the existing family card or enrolled on a card of their own (if 15 years of age or over).

The Medicare record must not be attached to the immigration data link when registering the consumer in CDMS, even when the New Zealand citizen has applied for permanent residency. This is because New Zealand citizens are eligible for Medicare simply by residing in Australia. The status of their permanent residency application does not affect their eligibility. Attaching the data link may result in the New Zealand citizen's eligibility ceasing or changing, when they remain entitled.

Where a New Zealand citizen has been enrolled in Medicare and their Medicare card has expired, Service Officers must update their Medicare entitlement to reflect their New Zealand citizen eligibility, as per this policy before issuing a new card.

New Zealand citizens who reside in Australia are eligible for Medicare, regardless of whether or not they are an applicant for permanent residency which was subsequently refused by the Department of Home Affairs.

If there is any doubt as to whether or not they are eligible, escalate the application. The customer must not be refused a Medicare card due to their application for permanent residency refusal. To update an entitlement type on an existing record, see Table 4 on the Process page.

A New Zealand citizen who permanently resides in Australia may lose their Medicare eligibility when they are absent from Australia for 12 months or more.

Where advice is received either verbally or in writing that the New Zealand citizen intends to or is residing overseas, enter the departure date (if known), in the Comments field in Personal.

Where it is confirmed that a New Zealand citizen has been absent from Australia for 12 months or more but the exact date they left the country is unknown, eligibility can be end dated with the date the advice was received.

See the Table 3 in Amend customer entitlement details in the Consumer Directory Maintenance System (CDMS) for Medicare.

Note: an end date should not be applied to a customer’s record until they have been residing outside Australia for 12 months or more.

If a New Zealand citizen is absent from Australia for 12 months or more, they can re-enrol in Medicare when they provide evidence that they have returned to reside in Australia.

The Process page contains more details.

Documents required to re-enrol in Medicare

The following documents must be provided with a completed Medicare enrolment form (MS004) or digital Medicare enrolment (DME) application:

• passports for each person, and
• 2 residency documents proving they live in Australia. Only 2 residency documents are needed for a family, if all family members:
• are New Zealand citizens, and
• arrived in Australia on the same day

If a customer was enrolled on a Medicare card with other family members, and those members have not returned to live in Australia, the applicant must be transferred to a new Medicare card. The applicant does not need to complete an Application to copy or transfer from one Medicare card to another (MS011) form.

Insufficient residency documents

Customers can submit a Commonwealth statutory declaration after 6 months of living in Australia if they are unable to provide any supporting residency evidence. The Commonwealth statutory declaration must be:

• comprehensive, and
• state why the customer could not provide sufficient residency documents

See Child enrolments – both parents are New Zealand citizens for more details.

See Child born overseas enrolling in Medicare > Child born overseas to New Zealand citizen.

Eligibility to Medicare

Where a child arrives on their own to reside with a relative or friend in Australia, they are eligible to enrol on the primary carer’s Medicare card.

Documents required to enrol in Medicare

The following must be provided with a completed Medicare enrolment form (MS004):

• child’s passport
• a letter from their school confirming the child is enrolled and attending school in Australia (only required when the child is of school age)
• a Commonwealth statutory declaration completed by the parents stating:
• they (parents) are not residing in Australia
• the date the child entered Australia, and
• the name of the person whom the child is residing with in Australia

Where a Commonwealth Statutory Declaration cannot be completed by the parents escalate the application.

The Resources page contains a link to the:

• Medicare enrolment form (MS004), and
• Commonwealth statutory declaration

From 1 July 2023, New Zealand citizens can apply for Australian citizenship without being first granted a permanent visa.

To be eligible, New Zealand citizens must:

• hold a non-protected Special Category visa (SCV) subclass 444, and
• have been in Australia for 4 years, and
• have been residing in Australia permanently for at least 12 months before applying

Note: Home Affairs will assess applications for Australian citizenship.

From the date the government grants Australian citizenship, the person:

• is considered a legal permanent resident and/or citizen of Australia, and
• remains eligible for Medicare

The person’s permanent residency status will not be notified through the Immigration Data link. The customer’s entitlement must be manually updated by the Service Officer after sighting a letter from the:

• Department of Home Affairs, or
• Australian Citizenship Certificate

See Parent, spouse, de facto or child of a New Zealand citizen in Ministerial orders and Medicare eligibility.

• Identification documents must be verified for all customers in the Medicare Document Verification Service (DVS) Portal before processing an application
• If an application is received and processed in a service centre, DVS is only required if the Service Officer is not satisfied with the validity of the documents. See Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal

If a customer fails the DVS check and attends a service centre with an issued letter, see Table 3 in Identity verification for Medicare enrolments and re-enrolments in the document verification service (DVS).