Skip to navigation Skip to content

Lifetime Health Cover (LHC) eligibility in Medicare 011-44080000



This document explains details for Service Officers when issuing a LHC letter.

LHC letter

This table explains how:

  • customers request an LHC letter
  • Service Officers respond to LHC letter requests and how to find the correct Medicare registration date in CDMS

Note: Service Officers should not use the association start date under the Members tab in Group, this may not give the correct LHC letter date.

Step

Action

1

Requests for LHC letter + Read more ...

An eligible person can request an LHC letter by any of the following:

  • Over the telephone the caller must be authenticated
  • In person at a service centre the customer must be authenticated
  • Written request with:
    • name
    • Medicare number, and
    • signature
  • Medicare enrolment form (MS004) - the Medicare enrolment form (MS004) can be used to request an LHC letter at the same time as enrolling in Medicare
  • Digital Medicare enrolment (DME) and extensions (DMX)
    • Customers can request an LHC letter as part of their digital Medicare application
    • For customers over 31 years, Service Officers must create LHC letters requested as part of a digital Medicare application in the MEE Portal. See Digital Medicare enrolments and extensions in the MEE Portal for the process
    • If a customer under 31 years requests a LHC letters as part of their digital Medicare application, Service Officers must create a LHC letters manually. Go to Step 2

Note:

  • the letter should only be given to the person requesting it
  • if there are multiple persons on the one card that require the letter, each individual over 14 years should request one separately
  • if persons under 14 years are included with the request for a LHC letter, these persons must be included on the LHC letter of the applicant
  • if all persons aged 14 and over are present or on the phone, and request to be on the same letter:
    • get each individual's consent for the letter and complete a security check
    • add comments to the Personal tab to record that the customer consented to be on the same letter as the requestor
  • LHC letters do not apply to:
    • diplomats, and
    • customers of Reciprocal Health Care Agreement (RHCA) countries
  • if the Production Control address is recorded on the customer's record, the customer's Group address must be updated:
    • before sending an LHC letter update to a valid postal address, and
    • after successful completion of a security check and appropriate confirmation of identity

See:

2

Access program entitlement events in CDMS + Read more ...

On CDMS home page, select inquire on consumer details.

  • key the Medicare card number in the ID Number field
  • select Personal

On Personal Detail Inquiry screen:

  • select the consumer using the radio button
  • scroll to bottom of page and select Summary
  • select History from dropdown menu

On Consumer History Summary screen:

  • select Program Entitlement from the All Events dropdown menu
  • select Filter Results

All events that have a program entitlement will show.

3

Determine correct date + Read more ...

Select the radio button of any event that has Program MCARE.

Select History details tab.

The History detail - Program Entitlement screen will show all previous, current and deleted program entitlement details.

See the Reference column to find the Medicare registration date (applicable date for LHC letter).

If a person has multiple entitlements, go to Step 4.

4

Determine Medicare entitlement and applicable date for LHC letter + Read more ...

If a person has Medicare entitlement type/s) of:

  • Migrant (only)
    • LHC date = date of registration (processing date)
  • Conditional migrant (only)
    • LHC date = date of registration (processing date)
  • Ministerial order
    • LHC date = date of registration (processing date)

Conditional migrant and RHCA

  • LHC date = date on which the Conditional migrant was registered (processed date)
  • Conditional migrant and Migrant
    • LHC date = date on which the Conditional migrant was registered (processed date)
  • RHCA and Migrant
    • LHC date = date on which the Migrant was registered (processed date)
  • Australian citizen newly arrived and not previously enrolled
    • LHC date = date on which the Australian citizen was registered (processed date)
    • if the person was previously enrolled and has been absent from Australia and recently returned, see the Resources page for more details
  • New Zealand citizen newly arrived and not previously enrolled
    • LHC date = date on which the New Zealand citizen was registered (processed date)
    • if the person was previously enrolled and has been absent from Australia and recently returned, see the Resources page for more details

5

Complete LHC letter + Read more ...

Choose the appropriate letter. See the Resources page for more details.

Use the options available in the Standard Letter Template (SLT) to create a letter.

To complete the Address and Signatory tab:

  • for a person with only one name, key the name in the mandatory first name field in Addressee Details of the letter
  • use the customer's first name and last name recorded in the Personal tab in CDMS
  • there is a blank option in the title field dropdown menu
  • use the address recorded in the Group tab in CDMS

To complete the Details of People Covered tab (only in the Z0138 letter):

  • key the customer's first name/s, middle initial (if they have one) and last name recorded in the Personal tab in CDMS
    • for a person with only one name, key the name in the first name field
  • add one of the following comments in the Personal tab in CDMS:
    • Z0138 - LHC letter for date of registration <insert date> and (if applicable). Customer consented to be included in the same letter as the applicant
    • Z2780 - Unable to confirm applicable date in Medicare letter sent, or
    • Z2781 - Lifetime Health Cover does not apply to you letter sent

Once completed:

Once approved by the delegate, give (if in person) or mail the letter to the customer.