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

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
  • Service Officers must create LHC letters in Digital Messaging Capability (DMC) - Health

For both MS004 and DME/DMX:

• The letter should only be given to the customer requesting it
• If there are multiple members on the one card that require the letter, each individual aged 15 years and over must request one separately
• If members aged 14 years and under are included with the request for an LHC letter, these members must be included on the LHC letter of the requestor
• If all members aged 15 years and over are present or on the phone, and request to be on the same letter:
  • get each member's consent for the letter and complete authentication
  • 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 authentication and appropriate confirmation of identity

See:

• Amend address in the Consumer Directory Maintenance System (CDMS) for Medicare
• Authenticating a Medicare customer
• Resources page for Medicare entitlement types and eligibility for LHC letter

On CDMS Home page, select Inquire on Consumer Details.

• key the customer's 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 show.

• Select the radio button of any event that has Program MCARE
• Select History details tab
• The History detail - Program Entitlement screen shows 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 customer has multiple entitlements, go to Step 4.

If a customer 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 (only):
  • 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 customer 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 customer was previously enrolled and has been absent from Australia and recently returned, see the Resources page for more details

Send the Lifetime Health Cover letter (Z0138). Service Officers must choose the option that applies to the customer’s situation:

• LHC applicable date
• LHC IMR may be required
• LHC does not apply to applicant

See Digital Messaging Capability (DMC) - Health.

Once completed:

• For a PaNDA work item, add a note to include the DMC Letter request ID. View the draft letter in the DMC under Letter history
• For a DME/DMX, add a note to the activity log to include the DMC Letter request ID. View the draft letter in the DMC under Letter history
• A link to the sent letter saves automatically on the Interactions tab in the customer's record for future reference

The Z0138 Lifetime Health Cover DMC:

• must be quality checked
• does not need a comment in CDMS
• can be sent by the Service Officer