Amend a person's Medicare enrolment details 011-44110000

Minor changes to the Medicare Enrolment File may be made without supporting documents.

These amendments do not change the substance of a person's details. They correct minor spelling or typographical errors that may have been made by Service Officers in the normal course of their duties. It is acceptable to make these amendments, particularly as the agency has an obligation to make sure that the personal details it holds about customers is up-to-date and accurate.

If advised that a name has been spelt incorrectly or needs updating, see Change legal name on Medicare record for more details.

In some situations, refugees and other people born overseas cannot verify their date of birth. For people who are born overseas and whose DOB is unknown, the Department of Home Affairs policy is to assume a date of birth. For applicants who cannot verify their DOB, visa documents presented may show as:

• 31/12/yyyy
• 01/01/yyyy
• XX XX/yyyy

Those applicants who have been given an assumed DOB and shows as XX XX/yyyy, the DOB to be keyed is 31/12/yyyy.

See Escalation process for Medicare Eligibility for help.

Minor date of birth variations

These are examples only and - not limited to the following:

• the day of the month and the month are transposed
• at the beginning of the year, the operator keys the previous year
• the day is one day out

Major date of birth variations

If the date of birth is not a minor variation to their recorded date, customers are required to give supporting documents to verify the required changes.

Customers' can do a major variation to their date of birth by:

• calling us
• email or mail the request and supporting document, or
• in a service centre

The Process page contains details about Acceptable documents for incorrectly recorded date of birth or gender.

Note: a current restriction within the CDMS stops an incorrect date of birth from being amended where the Entitlement Start Date is before the date of birth. This could occur due to a system error or Service Officer error. For example:

• a person who was initially enrolled on an existing Medicare record automatically adopted the same entitlement start date as the person already enrolled on the existing card, or
• a person is being enrolled with an incorrect date of birth which is before the entitlement start date and the correct date of birth is after the entitlement start date

Examples such as these will require specific process steps to be followed when amending a date of birth.

The Process page contains instructions for amending an incorrect date of birth when the error message 12300 DATE OF BIRTH>MEDICARE ENTITLEMENT START DATE is showing.

For help, see Escalation process for Medicare Eligibility

The Resources page contains details describing when a title must be updated on existing enrolment records.

If a customer has been enrolled in Medicare and at a later date either a claim that is a gender specific item has been rejected, documents or advice received from the customer indicates that gender recorded on CDMS is incorrect, the gender field can be changed without supporting documents in the below instances:

• an item on claims history has been overridden which may indicate that the gender field is incorrect
• a person has received documents to participate in a particular trial and the applicant tells they are not of the gender required for participation in the program
• if the title on a group contact does not correspond with the enrolment details (for example, in longstanding enrolments)

If there does not appear to be any logical explanation for the error, documents must be given to support a change in the gender field. Customers can do this by:

• calling us
• email or mail the request and supporting documents, or
• in a service centre

Note: evidence standards are to be met for requests to change gender on CDMS, see Change of gender for Medicare enrolments and Gender Guidelines Implementation.

Document verification

Identification documents must be verified in the Medicare Document Verification Service (DVS) Portal. The Process page contains details on how to verify and record these details.

The Resources page contains contact details and also details about updating titles in CDMS.