Medicare cards 011-44150000

Service Officers must check the customer:

• is over 15 years of age
• is listed on the card, and
• has been authenticated

Service Officers can re-issue a replacement card if the card has an expiry date of less than 6 months.

If the expiry date in CDMS is greater than 6 months, see New card requests for cards expired for over 6 months table for more details.

The customer must be registered for a Medicare account online.

Customers can order a maximum of 2 replacement Medicare cards online in a 12 month period. If the customer requires more cards, they must:

• submit a written request
• call the Medicare general enquiry line, or
• visit a service centre

The customer must provide identity documents. See Document types for Medicare eligibility and enrolments for more details.

If the customer cannot provide identity documents, Service Officers must authenticate the customer. See Authenticating a Medicare customer.

Note: a person requesting a Medicare card must be over 15 years of age and be listed on the card.

A written request can be submitted identifying information including:

• Name
• Medicare number
• Signature or declaration
• A copy of identification for the customer making the request

Note: a person requesting a Medicare card must be over 15 years of age and listed on that card.

See Standards for Medicare enrolment forms.

• To verify documents for enrolments, see Table 1 in 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, see Table 3 in Identity verification for Medicare enrolments and re-enrolments in the Medicare Document Verification Service (DVS) Portal

Note: if a customer submits a DME application, DVS is completed in the MEE Portal. See Digital Medicare enrolments (DME) and the MEE Portal.

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

On CDMS Home page:

• select Inquire Consumer Details
• key the customers Medicare card number in ID Number field
• select Group
• select Current Issue Details

Has a new card issued?

• Yes, go to Step 3
• No, go to Step 6

Select Interactions tab to display when a Medicare card was sent and to what address.

Is the address different to what is recorded in CDMS?

• Yes, see Table 3
• No, address is the same, go to Step 4

• On CDMS Home page, select Inquire Consumer Details
• Key the customers Medicare card number in ID Number field
• Select Group
• Select Address Details tab

This displays in the field Type of Mail Returned.

Is the return mail indicator present?

• Yes:
• confirm the address recorded in CDMS is correct
• remove a return mail indicator in CDMS for Medicare.
  Note: if there is a return mail indicator and the address is updated, this will automatically remove the indicator. Update this before issuing a Medicare card
• go to Table 3
• No, go to Step 5

If the customer is in a service centre, or on the phone, go to Step 6.

• Issue a replacement card
• Tell the customer they can view a digital copy of the Medicare card using the Medicare Express Plus App or the myGov app

Card expired for more than 6 months

Go to Step 7

Has the customer been residing outside of Australia?

• Yes, go to Step 8
• No, see Table 3

Less than 5 years for Australian citizens or less than 12 months for permanent resident or New Zealand citizen

Customers are regarded as a resident for Medicare purposes, see Table 3 and record the date of departure in the comments field at Personal level.

Service Officers cannot refuse to issue a Medicare card. See Ministerial orders and Medicare eligibility for more details.

More than 5 years for Australian citizens or more than 12 months for permanent resident or New Zealand citizen.

Determine if the customer has returned to Australia to reside. The customer must provide evidence to re-enrol in Medicare. Service Officers must not update any personal details held in CDMS until they have proven residency.

Australian Government employee or a member of the Australian Defence Force

Where the customer is a government employee or a member of the Defence Force, and has been absent from Australia for more than 5 years, they:

• stay eligible for medical benefits incurred in Australia
• are not required to satisfy the usual process for residency
• must provide documents to support they are a government employee or a member of the Australian Defence Force

See also:

• Ministerial orders and Medicare eligibility
• Medicare eligibility for customers with permanent resident status
• Medicare eligibility for New Zealand citizens

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

Before issuing a new or replacement Medicare card for a customer, check all CDMS Group comments to identify if a BI flag comment exists.

• If no comment exists, go to Step 3
• If a comment exists, see Suspected Medicare fraud and Business Integrity (BI) flags

On CDMS home page:

• select Amend Consumer Details
• key the customers Medicare card number in ID Number field
• select Group

Note: Suspected Medicare fraud and Business Integrity (BI) flags may be present, preventing amendments. If this occurs, contact a Medicare and Aged Care - Local Peer Support (LPS) for help, if required.

• Select Card Requests tab
• Tick the required checkbox to request:
• replace current card
• duplicate current card, or
• duplicate replacement card
• Select Replacement Reason from the dropdown box
• Select Card Request Source from the dropdown box
• Select Validate, Validate, Update to confirm the details displayed

Note: a duplicate card should only be issued if there is more than one person over the age of 15 years enrolled on the card. If an error message displays Replacement not Allowed see Table 10 in Amend customer details in the CDMS for Medicare.

Service Officers must:

• authenticate the customer
• check the address is current
• issue a replacement Medicare card

• authenticate the customer
• select the address is a production control address checkbox in CDMS
• issue a replacement Medicare card, noting a card will not be physically sent

If the enquiry is by phone or in a service centre, tell the customer that a Medicare card will not be sent.

See Reciprocal Health Care Agreements (RHCA) eligibility for Medicare and Pharmaceutical Benefits Scheme (PBS) for the relevant country.

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

• Select Amend Consumer Details
• Key the customers Medicare card number in ID Number field
• Select Group

Note: Suspected Medicare fraud and Business Integrity (BI) flags may be present, preventing amendments. If this occurs, contact a Medicare and Aged Care - Local Peer Support (LPS) for help, if required.

Select Card Requests tab.

In Group Eligibility End date field:

• key the allowable extended date
• tick the checkbox to request
• replace current card
• select Replacement Reason from the dropdown box
• select Card Request Source from the dropdown box
• select Validate, Validate, Update to confirm the details displayed
• select Comments
• add a comment explaining the reasons why the card has been extended

Note: this date shows in Entitlement, do not add, or amend a new entitlement.

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

If a customer is eligible for Medicare but has been enrolled in Medicare without providing sufficient documents, Service Officers must stop the Medicare card.

On CDMS Home page:

• select Amend Consumer Details
• key the Medicare card number in the ID Number field
• go to the Card Request tab > Group
• tick the Stop Card indicator
• select Validate, Validate, Update to confirm the details displayed

Tell the customer that the Medicare card will not be issued until the required documents are provided.

Provide detailed comments in the Group Comments field in CDMS, outlining the documentation required to remove the stop.

Once the customer has provided the required documents, Service Officers must assess eligibility.

Remove the stop on the Medicare card if eligible.

On CDMS Home page:

• select Amend Consumer Details
• key the Medicare card number in the ID Number field
• go to the Card Request tab > Group
• untick the Stop Card indicator
• select Validate, Validate, Update to confirm the details displayed

If the:

• Service Officer has created a duplicate Consumer ID (no programs attached) go to Step 2
• customer is already enrolled and a duplicate PIN has been created, go to Step 3
• card has been issued in error and the customer is eligible for Medicare, go to Step 4
• customer has been enrolled in error and is not eligible for Medicare, go to Step 5

See Duplicate Medicare enrolment and Consumer IDs in Medicare for more details.

Contact the Medicare and Aged Care - Local peer Support to request the Consumer ID be deleted.

See Duplicate Medicare enrolment and Consumer IDs in Medicare process for details.

If a card is issued in error, extract the card by completing a card extraction form no later than 12 noon (AEST) the following day. The form is available on the Resources page.

The extracted card will not need to be returned to the Service Office as the error must be rectified immediately.

If the cut-off time of 12 noon is missed, a Medicare card will be issued and sent to the customer. In this case the Service Officer must:

• phone the group contact of the Medicare card impacted
• apologise for the error related to the enrolment and tell the group contact they will get an incorrect Medicare card
• tell the group contact:
• do not use this card
• the card must be destroyed, and
• they are required to tell any other members about the card
• if contact attempts are unsuccessful, record a comment in Personal in CDMS stating:
• the error that has occurred, and
• contact attempts were unsuccessful

The customer must have a customer end date keyed and a comment recorded in Personal CDMS. Extract the card by completing a card extraction form no later than 12 noon (AEST) the following day. The form is available on the Resources page.

If the error was identified after the card extraction timeframe, contact the group card holder to tell them they:

• will get a card, and
• are not eligible

If contact attempts are unsuccessful, record a comment in Personal in CDMS stating:

• the error that has occurred, and
• contact attempts were unsuccessful

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

On the CDMS Home page:

• select Amend Consumer Details
• key the customers Medicare card number in ID Number field
• select Group
• select Name/Address tab

In the Contact Name, change the details of the group contact as required.

Is the group contact associated with the card?

• Yes:
• select the Group Association checkbox
• key the reference number of the customer in Contact Reference Number
• select Get Details

The mailing address automatically populates in the address fields.

• No:
• untick the Group Association checkbox
• remove the reference number
• key customer's name in the Contact Name field (Surname, comma, title, initial, for example, Smith,Mr J)
• complete all required Address fields

Make other amendments in the remaining fields, as required:

• Scroll down and select Validate. An information message displays advising if the amendments were accepted or not accepted
• Select OK to acknowledge the message. If not acceptable, update the amendments as required
• Scroll down and select Validate
• When the details are correct, select Update

The Confirm Amended Card Details screen displays the updated details.

Was authentication successful? See Authenticating a Medicare customer.

• Yes, go to Step 2
• No, tell the customer they will need to attend a service centre with an approved photographic identity document. Procedure ends here

On CDMS Home page:

• select Amend Consumer Details
• key the customers Medicare card number in ID Number field
• select Group

Note: Suspected Medicare fraud and Business Integrity (BI) flags may be present, preventing amendments. If this occurs, contact a Medicare and Aged Care - Local Peer Support (LPS).

Select:

• Card Requests tab
• Display Medicare Card
• Print

Does the service centre have a digital secure bin on site?

• Yes, go to Step 2
• No, go to Step 3

Service Officers must place the Medicare card in the digital secure bin to be disposed of securely.

Service Officers must:

• put the cut up Medicare card in a sealed envelope
• address the envelope to either Services Australia mailroom
• add the envelope to the site outgoing mail