Applying for a Medicare number for a child in care | Child Protection Manual

Follow this procedure when:
obtaining a child's existing Medicare number; or applying for new Medicare number on behalf of a child or young person in care.
This procedure is relevant to all children and young people in care. Note: the procedure differs for young people aged over 15 years.
Document ID number 1125, version 3, 6 September 2022.

Introduction

It is important all children and young people in care are able to access Medicare services from the time they first enter care. The Commonwealth Government funds many health services where access and reimbursement of costs require presentation of a valid Medicare card (or a valid Medicare number). This includes visiting a doctor who bulk bills, or accessing other free health services. Medicare has designated processes that make it easier for Child Protection to obtain Medicare numbers and cards for children and young people in care.

Policy

Child Protection must obtain a Medicare number and Individual Reference Number (IRN) for each child in care. The IRN is the number on the Medicare card to the left of the child’s name. It is used to distinguish individuals named on a card and must be recorded on Medicare claim forms.

As soon as possible upon entry to care, child protection must obtain the child’s existing Medicare number and IRN from their parents or directly from Medicare, irrespective of the placement or order type. This is necessary for the child or young person to access Medicare services and benefits from the time they first enter care. It is also required before a child’s My Health Record can be accessed and managed, as required, by Child Protection practitioners.

If the child in care returns to their parent’s care, the information from their Medicare card (whilst in care) will be linked by Medicare so information is not lost. Similarly, a child who has entered care and obtained a new Medicare card will have their existing information, from their parents Medicare card, linked to their new Medicare card.

Upon the making of an order that places a child in care, if the child does not already have their own Medicare number, Child Protection must obtain a new Medicare number and card on behalf of the child. This will protect the child’s personal information while they are in care.

Procedure

Case practitioner tasks

Obtaining an existing Medicare number for a child 14 years and younger

Request the child’s parents to provide the child’s Medicare number and IRN and explain why it is necessary upon entry into care.
Record on CRIS the parent’s response and, if provided, document the child’s Medicare number and IRN in the medical component tab of CRIS.
If the parents’ advise that they are unable or unwilling to provide the child’s Medicare number and IRN, obtain these from Medicare directly.
To obtain the Medicare number and IRN directly from Medicare you are required to use the number for authorised agency employees. This is a designated number for Child Protection practitioners and is not publicly available. The number can be found on page one of the fact sheet: Medicare for children and young people in out-of-home care .
Prior to contacting Medicare, obtain a password and agency ID from the Services Australia contact officer by emailing: CommonwealthInfoRequest@dhhs.vic.gov.au. These must be provided to Medicare for verification purposes. The password is updated regularly and must not be disclosed to anyone outside Child Protection.
Record the Medicare number and IRN for the child on CRIS in the medical component tab once obtained.
Consider, in consultation with a supervisor, whether there is a need to restrict access to the child’s My Health Record to protect the privacy of the child’s placement. Access to the child’s My Health Record should be restricted if it is assessed to be in the child’s best interests or ordered by the Children’s Court. For more information see My Health Record - procedure.

Obtaining an existing Medicare number for a young person aged 15-17 years

If seeking a Medicare number and IRN for a young person aged 15 years or older, the young person must speak with Medicare directly.
For young people, they must be with you when you contact Medicare through the designated number for authorised agency employees. You will be required to provide a password and agency ID which can be obtained from the Services Australia contact officer by emailing: CommonwealthInfoRequest@dhhs.vic.gov.au. The young person will be asked to confirm their identity by answering some security questions.
Upon the young person obtaining their Medicare number and IRN, discuss with the young person whether they wish to share their Medicare number and IRN with Child Protection. It is particularly important for Child Protection to have a record of the young person’s Medicare number if there is a requirement for Child Protection to be an authorised person on the young person’s My Health Record. For further information see My Health Record – procedure.

Child Protection can only be an authorised person or nominated representative on a young person’s My Health Record, if the young person provides consent (except for in exceptional circumstances. E.g. due to a disability etc).

Contact Medicare for advice if the young person is not able to speak to Medicare due to a disability, or any other reason. It may be necessary to apply for a new number on behalf of the young person.

Enrolling a child in Medicare or obtaining a new Medicare number on behalf of a child aged 14 years or younger (including newborns)

Follow these steps, as soon as practicable, after the making of the following orders:
- Interim accommodation orders
- family reunification order
- therapeutic treatment placement order
- care by Secretary order
- long-term care order
Complete the Medicare enrolment or new Medicare number request for use by Child Protection Agencies.
Provide all required documentation as outlined in the form including:
- a copy of the child’s court order (first page only)
- a letter on divisional letterhead requesting a new Medicare number for the child. Refer to the information contained in the application form for further information about what the letter must include.
- a certified copy of a proof of birth document. Refer to the list of acceptable documents on page 2 of the Medicare enrolment form.

If you are working with a newborn child who has not been enrolled in Medicare, follow the steps above and provide a copy of a proof of birth document which can include the back page of the Newborn Child Declaration form (FA081) issued by the hospital or birthing centre.

A child can be considered a newborn if aged up to and including 52 weeks of age and can be enrolled in Medicare depending on their parents’ Medicare eligibility. A newborn child must have at least one parent who is eligible for Medicare to be enrolled in Medicare.

Where a certified copy of a proof of birth document cannot be provided, a substitute letter on departmental letterhead can be completed. Refer to Substitute Proof of Birth Letter Template for the template letter.
Send an encrypted email containing the completed form and supporting documentation in PDF format, checking the documents are not password protected (these are Medicare requirements), to MPS.Eligibility@servicesaustralia.gov.au with the following subject line: Victoria Child Protection <initial and surname of the child or young person>. Refer to How to send an encrypted email in Outlook for instructions to securely send emails with sensitive information.

If applying for multiple Medicare numbers, for example on behalf of a sibling group, a separate form and email must be sent for each child.

Record the new Medicare number and IRN for the child on CRIS in the medical component tab, once received.
Provide the new Medicare number to the child’s carer. See below for further information about providing Medicare numbers and cards to carers.

Enrolling a young person in Medicare or obtaining a new Medicare number on behalf of young person aged 15-17 years

Discuss the role of Medicare with the young person and how Medicare numbers are used. Refer to the Australian Government’s Medicare website for information.
Ask the young person if they would like their new Medicare number to be sent to Child Protection or if they would prefer to have it provided to them directly.
Request the young person to sign page four of the application form, if the young person chooses for Child Protection to be provided with their Medicare number.
Support the young person to request their own Medicare card by completing an Application to copy or transfer from one Medicare card to another form, if the young person does not want Child Protection to apply for a new number on their behalf. Alternatively ask the young person to nominate a member of their care team to assist them to complete the application form.
Discuss with the young person whether they agree to share their Medicare number and IRN with Child Protection, if they apply for their own card. It is particularly important for Child Protection to have a record of the young person’s Medicare number if there is a requirement for Child Protection to be an authorised person on the young person’s My Health Record. For further information see My Health Record - Procedure.

Contact Medicare for advice where you are working with a young person who may not be able to communicate their wishes due to a disability or any other reason.

Aboriginal and Torres Strait Islander children

If you are working with an Aboriginal child and the child does not have identity documents a new Medicare number may still be obtained. You will need to complete the Aboriginal and Torres Strait Islander Medicare enrolment and amendment form.
Speak to your supervisor, to determine whether it would be more appropriate for a member of the care team (who is not a Child Protection Practitioner) to support the child in obtaining a new Medicare number. For example, a care team member from the Aboriginal Community Controlled Organisation.

Providing Medicare cards to carers and storing the child’s Medicare card

Provide the child’s carer with the child’s Medicare number as soon as possible. This will allow the carer to claim Medicare benefits if they have to pay for a child’s medical expenses.
Store the child’s Medicare card in the child’s paper file. This will minimise the risk of the card getting lost if the child’s care arrangements change.
Consider providing the Medicare card to the child’s carer in the following circumstances:
- if the child is subject to a care by Secretary order and has a permanency objective of long-term out-of-home care or permanent care and their care arrangements are unlikely to change
- if the child is subject to a long-term care order.

Obtain Team Manager approval before providing the Medicare card to the child’s carer.
Where a young person aged 15 years and over has elected to have their Medicare card provided directly to them, talk to the young person about this responsibility and what to do if they cannot find their card or wish to get in contact with Medicare.
If a permanent care order is made the permanent care parent(s) must be provided with the child’s Medicare card.
If the child is authorised to an Aboriginal Children in Aboriginal Care (ACAC) provider under section 18 of CYFA, provide the Medicare card to the ACAC provider as part of the file transfer process.

Medicare cards and leaving care planning

As part of transition planning, consider the young person’s capacity to access Medicare. Upon transitioning out of care at the age of 18, young adults may keep the same Medicare number they used while in care. Prior to the young person’s care order ceasing, their contact and address details with Medicare need to be updated by the young person. If required a member of the young person’s care team should assist the young person to complete this task.
Refer to the Better Futures referral checklist which includes a section on the status of the young person’s key documentation including Medicare card. This detail will give the Better Futures worker background on the status of the Medicare card post care.
Refer to the fact sheet: Medicare for children and young people in out-of-home care for instructions on how to stop receiving correspondence from Medicare on behalf of a young person who has transitioned from care.

Supervisor tasks

Provide ongoing supervision and support.

Team manager tasks

Endorse any decision to provide the child’s Medicare card to a carer.

Related procedures

Additional information