Medicare Enrolment Application Form

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Medicare enrolment application
When to use this form
Applicant(s) circumstances and documents required
Use this form if you are:
Migrant (holder of a permanent resident visa)
•
a migrant living in Australia
Documents required
•
applying for permanent residency and living in Australia
•
current passports and valid visa or original visa grant letter for all
•
a visitor to Australia
people listed on the application.
•
an Australian citizen returning to live in Australia
•
a New Zealand citizen living in Australia, or
Applying for permanent residency
•
a permanent resident visa holder (previously enrolled) returning
People who have applied for a permanent resident visa (except for
to live in Australia.
a parent visa) may be eligible for the Medicare and Pharmaceutical
This form allows up to 5 people to be listed on your Medicare card(s)
Benefits Scheme programs if they have a visa authorising their stay in
(including the contact person). If more than 5 names are to be
Australia and:
included on your card(s), attach the additional details on a separate
•
have permission to work, or
sheet(s).
•
their parent, spouse or child is an Australian citizen or holds an
All correspondence, including the Medicare card(s) will be sent to the
Australian permanent resident visa.
contact person.
Documents required
•
current passport or travel document for each person being
For more information
enrolled
For more information about Medicare or for assistance completing this
•
valid visa or original visa grant letter for each person being
humanservices.gov.au/medicare or email
form go to our website
enrolled
www.
medicare@humanservices.gov.au or call 132 011.
•
where the applicants do not have permission to work, it is
Note: Call charges apply – calls from mobile phones may be charged
necessary to provide proof of their relationship with a spouse,
at a higher rate.
parent or child who is an Australian citizen or an Australian
permanent resident visa holder.
Filling in this form
Receipt from the Department of Immigration and Citizenship (DIAC)
Please use black or blue pen
•
when you paid to apply for permanent residency may be required.
•
Print in BLOCK LETTERS
Information about visas, applications and receipts, will be accepted if
✓
7
•
Mark boxes like this
with a
or
on letterhead or by email from DIAC and addressed to the applicant or
•
Where you see a box like this
skip to the question
Go to 5
registered migration agent.
number shown. You do not need to answer the questions in
Note: People travelling on a visa subclass 309 or 310 only need to
between.
provide their passport and visa.
Returning your form
Visitors to Australia
Check that you have answered all the questions you need to answer
and that you have signed and dated this form.
Visitors that are residents of the United Kingdom, the Netherlands,
Sweden, Slovenia, Norway, Finland, Italy, Malta, Belgium, the Republic
Return your completed form and original or certified documents
of Ireland and New Zealand* may be eligible under the Reciprocal
to your nearest Medicare Service Centre. For initial enrolments, all
Health Care Agreement.
people 15 years of age and over on the application must go with you
to a Medicare Service Centre.
Visitors from Malta and Italy must be both residents and citizens of
those countries. They are eligible for a period of 6 months from their
If you live in an area remote from a Medicare Service Centre, or there
date of arrival in Australia.
is a reason for not being able to attend, you can send your application
together with certified copies of documents and the reason for not
* Visitors from the Republic of Ireland and New Zealand will not be
being able to attend in person, to:
enrolled in Medicare. Reciprocal Health Care Agreements provide
access as a public patient in a public hospital including outpatient
Department of Human Services
services and medicines available on prescription, which are
GPO Box 9822
subsidised under the Pharmaceutical Benefits Scheme for medically
in your capital city
necessary treatment.
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3101.1306

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