18.104.22.168 Health care card (HCC)
This topic provides information on when an individual is issued a HCC and covers the following:
- automatic issue of HCC
- individuals with regular care children
- individuals with shared care of FTB children, and
- where HCC entitlement is not automatic, due to the income estimate.
Automatic issue of HCC
Individuals who are eligible to receive FTB Part A at a rate greater than nil and whose income is below the FTB Part A income free area (22.214.171.124), automatically qualify for a HCC. Qualification for the HCC is not affected by maintenance income or failure of the MAT.
This HCC qualification is only available to individuals who receive FTB by fortnightly instalments. The HCC is issued for a 12 month period and renewed automatically based on the individual meeting the eligibility criteria.
Individuals who receive FTB are issued with a HCC on the first day on which their estimate of income is below the FTB Part A income free area. When the individual's income increases to an amount above the FTB Part A income free area they are no longer eligible for the HCC. These individuals are able to test their eligibility for a low income HCC (LIC) (SS Guide 126.96.36.199).
Note: Where reconciliation shows that an individual who receives FTB instalment payments would have been eligible for the FTB HCC (but their agreed estimate exceeded the FTB Part A income free area) it may be possible to obtain the HCC retrospectively. However, this would only be of benefit where the person has retained all evidence and receipts of pharmaceutical expenditure for the elapsed period. Some reimbursement of these costs may be possible through Medicare.
From 1 January 2019, a 52 week NARWP applies to FTB Part A. An individual who is serving a NARWP for FTB Part A can remain eligible for FTB, but receives a nil rate for FTB Part A. This means the individual is not eligible for HCC while they are serving the NARWP for FTB Part A. There are a range of exemptions from the NARWP for various payments and concession cards, and situations where the NARWP does not apply (188.8.131.52). From 1 January 2019, individuals who have an FTB child are exempt from the NARWP for a LIC. A person does not have to be receiving FTB to qualify for this exemption.
Act reference: SSAct 1061ZQ(2) Subsection (1) does not apply to a person who …
Individuals with regular care children
Individuals who have regular care of their child/ren may also qualify for the HCC if their family income does not exceed the FTB Part A income free area. Qualification still arises even if they are not entitled to be paid FTB Part A via instalment.
Policy reference: FA Guide 1.1.R.21 Regular care child
Individuals with shared care of FTB children
If an individual is receiving a part rate of FTB Part A due to having shared care of an FTB child, they may still qualify for an automatic HCC if their ATI is below the FTB Part A income free area.
If both parents/carers are eligible to receive a HCC, their FTB child will appear on each individual's card.
Where HCC entitlement is not automatic, due to the income estimate
Where an individual loses entitlement to the FTB HCC because their agreed estimate exceeds the FTB Part A income free area, they may choose to test their eligibility for a HCC under the provisions for low income earners. Eligibility for the LIC is determined using an individual's actual income over the 8-week period immediately before they claimed the card. (The additional child add-on amount for this HCC takes the qualifying income limits above the FTB Part A income free area for families with 3 or more children.)
Act reference: SSAct section 1061ZK Qualification: general rules