3.1.4.50 Health care card (HCC)

Summary

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 individual's 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 (3.1.1.20), 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 that their income estimate is below the FTB Part A income free area. If 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 3.9.1.20).

Note: Where reconciliation shows that an individual who received FTB instalment payments would have been eligible for the FTB HCC (but their income 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 (2.2.1.10). 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.

Individuals with regular care children

Individuals who have regular care of their child/ren may also qualify for the HCC if their income estimate 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.

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 their FTB child/ren, they may still qualify for an automatic HCC if their ATI is below the FTB Part A income free area.

If both parents/carers of an FTB child are eligible to receive a HCC, the FTB child will appear on each individual's card.

Where HCC entitlement is not automatic, due to the individual's income estimate

Where an individual is not entitled to the FTB HCC because their income estimate exceeds the FTB Part A income free area, they may choose to test their eligibility for a LIC. 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 the LIC can result in the individual’s qualifying income limit being above the FTB Part A income free area. Similarly, an individual’s FTB income estimate may exceed the FTB Part A income free area, but their actual income over the 8-week LIC period may be below their qualifying income limit.)