18.104.22.168 Start Day for HCC
The start day for an automatic issue HCC is the start day of the payment for which the card was issued.
The start day for a claim required HCC is the date the claim is made/deemed to have been made, unless specific backdating provisions apply (see below).
Act reference: SS(Admin)Act Schedule 2 clause 3(2)(b) Start day-general rule, section 14 Deemed claim-person contacting Department about a claim for a concession card
The LIC, the foster child HCC and the ex-CA (child) HCC are not issued retrospectively. However, provisions do exist which outline that these cards may be backdated for 13 weeks, or more, before the claim was made.
Explanation: In practice, this enables a person who has not yet claimed their card to receive necessary treatment or medication and to then seek reimbursement of the cost of the treatment, or the difference between the general and concessional rates for pharmaceutical items.
Claims may be 'backdated' to the date of the service or treatment, provided eligibility can be established throughout the period between the service or treatment and the claim for the card. For the LIC this means that the income in the 8 weeks ending on that date (service or treatment) was below the allowable income (1.1.A.125) limit applicable to that claimant, and remained so throughout the period up to the claim date. For a foster child HCC, this means the claimant must have been in foster care throughout the period.
For an ex-CA (child) HCC this means the claimant must have been a full-time student throughout the period. As this HCC was introduced from 1 October 2007, it cannot be backdated prior to that date.
Explanation: To claim pharmaceutical benefits retrospectively a person is required to provide their HCC or proof of entitlement from Centrelink and receipts for pharmaceuticals purchased, to Medicare who may reimburse the excess costs incurred, less any allowable additional charges or premiums for more expensive medications.
Act reference: SS(Admin)Act Schedule 2 clause 37(1) to (4) HCCs, other than automatic issue HCCs