The Guides to Social Policy Law is a collection of publications designed to assist decision makers administering social policy law. The information contained in this publication is intended only as a guide to relevant legislation/policy. The information is accurate as at the date listed at the bottom of the page, but may be subject to change. To discuss individual circumstances please contact Services Australia.

3.9.3.10 Qualification for CSHC

Qualification criteria

To qualify for a CSHC, a person must meet the criteria listed in the following table. Where more detail about a criterion is required, the second column indicates where you will find this.

Criterion More detail
ALL of the following:

Be a person, NOT receiving a:

  • social security pension or benefit, OR
  • DVA service pension or income support supplement, AND
 -
Be of age pension qualification age, AND -
Be an Australian resident or an SCV holder, present in Australia (1.1.A.320) at the time of lodging the claim, AND 3.1.1 Residence requirements
Have income BELOW the applicable income cut-off limits, AND 3.9.3.30 Assessment of income for CSHC
Have served a NARWP (1.1.N.70) if it applies, AND 3.1.2.40 Newly arrived resident's waiting period (NARWP)
Meet TFN requirements. 8.1.3.20 Providing TFN Information

Act reference: SSAct section 23(1)-'social security pension', section 23(1)-'social security benefit', section 23(5A) to (5D) Pension age, section 7(2) An Australian resident is a person who …

Overseas pensions

Overseas pensions are included as income.

Explanation: If a person's overseas pension forms part of their Australian taxable income (that is, they pay Australian income tax on that pension) then that pension is already included in the CSHC income test. If a person's overseas pension does not form part of their taxable income (that is, they pay no Australian tax on that pension) then that pension must be added back into the ATI test.

Cardholders travelling overseas

From 1 January 2015, the CSHC has a non-cancellation period of 19 weeks if the holder temporarily departs Australia.

In those cases where a CSHC holder has been overseas for more than 19 weeks and their card is cancelled they may be eligible to lodge a verbal phone claim for a new CSHC.

In order to use this streamlined verbal claim service the applicant must:

  • be in Australia when they make the claim
  • have their income details up-to-date (that is, have provided a TNA from the tax year immediately preceding the current tax year. If the applicant has not received a TNA for the reference tax year, the tax year immediately preceding will be the reference tax year)
  • make the claim within 13 weeks of having their card cancelled.

Applicants who meet these requirements can then have their claim assessed over the phone. If their claim is successful their CSHC can be re-activated.

Where a person's income details are more than 2 years old or their card has been cancelled for 26 weeks or less, they will need to lodge an abridged re-claim.

If their card has been cancelled for more than 26 weeks, they will need to complete a full claim.

Act reference: SSAct section 1061ZUB Non-cancellation of concession cards for temporary overseas absences

Policy reference: SS Guide 3.9.4.20 Non-cancellation of Concession Cards for Temporary Overseas Absences

Low income claimants

If a claimant does NOT receive a TNA due to low income, they should be assessed to determine their eligibility for Age.

Explanation: It is expected that there will be a small number of these people who will NOT be eligible for Age due to assets test or residency requirements.

Act reference: SSAct section 1061ZG Qualification rules, section 1061ZI Duration of newly arrived resident's waiting period

Policy reference: SS Guide 3.4.1.10 Qualification for Age

Prisoners & detainees

Prisoners and detainees are prevented from qualifying for social security payments, and the concession cards that are automatically issued with these payments, under SSAct section 1158.

Prisoners and detainees are also prevented from qualifying for claim-required concession cards like the LIC and CSHC, under SSAct section 1159A.

However, certain prisoners are 'licensed on day release' to undertake activities such as engaging in paid work or TAFE training and may qualify for claimable concession cards.

Act reference: SSAct section 1158 Some social security payments not payable during period in gaol or in psychiatric confinement following criminal charge, section 1159A Person not qualified for some concession cards when in gaol or in psychiatric confinement following criminal charge

LIC holders & the CSHC

Holders of the LIC who are also able to qualify for the CSHC may hold and retain both concession cards concurrently.

HEAS

Payments to a person under the HEAS (formerly PLS) are not included in their ATI for CSHC purposes.

Policy reference: SS Guide 3.4.5.60 Supplementary benefits & assistance for HEAS recipients

Provision of TFN

From 1 September 2008 all claimants for the CSHC are required to provide their TFN. A CSHC will not be granted unless TFN requirements are met.

Policy reference: SS Guide 8.1.3.20 Providing TFN Information

CSHC for age pensioners losing pension eligibility on 1 January 2017 due to the rebalancing the assets test measure

Age pensioners who lost their pension entitlement and PCC on 1 January 2017 as a result of the measure to rebalance the assets test were automatically issued with a CSHC and a LIC without having to meet the usual income test requirements. However, from 9 October 2017, these pensioners had their PCCs automatically reissued with an ongoing income and assets test exemption. Other eligibility requirements, such as portability conditions, still need to be met.

Act reference: SSAct section 1061ZJA Modifications if person's rate of social security pension is nil on 1 January 2017

Policy reference: SS Guide 3.9.3.30 Assessment of income for CSHC, 3.9.1.20 Qualification for LIC, 3.9.1.70 LIC - assessment of income

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