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3.9.1.10 Qualification for HCC - Automatic Issue

Qualification (1.1.Q.10) criteria

HCCs are either automatic issue cards or claim required cards. This topic covers only the automatic issue HCCs.

 

To qualify for and obtain an automatic issue HCC, a person must:

  • be receiving payments or be eligible for specific programs which automatically attract a HCC (see table 1), or
  • be in an employment income nil rate period (see table 2), or
  • have stopped receiving their social security pension or benefit because of commencing employment or increasing employment income and be qualified to keep their HCC for one or both of the allowable extension periods (i.e. be an employment-affected person) (see tables 3 and 4), or
  • have commenced NDIS participation and had their MOB cancelled as a result (see table 5).

 

The 5 tables below set out who receives an automatic issue HCC, the act reference that applies and the period for which the card is issued.

 

Act reference: SSAct section 23(1)-'income support payment'

 

Table 1 - Payments attracting HCC while person receiving income support

Requirement

SSAct section

Period of Issue

Be receiving:

- NSA other than as a single principal carer or with a partial capacity to work,

- YA other than a full-time Australian apprentice or full-time student, or as a single principal carer or with partial capacity to work,

- partner allowance,

- widow allowance,

- benefit PP (partnered),

- special benefit,

- exceptional circumstances relief payment,

- farm help income support,

1061ZK(5)(b)(i)

1061ZK(5)(a)

1061ZK(5)(b)(ii)

1061ZK(5)(b)(iii)

1061ZK(5)(b)(iv)

1061ZK(5)(b)(vi)

1061ZK(6)

1061ZK(6)

12 weeks

12 weeks

12 weeks

12 weeks

12 weeks

12 weeks

12 weeks

12 weeks

- sickness allowance,

1061ZK(5)(b)(v)

period of medical certificate to a maximum of 13 weeks

- FTB Part A by instalment,

- MOB (non-pensioner),

1061ZK(4)

1061ZK(7)

26 weeks

26 weeks

- CP (child) episodic or short term care,

- CA (child),

- CA (child) HCC only.

1061ZK(3A)

1061ZK(2)

1061ZK(3)

26 weeks

12 months

12 months

 

Act reference: SSAct section 1061ZK Qualification: general rules

 

Provisions for CDEP participants

CDEP participants receiving the CPS and/or add-ons are taken to be in receipt of an income support payment. They receive the HCC appropriate to their payment type.

 

Act reference: SSAct section 1061ZK Qualification: general rules

 

Table 2 - Payments attracting HCC continuation while person has an employment income nil rate period

Requirement

SSAct section

Period of Issue

Remain qualified for a payment listed below, although payment is not payable because of employment income:

- benefit PP (partnered),

- NSA other than as a single principal carer or with partial capacity to work,

- sickness allowance,

- widow allowance,

- partner allowance,

- YA (other than as an Australian apprentice or full-time student) or a single principal carer or with partial capacity to work.

section 1061ZMA Further extended qualification rule: loss of payment because of employment income

up to 12 weeks

Explanation: The 12 week continuation during the employment income nil rate period aims to provide an incentive for recipients to take up work. NSA and YA (job seeker) recipients who are single principal carers or with partial capacity to work remain qualified for PCC during employment income nil rate periods.

 

Policy reference: SS Guide 3.1.12 Employment Income Nil Rate Period

 

Table 3 - Payments attracting HCC extension for employment-affected persons

Requirement

SSAct section

Period of Issue

Be a qualified recipient of an income support payment listed below, who becomes an employment-affected person through commencement of employment by self or partner OR though an increase in employment income of self or partner:

- pension PPS*,

- NSA (other than those who hold a PCC),

- sickness allowance,

- special benefit,

- widow allowance,

- partner allowance,

- YA (job seeker).

section 1061ZM Qualification for health care card: employment-affected person

26 weeks

Explanation: The 26 week extension aims to provide an incentive for long-term income support recipients to take up work.

* Note: PPS recipients who qualify for an employment income nil rate period retain their PCC during the nil rate period and receive a HCC for the balance of the 26 week HCC extension as the extension periods run concurrently.

 

Table 4 - Special concession card extensions for single principal carers in receipt of NSA or YA (job seeker)

Requirement

SSAct section

Period of Issue

HCC kept for a further 14 weeks following a cessation of 12 weeks extended qualification for a PCC through commencement of employment or an increase in ordinary income from employment:

- NSA single principal carer,

- YA (job seeker) single principal carer.

section 1061ZM(1BA) If the person...

For a period commencing on the day they cease to be qualified for a PCC and ending 26 weeks from the day on which they cease to be an employment-affected person.

Explanation: The 2 extensions (approximately 12 weeks PCC followed by about 14 weeks HCC) aim to provide an incentive for single principal carers to take up work.

 

Table 5 - MOB HCC continuation for certain NDIS participants

Requirement

Act References

Period of Issue

The MOB HCC can be retained where a person:

- commences NDIS participation,

- their NDIS plan contains funding for reasonable and necessary supports, and

- their MOB is cancelled as a result.

SSAct section 1061ZK(7) ...on that day, the person is receiving MOB, section1038 MOB not payable when person is NDIS participant

 

National Disability Insurance Scheme Legislation Amendment Act 2013 Schedule 2 item 17

Reissued every 26 weeks, subject to ongoing eligibility.

 

Qualification - HCC during an 8 week non-payment period

Income support recipients serving an 8 week non-payment period due to a serious participation failure or multiple participation failures retain access to their HCC during the non-payment period.

 

Qualification - HCC during employment income nil rate period

A person is qualified to START a 12 week HCC continuation if they:

  • are below age pension age (1.1.P.129), and
  • stop receiving their social security pension or benefit because of ordinary income, made up entirely or partly of employment income (1.1.E.102), and
  • have a rate of payment of pension or benefit that is worked out with regard to the income test module of a rate calculator in Chapter 3, and
  • have and are qualified for a HCC when their payment ceases, and would have been qualified for the HCC but for the employment income or the combined income.

Example 1: Skye is a NSA recipient who takes up a casual job that is expected to last for 4 weeks, but could be extended. In the first fortnight that she earns income from the job her NSA is reduced to nil rate. None of Skye's other circumstances change, so if she had not received the employment income she would have continued to receive NSA and be entitled to the HCC. Skye is qualified to start the 12 week HCC continuation, and provided her other circumstances do not change she will remain qualified for it until the job finishes, or the end of 12 weeks, whichever is the earlier.

 

Example 2: Kyle is a NSA recipient who starts a full-time job and is no longer qualified for NSA because he is no longer unemployed. Kyle does not qualify for a HCC continuation because he is no longer qualified for NSA. If Kyle had been a qualified recipient of the payment for a continuous period of 52 weeks prior to the cancellation of his payment he would be entitled to a 26 week continuation of HCC entitlement under SSAct section 1061ZM when he ceased to be an employment-affected person.

 

A person is qualified for the HCC continuation for 12 weeks if they continue to satisfy the following criteria:

  • are below age pension age, and
  • continue to qualify for their income support payment but for their employment income, or such income combined with other income.

Example: Catriona is a NSA recipient who starts a casual job. In the first fortnight she earns over the income cut-out point, so she commences a HCC continuation. In the next fortnight she accepts a permanent full-time job, which makes her ineligible to keep the HCC continuation. She may be eligible for EEP, and for the 26 week HCC extension.

 

Start date - HCC continuation during employment income nil rate period

The 12 week HCC continuation starts on the date the recipient's rate reduces to nil (i.e., after any working credit balance has been used), and finishes 12 weeks after the end of the entitlement period in which the person ceased to receive the income support payment. In effect the period that is referred to as 12 weeks could run for up to almost 14 weeks.

 

HCC kept for a 26 week extension - employment-affected persons

Income support recipients (as listed in the table 3 above) can keep their HCC for a 26 week extension if they:

  • have been in receipt of income support payments for a continuous period of 52 weeks immediately prior to cancellation and have employment or employment income that precludes their payment, OR
  • have been in receipt of income support payments for a continuous period of 52 weeks immediately prior to cancellation (this can include the period the recipient has been on an employment income nil rate period) and have had their 12 week HCC continuation and are still employed at the end of the employment income nil rate period.

Explanation: This provision aims to encourage long term unemployed people to take up work by allowing them to retain their HCC for 26 weeks after they start a job.

 

Start date for 26 week HCC extension - employment-affected HCC holder

If the cardholder has been on the 12 week HCC continuation, the 26 week HCC extension starts on the day after the 12 week continuation finishes.

 

If the cardholder has not been on the 12 week HCC continuation, the 26 week HCC extension starts the day after the person's social security pension or benefit is cancelled (after any working credit balance has been used).

 

Act reference: SSAct section 1061ZM Qualification for health care card: employment-affected person, section 1061ZMA Further extended qualification rule: loss of payment because of employment income, section 1061ZEA Further extended qualification rule: loss of payment because of employment income

Policy reference: SS Guide 3.1.11.30 Working Credit Depletion

 

Interaction of HCC 12 week continuation & 26 week extension

A cardholder can be qualified for both the 12 week continuation and the 26 week extension or for either one of them.

 

If the cardholder is qualified for both the continuation and the extension, the 12 week continuation runs first, then the 26 week extension. The time the cardholder spends on the 12 week HCC continuation counts towards the qualifying period of receipt requirement for the 26 week extension.

 

Start date for 26 week HCC extension - employment-affected PCC holder

If the PCC holder has been on either the 12 week PCC continuation or extension, the 26 week HCC extension starts on the same day as the 12 week PCC continuation or extension commences.

 

Cardholders travelling overseas

From 1 January 2013 concession cards have a limited non-cancellation period of 6 weeks if the holder departs Australia temporarily. Therefore, all auto-issue HCCs will remain current if the holder departs Australia temporarily (for no more than 6 weeks).

 

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

_______________________________________________________

Last reviewed: 20 September 2013


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Last Edited: 09/09/2013 3:19:46 PM


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