3.9.1.20 Qualification for Low Income HCC

Qualification (1.1.Q.10) criteria

To qualify for a low income HCC, 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.

Act reference: SSAct section 7(2) An Australian resident is a person who:...

YA, Austudy & ABSTUDY recipients & the low income HCC (LIC)

YA job seekers automatically receive a HCC with their payments. However YA, Austudy and ABSTUDY students are required to test their eligibility for the LIC. The policy rationale that allows the automatic issue of HCCs to YA job seekers but not to YA (and Austudy and ABSTUDY) students, lies in the potential for these students to receive a higher level of income than YA job seekers. With a more generous income test, and access to a student income bank, these students can earn substantially more than YA job seekers, and more than the LIC cut-out, before they lose qualification for YA (and Austudy and ABSTUDY). It is therefore considered appropriate to require these students to claim the HCC, and meet the relevant income test, in order to qualify for a concession card.

Payments of YA, Austudy and ABSTUDY must be included as assessable income for LIC purposes.

Policy reference: SS Guide 3.9.1.70 Low Income HCC - Assessment of Income

FTB recipients & the low income HCC

If a person applies for FTB, and is rejected, or does not receive the maximum fortnightly rate (and associated auto HCC), they may test their eligibility for a low income HCC under the 8 weekly income test.

Explanation: FTB is based on an annual income estimate while the low income HCC is assessed on actual income over an 8 week period prior to claim.

Low income HCC holder claims FTB

If a low income HCC holder claims FTB, the following scenarios apply, where the maximum rate of FTB is:

• payable (by instalment), the associated FTB HCC is issued and supersedes the low income HCC, AND
• not payable, qualification for the low income HCC continues unless the person becomes ineligible.

Example: The person is no longer eligible when income equals or exceeds the relevant 125% income limit.

Policy reference: SS Guide 3.9.1.70 Low Income HCC - Assessment of Income

FA Guide 1.1.A.20 Adjusted taxable income (ATI)

Cardholders travelling overseas

From 1 January 2013 concession cards have a limited non-cancellation period of 6 weeks if the holder departs Australia temporarily. Low income 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

Claimants returning from overseas who require urgent medical attention

Claimants returning from an overseas trip of longer than 6 weeks (including, for example, overseas volunteers and missionaries) who require urgent medical attention can lodge their HCC claim forms immediately on return to Australia and have them processed as a matter of urgency. This ensures that claimants can gain immediate access to medical treatment at the concessional rate (where the medical provider offers a concession).

Residence requirements - New Zealanders

While an SCV holder (non-protected) may qualify for the LIC, SCV holders must have been living in Australia for a period or periods totalling 104 weeks for the LIC to be granted.

Act reference: SSAct section 1061ZQ(2) Newly arrived resident's waiting period

Policy reference: SS Guide 3.1.1 Residence Requirements, 3.1.2.40 Newly Arrived Resident's Waiting Period

Residence qualification - international health agreements

Visitors from other countries including those with which Australia has an international health care agreement are NOT residentially qualified for a low income HCC. These people however may wish to enquire at a Medicare office about their eligibility for Medicare assistance.

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. They do not fall within the 'in gaol' definition under SSAct section 23(5) and may qualify for claimable concession cards like the LIC.

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, section 23(5) For the purposes of this Act, a person is in gaol if...

CSHC holders & the low income HCC

CSHC holders who also meet the low income HCC income test can qualify for and retain both concession cards.

Act reference: SSAct section 1061ZO Qualification for health care cards for which claim required

Card claim & issue

The low income HCC can be claimed using form number SS050 - 'Claim for HCC'. When granted, the HCC is issued for a period of 26 weeks. Cardholders are required to advise Centrelink if a notifiable event occurs during this period. Renewal forms (reviews of eligibility) are issued automatically to the cardholder towards the end of the card issue period to allow them to retest their eligibility.

Policy reference: SS Guide 3.9.1.90 Notification & Recipient Obligations for HCC, 3.9.1.70 Low Income HCC - Assessment of Income

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Last reviewed: 3 January 2013