DATE OF ISSUE: 24 JANUARY 1996
BUDGET INITIATIVE: EXTENDED ELIGIBILITY FOR COMMONWEALTH SENIORS HEALTH CARD (CSHC)
INTRODUCTION
The purpose of this Departmental instruction is to provide information about the extension of eligibility for the CSHC to widows, widowers and non-illness separated spouses of veterans. This amendment received Royal Assent on 14 November 1995.
BACKGROUND
2.The CSHC was introduced in July 1994 to provide health concessions to those retirees and other eligible veterans of pension age who fail to qualify for a service pension payment because they exceed the Assets Test limit or do not meet the 10 year residency rule.
3.Under the existing legislation, widowers and non-illness separated partners are eligible for the Pensioner Concession Card (PCC) if they retain partner service pension. The legislation precluded DVA from issuing the CSHC to widow/ers and non-illness separated spouses who lose entitlement to the PCC even though they are still eligible for the CSHC from DSS by virtue of meeting the income and assets test requirements. Potentially they could alternate in and out of DVA entitlement. The situation was exacerbated by the increase from partner rate to standard rate pension for widowed and separated partners of former veteran service pensioners in March 1995. This change has encouraged these partners to transfer from DSS to DVA to receive their pension.
4.As part of the 1995/96 Budget, the Government announced the extension of eligibility for the CSHC to widows, widowers and non-illness separated partners of veterans to remove this anomoly.
LEGISLATION
5.The legislative change to Section 118V of the Veterans' Entitlements Act 1986, introduced by the Veterans' Affairs (1995-96 Budget Measures) Legislative Amendment Bill 1985, enables DVA to issue the CSHC to widow/ers and non-illness separated spouses of veterans. This measure received Royal Assent on 14 November 1995. As a result, widow/ers of veterans and non-illness separated spouses of persons receiving an age or invalidity service pension no longer need to change between DSS for their CSHC and DVA for their PCC.
TARGET POPULATION
6.Current eligible clients retain their eligibility. Eligibility is now extended to:
the non-illness separated spouse of a person who is receiving an age or invalidity service pension;
the non-illness separated spouse of a person who is eligible for a seniors health card; and
a widow or widower of a veteran.
7.It is estimated that a maximum of 200 people gain eligibility under the extended criteria. Experience with the takeup rate for the CSHC suggests that less than half of those eligible will apply for the card. Takeup should be encouraged.
ELIGIBILITY
8.The person must be eligible for a partner service pension or income support supplement.
9.The other criteria for eligibility such as the age and residency requirements remain the same as for partners of veterans.
IDENTIFICATION OF EXTENDED GROUP
10.Some of the people eligible for the CSHC under the new rules may not have an entitlement number on the DVA database. This may be because they or their spouse did not receive any service pension or have not claimed for the CSHC. Where they have been eligible for the PCC and lose it due to a change in their marital or financial circumstances, they should be tested for eligibility for the CSHC in the same manner that existing PCC holders are tested when they lose eligibility. Consider the following senarios:
Case 1:WIDOW/ER OF SERVICE PENSIONER:
Couple on service pension with PCC at the time the veteran dies, but the widow/er later loses eligibility for the pension due to a change in circumstances.
The trial screen (PP.TR) and submission screen (PP.SU) produce a warning message:
'Client may be eligible for a CSHC''
when the assessment module verifies assets over, but income under the test cutoff limits. The examiner must check other eligibility criteria such as age when testing for CSHC eligibility.
Case 2:WIDOW/ER OF VETERAN, NOT SERVICE PENSIONER
Couple not receiving service pension or PCC at the time the veteran dies.
If we do not hold any details of this couple, the survivor must apply for the CSHC as a new application. These widow/ers will only learn of their eligibility through general media sources as we do not have a direct means of contacting them (as indeed we cannot identify other potential CSHC recipients). In some cases, the veteran and spouse may already have held a CSHC from DVA. In that case the CSHC should be continued.
Case 3:NON-ILLNESS SEPARATED SPOUSE OF SERVICE PENSIONER OR VETERAN ELIGIBLE FOR CSHC
Non-illness separated couple.
The non-illness separated spouse is eligible, subject to approval criteria, for the cshc regardless of whether the veteran receives a pcc, cshc or neither. When the separation is registered, the examiner should check the non-veteran's eligibility for the cshc. If sufficient details for the assessment are not held on the system, the person should be sent a cshc brochure and a letter notifying them of their possible eligibility.
PROCESSING APPLICATIONS FOR CSHC
11.Processing a CSHC application from a widow/er or non-illness separated partner will be the same as for existing clients. If the payments have previously been terminated, a full application must be processed with the following conditions:
if the assessment for the CSHC is successful, the same client details (personal and income/asset), are retained as for any other pension recipient. However, they are flagged as a nil rate pension client;
if an assessment for service pension or CSHC eligibility is unsuccessful, no details of the potential client are kept.
12.Where a current client loses PCC eligibility, a screen message warns the examiner that the client may be eligible for the CSHC. The examiner should assess them for CSHC eligibility on the basis of their existing data.
13.The entitlement number of the non-pension/non-income support supplement client remains the same as the entitling veteran spouse, with the same segment link they would have had if they had remained a couple (ie, A). The normal rules apply for the identification of successive partners.
14.Unless the widow/er or non-illness separated client submits details which remove their eligibility, the CSHC will be reissued automatically each year.
CONTACT OFFICER
15.The contact officer for enquiries regarding this Instruction is Annette Smith on (06) 289 4739.
RJ HAY
BRANCH HEAD
INCOME SUPPORT