National Health (Lifetime Health Cover) Regulations 2000 (Cth)
made under the
This compilation was prepared on 6 June 2003
taking into account amendments up to SR 2000 No. 273
Prepared by the Office of Legislative Drafting,
Attorney-General’s Department, Canberra
These Regulations are the
National Health (Lifetime Health Cover) Regulations 2000 .
These Regulations commence on 1 July 2000.
In these Regulations:
Act means theNational Health Act 1953 .
(1) For the purpose of paragraph 3 (1) (b) of Schedule 2 to the Act, if the rules of a registered organization provide for suspension of hospital cover for an adult beneficiary, suspension may be granted by the registered organization concerned on the request of:
(a) the contributor for that cover; or
(b) the adult beneficiary.
(2) A period during which cover is suspended under paragraph 3 (1) (b) of Schedule 2 to the Act does not include a day referred to in paragraph 3 (1) (a) of Schedule 2 to the Act.
(3) The requirement, under subparagraph 3 (2) (b) (ii) of Schedule 2 to the Act, for a person who has suspended cover on or after 1 July 2000 but before 2 July 2001, is that the aggregate period of continuous contributions for that cover, before and after the period of suspension, be at least 366 days occurring after 30 June 2000.
(1) If a person becomes an adult beneficiary of hospital cover provided by a registered organization (the
new organization ) at a time when the person has suspended cover granted by another registered organization, the new organization must recognise, for the purposes of the Act, that the person has existing hospital cover.(2) Subregulation (1) does not apply to suspended cover that has been continuous for more than 2 years.
Note Subregulation (2) does not prevent the new organization from recognising existing hospital cover that has been suspended for more than 2 years, if the organization so elects.
(1) Subclause 4 (2) of Schedule 2 to the Act applies to persons in the following classes:
(a) a person whose health services are provided by the Australian Antarctic Division of the Department of the Environment and Heritage;
(b) a member of the Australian Defence Force on continuous full time service whose health services are provided by the Australian Defence Force;
(c) a dependant of a member mentioned in paragraph (b) whose health services are also provided by the Australian Defence Force;
(d) a person who is an Australian citizen or the holder of a permanent visa (within the meaning of the
Migration Act 1958 ), if:(i) the person:
(A) is overseas on 1 July 2000; and
(B) has not subsequently returned to, and remained in, Australia, for a period longer than 90 days; or
(ii) on and after 1 July 2000, the person is not residing in Australia.
(2) Subclause 4 (2) of Schedule 2 to the Act applies, for subparagraph 1 (1) (b) (ii) of that Schedule, to a person mentioned in paragraph (1) (a), (b) or (c) who, because of that paragraph, is taken to have hospital cover on 1 July 2000, and to a person mentioned in paragraph (1) (d).
(3) For subparagraph (1) (d) (ii), a person is not residing in Australia if the person is not in Australia for a continuous period longer than 90 days.
For paragraphs 10 (1) (b) and (2) (b) of Schedule 2 to the Act, the Minister must be satisfied that the person received an income support payment, within the meaning of the
Social Security Act 1991 , or was the holder of a Health Care Card, during the period beginning on 1 July 1999 and ending on 1 July 2000, and:
(a) has had hospital cover, or cover for ancillary benefits provided by a registered organization, that, in total, amounts to at least 3 years; or
(b) having been a member of the Australian Defence Force on continuous full time service, had his or her health services provided by the Australian Defence Force for at least 3 years; or
(c) during the period beginning on 1 July 1997 and ending on 1 July 2000:
(i) has had hospital cover, or cover for ancillary benefits provided by a registered organization, that, in total, amounts to at least 12 months; or
(ii) has been a member of the Australian Defence Force on continuous full time service, whose health services were provided by the Australian Defence Force for at least 12 months.
(1) For paragraphs 10 (1) (b) and (2) (b) of Schedule 2 to the Act, the Minister must be satisfied that, on 1 July 2000, the person is not entitled to Medicare benefits, and:
(a) is a person who:
(i) on 30 September 1999, was an Australian resident; and
(ii) holds a permanent visa; or
(b) is a person to whom an item in Schedule 1 applies.
(2) In this regulation, and in Schedule 1, a reference to
visa , or to avisa orentry permit of a particular class or subclass, has the same meaning as in theMigration Act 1958 orMigration Reform Act 1992 or in an instrument made under either of those Acts.
For paragraphs 10 (1) (b) and (2) (b) of Schedule 2 to the Act, the Minister must be satisfied that, because of exceptional circumstances affecting the person, it would be unreasonable to expect the person to have had hospital cover on 1 July 2000, but the person:
(a) has had hospital cover, or cover for ancillary benefits provided by a registered organization, that, in total, amounts to at least 3 years; or
(b) having been a member of the Australian Defence Force on continuous full time service, had his or her health services provided by the Australian Defence Force for at least 3 years; or
(c) during the period beginning on 1 July 1997 and ending on 1 July 2000:
(i) has had hospital cover, or cover for ancillary benefits provided by a registered organization, that, in total, amounts to at least 12 months; or
(ii) has been a member of the Australian Defence Force on continuous full time service, whose health services were provided by the Australian Defence Force for at least 12 months.
(1) An adult beneficiary requesting information about his or her hospital cover must be given the information, within 14 days of receipt of the request, by the registered organization providing the cover.
(2) Regardless of subregulation (1), a registered organization must give information, each year, to adult beneficiaries (except those for whom no contribution has been paid for the immediately preceding 12 months), about the hospital cover provided by the organization.
(3) The information must be clearly and simply expressed in writing, and must include:
(a) details of the type and level of cover applying to the adult beneficiary; and
(b) if the contributor has made an election under paragraph (ba) of Schedule 1 to the Act, details of the extent of the cover given by the applicable benefits arrangement applying; and
Example The terms of the cover may excuse the organization from meeting hospital expenses to the extent of arrangements known as
front-end deductibles ,co‑payments ,claimant’s excess andexclusions .(c) for an adult beneficiary affected by clause 1 or 2 of Schedule 2 to the Act, details of the amount by which contributions are consequently increased; and
(d) details of the organization’s record of the number of days the adult beneficiary has not had hospital cover since the beneficiary’s Schedule 2 application day, other than days to which paragraph 3 (1) (b) of Schedule 2 to the Act applies.
(4) Information under paragraphs (3) (c) and (d) may be expressed as a record based on an age notionally attributed to the adult beneficiary (known as the
certified age at entry ) as the age from which he or she is treated as having had continuous hospital cover.(5) The information may be given as a notice, or may be included with other information, sent to the adult beneficiary.
Example The information could be included in a statement issued under paragraph 4 (1) (a) of the
Private Health Insurance Incentives Regulations 1998 .(6) In the case of hospital cover applying jointly to adult beneficiaries, the information must be given to each joint beneficiary, and must set out the details applying to each, but, if any share an address, may be sent in a single notice to the beneficiaries at that address.
A person who applies to become, or inquires about becoming, an adult beneficiary in respect of hospital cover, must be given the following information by the registered organization providing the cover:
(a) the effect of clause 1 of Schedule 2 to the Act in respect of contributions payable under the rules of the organization by a person who is late, within the meaning of that clause, in taking out the hospital cover provided;
(b) the effect of clause 2 of Schedule 2 to the Act in respect of contributions payable under the rules of the organization by a person who, after 1 July 2000, ceases, for any period, to have hospital cover.
(1) For subclause 12 (2) of Schedule 2 to the Act, a registered organization giving information to another registered organization about increases under Schedule 2 to the Act in the amounts of the contribution payable for hospital cover must comply with subregulation (2).
(2) If the information includes details about a particular adult beneficiary, the information may only be provided:
(a) with the permission of the adult beneficiary; and
(b) in the case of joint hospital cover — with the permission of the adult beneficiary who is the contributor.
(3) Information under this regulation may be expressed as a record based on an age notionally attributed to the adult beneficiary (known as the
certified age at entry ) as the age from which he or she is treated as having had continuous hospital cover.
(1) For paragraph 13 (a) of Schedule 2 to the Act, a registered organization must accept the following kinds of evidence as conclusive evidence of a person having had hospital cover at a particular time, or during a particular period:
(a) the annual statement issued to, or on behalf of, the person by the registered organization (if any) providing the cover at the particular time or during the particular period;
(b) a determination made under subclause 10 (1) or (2) in Schedule 2 to the Act in respect of the person, if the date to which the determination applies is the particular time or is included in the particular period;
(c) a written statement issued by the Australian Antarctic Division of the Department of the Environment and Heritage, that the person had health services provided by the Australian Antarctic Division at the particular time or during the particular period;
(d) a written statement issued by the Australian Defence Force that the person had health services provided by the Australian Defence Force at the particular time or during the particular period.
(2) For paragraph 13 (b) of Schedule 2 to the Act, a registered organization must accept the following kinds of evidence as conclusive evidence of a person’s age:
(a) an original birth certificate in respect of the person;
(b) a current driver’s licence issued to the person;
(c) a current passport issued to the person.
(3) A registered organization may accept other evidence if a document of a kind mentioned in subregulation (1) or (2) is not available to be given in evidence.
(paragraph 8 (1) (b))
Persons who may be affected by paragraphs 10 (1) (b) and (2) (b) in Schedule 2 to the Act
For a person to whom paragraph 8 (1) (b) applies, the Minister must be satisfied that any of the following circumstances apply:
(a) the person has applied for a permanent visa, or permanent entry permit, before 30 September 1999 and, as a result of the application:
(i) is granted a permanent visa, or a transitional (permanent) visa, before 1 July 2002; and
(ii) if granted the visa outside Australia, enters Australia as holder of that visa before 1 July 2002;
(b) the person has applied for an Extended Eligibility (Temporary) (Class TK) visa and General (Residence) (Class AS) visa on or after 1 September 1994 and before 30 September 1999, and:
(i) is granted an Extended Eligibility (Temporary) (Class TK) visa, before 1 July 2002; and
(ii) remains an applicant for a General (Residence) (Class AS) visa;
(c) the person has applied for a Spouse (Provisional) (Class UF) visa and Spouse (Migrant) (Class BC) visa on or after 1 September 1994 and before 30 September 1999, and:
(i) enters Australia as holder of a Spouse (Provisional) (Class UF) visa, before 1 July 2002; and
(ii) remains an applicant for a Spouse (Migrant) (Class BC) visa;
(d) the person has applied for an Interdependency (Provisional) (Class UG) visa and Interdependency (Migrant) (Class BI) visa on or after 1 September 1994 and before 30 September 1999, and:
(i) enters Australia as holder of an Interdependency (Provisional) (Class UG) visa, before 1 July 2002; and
(ii) remains an applicant for an Interdependency (Migrant) (Class BI) visa;
(e) the person has applied for a Resolution of Status (Temporary) (Class UH) visa and Resolution of Status (Residence) (Class BL) visa before 30 September 1999; and:
(i) enters Australia as holder of a Resolution of Status (Temporary) (Class UH) visa, before 1 July 2002 or, being in Australia, is granted a visa of that class before that date; and
(ii) remains an applicant for a Resolution of Status (Residence) (Class BL) visa;
(f) the person:
(i) before 1 July 2002, is granted a transitional (temporary) visa because he or she has applied, under the Migration (1993) Regulations, for a Class 820 (Extended Eligibility (Spouse)) visa or entry permit; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under those Regulations, for a Class 801 (Spouse (After Entry)) entry permit;
(g) the person:
(i) before 1 July 2002, is granted, under the Migration (1993) Regulations, a Class 820 (Extended Eligibility (Spouse)) visa or entry permit that continues in effect, under the Migration Reform (Transitional Provisions) Regulations, as a transitional (temporary) visa; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under the Migration (1993) Regulations, for a Class 801 (Spouse (After Entry)) entry permit;
(h) the person:
(i) before 1 July 2002, is granted a transitional (temporary) visa because he or she has applied, under the Migration (1993) Regulations, for a Class 826 (Extended Eligibility (Interdependency)) visa or entry permit; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under those Regulations, for a Class 814 (Interdependency (Permanent)) entry permit;
(i) the person:
(i) before 1 July 2002, is granted, under the Migration (1993) Regulations, a Class 826 (Extended Eligibility (Interdependency)) visa or entry permit that continues in effect, under the Migration Reform (Transitional Provisions) Regulations, as a transitional (temporary) visa; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under the Migration (1993) Regulations, for a Class 814 (Interdependency (Permanent)) entry permit;
(j) the person:
(i) before 1 July 2002, is granted a transitional (temporary) visa because he or she has applied, under the Migration (1989) Regulations, for an extended eligibility (spouse) entry permit or visa; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under those Regulations, for a spouse (after entry) entry permit;
(k) the person:
(i) before 1 July 2002, is granted, under the Migration (1989) Regulations, an extended eligibility (spouse) entry permit or visa that continues in effect, under the Migration Reform (Transitional Provisions) Regulations, as a transitional (temporary) visa; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under the Migration (1993) Regulations, for a spouse (after entry) entry permit;
(l) the person:
(i) before 1 July 2002, is granted a transitional (temporary) visa because he or she has applied, under the Migration (1989) Regulations, for an extended eligibility (interdependency) entry permit or visa; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under those Regulations, for an interdependency (permanent) entry permit;
(m) the person:
(i) before 1 July 2002, is granted, under the Migration (1989) Regulations, an extended eligibility (interdependency) entry permit or visa that continues in effect, under the Migration Reform (Transitional Provisions) Regulations, as a transitional (temporary) visa; and
(ii) is an applicant for a transitional (permanent) visa because he or she is an applicant, under the Migration (1989) Regulations, for an interdependency (permanent) entry permit.
The
2000 No. 106 | 15 June 2000 | 1 July 2000 | |
2000 No. 273 | 5 Oct 2000 | 5 Oct 2000 | — |
am. = amended rep. = repealed rs. = repealed and substituted | |
R. 6......................................... | am. 2000 No. 273 |
R. 7......................................... | am. 2000 No. 273 |
R. 9......................................... | am. 2000 No. 273 |
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