Application to copy or transfer from one Medicare card to another form (MS011)

Complete this form to copy or transfer someone onto your own Medicare card or another Medicare card.

If you are 15 years or older the quickest and easiest way to get your own Medicare card or add someone to your card is online, using either:

If you are unable to do it online, download and complete the application to copy or transfer from one Medicare card to another form.

When the transfer or copy is to another person's Medicare card, that cardholder must also sign the form.

The applicant listed as person one on the form needs to send us both:

  • the completed form, signed by all those listed who are 15 years of age or older
  • their own identification.

You can send us your form and supporting documents using the email address and postal address on the bottom of the form. To help us process your request please include copy or transfer in the subject line. You don’t need to get your supporting documents certified.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.

Page last updated: 15 March 2023.
QC 34626

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