Claim for a Commonwealth Seniors Health Card form (SA296)

Use this form to claim a Commonwealth Seniors Health Card if you are age pension age.

New income limits for the Commonwealth Seniors Health Card

Subject to legislation coming into effect, new income limits will start from 20 September 2022. We’ll update our website when the legislation has passed. Read about the proposed changes on the Ministers for the Department of Social Services website.

Download and complete the Claim for a Commonwealth Seniors Health Card form.

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: 26 May 2022