What's new?

July 2014

Improvements will be made to the way some PBS medicines are processed under the Highly Specialised Drugs Programme from 1 July 2015.

Early Release of Superannuation – Guidance for medical/dental practitioners and specialists

A person may apply for early release of superannuation for a number of medical reasons. We can consider applications to meet the cost of medical treatment that is not readily available through the public health system, for example, medical procedures, appointments or medication.

This page provides information to registered medical/dental practitioners and specialists to help you understand what is required to satisfy these grounds.

Under Regulation 6.19A(1) of the Superannuation Industry (Supervision) Regulations 1994, a person may apply to the Department of Human Services (DHS) for early release of superannuation benefits on a number of compassionate grounds. These include:

  • pay for medical or dental treatment for the person or their dependant where the treatment is not readily available through the public health system or covered by health insurance
  • pay for transport for medical or dental treatment for the person or their dependant
  • modify the person's home or vehicle to accommodate a severe disability for them or their dependant
  • pay for expenses associated with palliative care for a terminal illness for them or their dependant.

Early release of superannuation for medical treatment

We can consider applications to meet the cost of medical treatment that is not readily available through the public health system, for example, medical procedures, appointments or medication. Regulation 6.19A(3)(a) requires the applicant give us written statements from two registered medical practitioners (one must be a specialist), which certify that the medical treatment is necessary to:

(i) treat a life threatening illness or injury or
(ii) alleviate acute or chronic pain or
(iii) alleviate an acute or chronic mental disturbance.

Medical treatment includes dental treatment. In these cases, certification must be provided by either two dental practitioners (one must be a specialist) or a General Practitioner and a dental specialist. Regulation 6.19A(3)(b) requires the medical/dental practitioner to certify that this treatment is not readily available through the public health system.

Who is a registered medical/dental practitioner?

A registered medical/dental practitioner has passed the required examinations and/or graduated from an accredited course and is registered by the relevant state registration board to practice. In most cases one of the medical/dental practitioners who provides a supporting letter will be the applicant's (or their dependant's) GP or dentist.

Who is a registered medical/dental specialist?

A registered medical/dental specialist is a medical practitioner or dentist who has had further medical training, holds further qualifications and is a fellow of a specialist medical college or is registered in their state as a specialist. A consultant physician is considered a specialist under the legislation. Any specialist giving an opinion should be specialised in the area where they are giving that opinion. Consultant physicians should clearly state their area(s) of specialisation in the certification.

Allied health professionals

Allied health professionals (including physiotherapists, psychologists, chiropractors and occupational therapists) are not considered medical practitioners under the legislation. Allied health professionals can supply additional evidence along with that provided by a GP or a specialist (for example, confirmation that a patient is being treated for a particular condition), however, it cannot be used as certification.

What is meant by 'life threatening'?

The term 'life threatening' should only be used where you determine that without recommended treatment it is likely that within 12 months the patient:

  • will die or
  • will suffer an irreversible degeneration of a condition that, if left untreated, would result in premature death.

A generic classification such as a 'potentially life threatening illness' is generally not sufficient to meet this requirement. There must be a clear and direct link between the current state of the illness or injury and the threat to the patient’s life.

What is meant by 'acute' and 'chronic'?

'Acute' refers to the rapid onset or progress of a condition and suggests that the condition has progressed to a stage where there is some urgency for treatment.

'Chronic' refers to a condition having an indefinite duration or less rapid change. The condition may have been stable for some time or be one which is characterised by periods of relapse or remission. It would usually refer to a condition of at least three months duration.

Certification using non-specific terms such as 'chronic medical condition' is generally not sufficient to meet this requirement.

What is meant by 'not readily available through the public health system'?

Regulation 6.19A (3) states that money can be released for medical treatment only if the treatment is not readily available through the public health system.

While medical treatment may be available through the public health system, the issue is whether it is readily available to the applicant or their dependant. The requirement is satisfied if treatment is available in a public hospital but only after a very long waiting period, which the applicant or their dependant cannot wait, or a surgeon requires the applicant go to a private hospital beyond their means (or they do not have private health insurance).

You must certify that the treatment is both necessary and not readily available in the public health system.

Medical transport

We can consider early release of superannuation to meet costs associated with transport to access medical treatment, for example, public transport, vehicle repairs, vehicle running costs or purchase of a reliable second hand vehicle.

In addition to meeting the certification requirements for 'medical treatment', a treating registered medical practitioner or specialist must also certify:

  • transport is required to access medical treatment
  • the frequency of the required medical treatment
  • the location of the medical appointments
  • the length of time the treatment is expected to be required.

Report for medical practitioners and/or specialists

Medical practitioners need to complete a Report for medical practitioners and or specialists. This information will help us determine if a customer is eligible to access their superannuation early.

Modifications to a home or motor vehicle

We can consider early release of superannuation to assist an applicant or their dependant to modify the applicant's home or vehicle if they have special needs arising from severe disability. Examples include installing ramps, widening doorways or installing hand controls.

In some cases, early release of superannuation to purchase aids such as wheelchairs, hearing aids or dentures may also be considered.

An application on this ground should be supported by a letter from a medical practitioner, which confirms:

  • the existence of the severe disability
  • the special needs it may give rise to
  • the utility of the proposed modifications.

The letter should also confirm that the cost of any modifications or aids required will not be met through the public health system, government program or nongovernment organisation.

Palliative care

We can consider early release of superannuation to assist an applicant or their dependant with the cost of palliative care. Examples include reasonable costs of accommodation in a hospice, employment of a palliative care nurse or the purchase of necessary medications. An application should be supported by a medical certificate, which states that the person is terminally ill and requires palliative care.

What is meant by 'palliative care'?

Palliative care can be described as the specialised care of people who are dying. A person receiving palliative care will most likely have an active, progressive and far advanced disease, with little or no prospect of cure.

It is important to note that another ground exists for the early release of superannuation benefits on the basis of terminal illness. This is administered by an individual’s superannuation fund, and not the department.

More information

For more information on the early release of superannuation please call 1300 131 060 or email ERSBenquiries@humanservices.gov.auEmail.

If you do not speak English and need help from us, ring the Translating and Interpreting Service on +61 131 450 between 8.30 am and 4.45 pm (local time), Monday to Friday.

Last updated: 24 July, 2013