19AB or 19AA Spousal Exemption for Medicare Provider Number

There is nothing like 19AA spousal exemption. However, there is 19AB spousal exemption for the overseas trained doctors who are subject to 19AB. Exemptions under the spousal provisions as set out within the Guidelines for Section 19AB of the Health Insurance Act 1973 (HIA).

Background to the spousal provisions

The Guidelines for section 19AB of the HIA include spousal provisions that allow overseas trained doctors (OTDs) and foreign graduates of accredited medical schools (FGAMS) who meet specific eligibility criteria to obtain a section 19AB(3) exemption so that they may access the Medicare benefits arrangements at a location close to their spouse’s place of employment. The spousal provisions apply to OTDs and FGAMS who are the medically qualified spouses of:

  • A medical practitioner who is not subject to the ten year moratorium requirement under section 19AB of the HIA;
  • An OTD or FGAMS who has received an exemption under section 19AB(3) of the HIA to access the Medicare benefits arrangements at a specific location; or
  • A person (non-medical practitioner) who was assessed by the Department of Immigration and Border Protection (DIBP formerly DIAC) as a skilled migrant within the ten years preceding the application, has been assessed by a relevant assessing authority as having a skilled occupation in demand and is currently employed, undertaking training or volunteering in a skilled occupation in Australia.

Applying for a spousal exemption

The application process for a spousal exemption is separate from the Medicare provider number application process. In order to apply for an exemption under the spousal provisions, the applicant doctor is required to provide the following supporting documentation to the Department of Health:

  • Evidence of spousal relationship (such as a marriage certificate);
  • Evidence of living together (joint bank account details, a lease agreement for a house, bills for utilities showing both parties live at the same residential address);
  • Current medical registration details of the applicant;
  • Passport page(s) and visa status (applicant and spouse);
  • The current work contract of spouse, including the occupation name and location;
  • (If the spouse is not a medical practitioner:) evidence that the applicant’s spouse was granted a skilled migration visa in the past ten years and that their skills and qualifications have been assessed by a DIBP approved assessing authority.
  • (If the spouse is a medical practitioner:) evidence of the spouse’s current medical registration details and if subject to s19AB of the HIA, evidence of a current s19AB(3) exemption.

All supporting documentation needs to be submitted as one submission, which will be considered the formal application for a spousal exemption under s19AB of the HIA. Health recommends supporting documents are provided in .PDF format. Failure to supply all required supporting documentation may result in the delegate being unable to grant favourable consideration to the application.

Applications are assessed and an outcome provided within 28 days. Applications should be emailed to 19AB@health.gov.au