Medicare enrolment form (MS004)

Use this form to enrol in Medicare for the first time, re-enrol in Medicare or enrol your newborn child in Medicare. This replaces the 3101 version of the form.

Complete and return your form

  1. Open the Medicare enrolment form, fill it in, print and sign it.
  2. Submit your form and supporting documents to us. The instructions are on the form.

You don’t need to complete this form for a newborn child enrolment if you chose to enrol them in Medicare when making a claim for Parental Leave Pay, Family Tax Benefit or Dad and Partner Pay.

Read more about how to add your newborn to your Medicare card as well as further information to consider when having a baby.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you use assistive technology because of a disability or impairment we provide help for assistive technology users of forms.

Page last updated: 5 March 2018