What is medical treatment
For the purposes of release of super on compassionate grounds, medical treatment is the application of medicines or the practice of medicine (such as surgery or psychotherapy) to a person.
Eligibility conditions for medical treatment
The medical treatment must meet both of the following eligibility conditions:
- Condition 1 – you or your dependant must require the medical treatment to either
- treat a life-threatening illness or injury
- alleviate acute or chronic pain
- alleviate an acute or chronic mental illness.
- Condition 2 – the medical treatment is not readily available through the public health system.
If you or your dependant have borrowed money to pay for the medical treatment, further eligibility criteria for the borrowed amount will need to be met in addition to these conditions.
If you also need to access your super to pay for medical transport, you can apply in the same application.
Eligible treatments
Expenses for the following medical treatments may be eligible where specific evidence is provided:
- surgery
- psychiatric treatment
- medicinal drugs
- in vitro fertilisation (IVF) treatments, though additional evidence is required for IVF treatment
- dental treatment, though additional evidence is required for dental treatment.
Ineligible treatments
Other expenses that are generally not eligible under the medical treatment expense category include:
- treatment not related to Condition 1
- treatment that a registered medical practitioner doesn't consider necessary under Condition 1
- treatment for potential conditions – that is, medical conditions you may develop in the future but don't currently have
- cosmetic procedures that are not required to treat a life-threatening illness or alleviate acute or chronic pain or mental illness
- holidays, health retreats, spa treatments and gym membership, because they are general personal expenses.
- administration fees charged by a third party to help you prepare your application for compassionate release.
Cosmetic treatments
Experiencing pain or distress does not automatically mean you may be eligible for an early release of super. The thresholds set out in condition 1 are serious ones requiring your medical practitioner to apply sound, professional judgment as to whether they have been met.
Where treatment options include those with varying degrees of cosmetic outcomes, medical practitioners are expected to certify and quote for only the treatment necessary to effectively treat the eligible condition. Even if your preference is for a higher cost treatment which provides cosmetic benefits, we can only approve what is absolutely necessary to treat the eligible condition.
Both you and your medical practitioner can be subject to various penalties where the diagnosis and certification of the necessary treatment is found to be false or misleading.
Evidence for the expense
You must provide the following:
- An itemised quote or invoice listing any out-of-pocket expenses. It must show the amount and a description of each part of the treatment. If relevant, the date of each treatment stage or appointment should be included.
- Two medical reports about your condition and the treatment
- One report from a relevant registered medical specialist who is a specialist in the area that you're applying to have medical treatment for.
- One report from either a registered medical practitioner or another registered medical specialist.
The medical reports and quote or invoice must meet the timing requirements.
If you're applying to pay an expense for another person, you may need to provide evidence that you're in a dependent relationship with them.
Where the expense has been paid by borrowing money, additional documents are required.
Medical reports
Ask your registered medical practitioner to use our medical report form to make sure they provide all the information we need. We also provide information for health practitioners about how to provide an appropriate report.
The reports must clearly explain the following:
- What is your, or your dependant’s, specific condition and how it is a life-threatening illness or injury, acute or chronic pain or mental illness.
- What the medical treatment is to treat the condition.
- If your medical treatment is occurring over multiple cycles, the number of cycles required.
- Why it is necessary for you or your dependant to undertake this medical treatment.
- How the medical treatment will
- treat your, or your dependant’s, life-threatening illness or injury
- alleviate your, or your dependant’s, acute or chronic pain
- alleviate your, or your dependant’s, acute or chronic mental illness.
- That the medical treatment you or your dependant needs to treat the condition is not readily available through the public health system.
Treatment over multiple cycles
If your medical treatment occurs over multiple cycles, and you are submitting an application for a later cycle, you can use the same reports as you used in your first application if they are no more than 6 months old. You will also need to provide evidence that the prior cycle of treatment was completed and paid. If it is more than 6 months since your first application, you will need to provide 2 new medical reports.
Additional evidence for in vitro fertilisation (IVF) treatments
If your application for IVF treatment is to support the treatment of your acute or chronic mental illness, your application will require a medical report from a psychiatrist and a registered medical practitioner outlining how IVF treatment will support your mental health.
If your IVF treatment requires donor gametes or embryos, your medical reports will need to support the need for these expenses. Your quote or invoice will also need to include a statement from the provider advising that they were acquired altruistically and comply with the relevant law and guidelines. If they were acquired from overseas, we may request further evidence from you.
If your application includes medical expenses for a third-party provider, both of the required 2 medical reports must certify that medical treatment for a third-party forms part of your or your dependant's necessary medical treatment.
If you apply for a second or later IVF treatment, you'll need to provide a new or updated quote or invoice each time you apply. However, you can use the same medical report if it is no more than 6 months old when you apply.
Additional evidence for dental treatment
In addition to your medical reports and quote or invoice, you will also need to provide a copy of your treatment plan, with details of all stages of the treatment.
Before applying for dental treatment, you should review the Dental Board of Australia'sExternal Link guidance. This includes important information about responsibilities of dentists, red flags and how to report a concern.