All things health: Medicare, medications, dental & OOHC health pathway

My personal health record, also known as the ‘Blue Book’, is given to all parents in NSW after the birth of a baby. When filled in regularly, it provides a record of the child’s health history. It also includes a developmental checklist to help identify any developmental problems early. 

If a child under five years of age is placed with you, your caseworker will give you the child’s My First Health Record, if possible. If it’s missing or unavailable, you can get a new one from your local child health care centre or hospital. The results of health assessments should be recorded in My First Health Record. 

If the child returns home or moves to another placement, they should take their My First Health Record with them. 

You play an important role in making sure the My First Health Record book is kept up to date. Before you go ahead with tests or immunisations, check in with your caseworker. It may be necessary to consult with the child’s parents first, especially if they will be returning home at some point.

For more information:

🔗 Blue Book

Immunisation is a simple, safe and effective way to protect against harmful diseases. The more people who get immunised, the less chance some diseases have to spread.

If you’re not immunised you may put people’s health at risk, especially:

• babies
• young children
• frail older people
• those who don’t have a strong immune system.

For more information:

🔗 Australian Childhood Immunisation Register

Children and young people entering statutory OOHC are referred by the Department of Communities and Justice to commence a primary health assessment as soon as possible, ideally within 30 days of a child or young person entering care.

These assessments are undertaken by a range of health care providers, including General Practitioners, Aboriginal Medical Services, Child and Family Health Nurses, and headspace and Youth Health Services where available.

After the primary health assessment, the health professional may then refer the child or young person for a comprehensive multidisciplinary health assessment. On the basis of these assessments, each child or young person has a Health Management Plan developed for/with them. The Health Management Plan identifies their state of health, recommended interventions and appropriate review process.

The program supports young people as they plan to leave care, including supporting the young person to establish and maintain an ongoing relationship with a primary health care provider. As young people grow, we seek their consent for and encourage their participation in health care and planning.

The program is a collaboration between NSW Health, Department of Communities and Justice, OOHC service providers, Department of Education, carers, and children and young people themselves.

Carers will be contacted by a health staff member from the child or young person's local health district to organise a primary health assessment after the child/young person enters care.

Each local health district has an OOHC Health Pathway coordinator responsible for managing and coordinating referrals. The contact details for each local coordinator, and information about local programs, can be found below. To find out which local health district you live in, search for your closest town using this 🔗 map locator.

🔗 Out-of-Home Care Health Pathway program

🔗 OOHC Health Pathway Guide for Carers

🔗 Animation OOHC Health Pathway - information for children and young people (1min 56 sec)

🔗 Animation OOHC Health Pathway - information for carers (1min 41 secs)

🔗 Short course on OOHC Health Pathway

The Care Allowance is expected to cover the child or young person’s general medical costs, including visits to the doctor, prescription medications and non-prescription medications.

Some out-of-pocket expenses that are approved in the Case Plan may be covered by DCJ or your agency. These could include medical specialists, counselling, speech therapy, occupational therapy, physiotherapy, medical aids, dental and orthodontic treatment, glasses and long-term prescription medications not covered under the Pharmaceutical Benefits Scheme (PBS).

Private health insurance 

Contact your private health insurance provider if you want to add the child or young person to your family’s policy. 

Your insurer can tell you what legal papers they need to prove the child or young person is in your care, and your caseworker can help you locate these. 

Some insurers allow you to add a child up to the age of 21 on your existing family health cover, for free. If your insurer charges you to add the child or young person in your care to your existing policy, the cost is to be met from the Care Allowance.

When you are giving the child or young person medication prescribed by a doctor, make sure you do it exactly as directed.

If they get the wrong dose or have a bad reaction seek immediate advice from your doctor or call:

• the Poisons Information Centre on 13 11 26
• an ambulance on 000.

When buying non-prescription medication, such as analgesics and cough and cold remedies, take into account the child or young person’s medical history and any past side effects to different types of medication.

Always make sure you store medicines safely and not within sight or reach of children in your care.

If you have any questions about prescription medicines, non prescription medicines or natural medications call 1300 MEDICINE (1300 633 424) Monday to Friday, 9 am to 5 pm AEST (excluding NSW public holidays).. The service is operated by Australian Healthcare Associates Pty Ltd (AHA) on behalf of the Australian Government.  Calls are answered by registered pharmacists.

Make a record of allergies and reactions

If the child or young person in your care has allergies or reactions to particular types of medication, tell your caseworker so they can record this for future reference.

Children and young people aged 14 years and older can give consent to their own medical treatment if they have sufficient maturity and are capable of understanding the nature and consequences of the treatment. 

Authorised carers can consent to many day-to-day medical and dental treatments for the children in their care. Note that carers must keep caseworkers informed of serious accidents, injuries or illnesses. 

In most other circumstances, consent must be obtained from DCJ. For certain children and young people whose placement is managed by Barnardos, parental responsibility for medical and dental consent remains with Barnardos. 

As an authorised carer you can consent to medical and dental treatment not involving surgery if advised by a medical or dental practitioner. You can also consent to emergency treatment involving surgery if certified, ideally in writing, by a medical or dental practitioner. Let your caseworker know about any treatment you’ve consented to, so they can include this in the child or young person’s file.

You need approval from your caseworker or a manager from your agency for other treatments, including: 

• medical and dental surgery (non-urgent)
• medical treatments for terminal illnesses
• end-of-life decisions or medical intervention
• drug and alcohol rehabilitation
• contraception for children aged under 14
• pregnancy termination for children aged under 14
• psychiatric admission and treatment
• DNA tests
• most other tests including HIV/AIDS and hepatitis

Serious accidents, illness and injuries 

It is important to note that the law requires authorised carers to immediately notify their agency if a child or young person in their care suffers a serious accident, illness or injury.

Note: Major dental work needs to be included in a child’s case plan and approved by DCJ. For most other dental treatment the authorised carer will need to inform the caseworker. If the dental treatment is urgent this may carried out first then a reimbursement may be sought from DCJ. 

For more information:

🔗 Consent for medical and dental treatment of children and young people

🔗 Medical and dental consent factsheet

🔗 Child dental benefits schedule (CDBS)

🔗 Table A: Day-to-day medical and dental treatments

🔗 Table B: Other Medical and Dental Treatments

Children and young people should have regular dental check-ups. The cost should be covered by the Care Allowance. 

As an authorised carer, you can consent to dental check-ups. However, you’ll need your caseworker’s prior approval if the child or young person needs dental treatment involving surgery. 

Your agency will cover the costs of ongoing dental or orthodontic treatment providing this is part of the child or young person’s approved Case Plan

The Australian government provides financial support for basic dental services to children and young people aged between two and 17 who are eligible for Medicare and who are supported by a government payment such as the Family Tax Benefit Part A or the Youth Allowance, either directly or through their carer. 

Benefits for basic dental services are capped at $1,158 per child over two consecutive calendar years and cover a range of services including examinations, x-rays, cleaning, fissure sealing, fillings, root canals, extractions and partial dentures. 

Benefits are not available for orthodontic or cosmetic dental work and cannot be paid for any services provided in a hospital. 

Services provided under the Child Dental Benefits Schedule will not count towards the Medicare Safety Net or the Extended Medicare Safety Net thresholds. 

For more information:

🔗 Child Dental Benefits Schedule 

You can give consent for the child or young person to be immunised against Hepatitis A and B. 

However, you can’t give consent for a child or young person to be tested for HIV/AIDS or Hepatitis C. 

For children under 14, medical tests that involve taking tissue samples or body fluids, such as blood or urine, can’t be done without your agency’s approval. If the child is 14 or older, they can make their own decisions about medical tests and give their own informed consent for testing.

Your agency will only give approval for testing if: 

• there are sufficient grounds to suspect the child or young person may be infected
• testing is considered to be in their best interests or they’ve asked to be tested. 

Privacy laws that apply to all adults and children in NSW mean you will only be informed that a child or young person in your care has HIV/AIDS, Hepatitis C or other infectious disease if: 

• you need to know this information to provide appropriate care for them
• the disease could pose a significant health risk to you or members of your family. 

If you or a member of your family has an infectious disease you are not required to tell your caseworker provided that: 

• you’re using universal infection control procedures
• the disease doesn’t affect your ability to provide adequate care. 

If you are told about a child or young person’s infectious disease status, you cannot disclose this information to anyone except a medical practitioner or dentist for the purpose of medical advice or treatment, or in certain circumstances approved by the Minister.

As a general rule, carers should always treat all bodily substances including blood, body fluid, urine and faeces as potentially infectious and use sensible protective practices, such as wearing rubber gloves.

A psychotropic drug is a prescribed medication that affects a person’s perception, thinking, mood, level of arousal or behaviour. It may be prescribed by a doctor to treat mental illness, psychiatric disorders or other symptoms. 

Psychotropic medication is not a stand-alone solution for challenging behaviour. It should only be considered in the context of behaviour support strategies that may have a positive impact on behaviour. 

All children on psychotropic medication must also have a Behaviour Support Plan developed by the caseworker and a psychologist or other specialist. 

When a child is prescribed a psychotropic drug by a medical practitioner: 

• the carer must immediately notify their caseworker
• the carer can administer the medication
• the caseworker and carer must update each other on any changes to the medication or the dosage, and any changes in the child or young person’s moods or behaviour; this information should be provided to the medical practitioner at the child’s medical review

You may be able to get help with travel costs associated with taking the child or young person in your care to specialist medical appointments. This includes help with fares, petrol for kilometres travelled and parking costs. It’s important that you get prior approval from your caseworker if you wish to receive support for travel costs.

When a child or young person is placed in out-of-home care, the caseworker will immediately apply for a new Medicare card number for the child or young person. While waiting for a new Medicare card to be issued, a carer can still access medical services or prescriptions for the child or young person in care and receive reimbursement for medical services provided.

If a child is taken to a doctor who bulk bills, the doctor can obtain the child or young person’s card number directly from Medicare for billing purposes. Alternatively, if a carer has paid for a Medicare service for a child or young person in their care, they can be paid the Medicare benefit by advising the officer in a Medicare office that they paid for the service.

There is no legislation that compels a doctor to perform a service, so it is possible that a carer may be required to pay for a service up front. If they are unable to do this they will need to get a bill from the doctor.

The Pharmaceutical Benefits Scheme (PBS) makes certain medications available at subsidised rates. If the child or young person in your care requires a PBS medication, you will need to provide their Medicare card number to the pharmacist so they can confirm the child or young person’s eligibility for the subsidy.

Sometimes it is not possible for a carer to provide a child’s Medicare card details. With the consent of the carer, the pharmacist can phone the Medicare Australia PBS enquiry line to obtain the child or young person’s Medicare card number. In certain situations, the pharmacist can use a pharmacy-only Special Medicare Number.

For more information:

🔗 Medicare number process for children and young people in OOHC (PDF 243.03KB)

🔗 Medicare Card

🔗 Medicare Safety Net - helps with the costs of out of hospital medical services that attract a Medicare benefit.

🔗 Pharmaceutical Benefits Scheme (PBS) Safety Net - can reduce the cost of prescription medicines once the threshold has been reached.

A concession card to get cheaper medicines.

For more information:

🔗 Health care card

🔗 Eligibility

The Foster Child Health Care Card is a concession card issued by Services Australia.

It helps carers with the cost of raising a child who is not their biological or adopted child, including children in both formal and informal care arrangements.

In simple terms: it helps reduce some everyday costs, particularly for medicines and certain services.

Medicare vs Foster Child Health Care Card – What’s the difference?

These two cards serve different purposes, and most carers will need both.

Medicare Card

• Provides access to Australia’s public health system
• Used for GP visits, specialists and hospital care
• Think of it as: access to healthcare

Foster Child Health Care Card

• Helps reduce out-of-pocket expenses
• Provides cheaper medicines through the PBS and access to some discounts
• Think of it as: making healthcare (and some living costs) more affordable

Why you need both

• Use the Medicare card to access health services
• Use the Foster Child Health Care Card to reduce the cost of those services

Who can get the card?

You may be eligible if:

• You are caring for a child who is not your biological or adopted child
• The child is currently in your care
• The care arrangement is either formal or informal

For more information:

🔗 Foster child health care card

Looking for health information in a language other than English? The Multicultural HIV and Hepatitis Service (MHAHS) provides free, trusted health information in 17 languages, covering topics including HIV, hepatitis B and C, sexual health, and understanding the Australian health system.

The website also includes multilingual resources, educational materials, and information about available support services. These resources may be helpful for carers supporting children, young people and families from culturally and linguistically diverse backgrounds.

Visit the MHAHS website to access multilingual health information and resources.