Medicare enrolment or new Medicare number request For use by Child Protection Agencies 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in the Child Protection Agency details, including the agency name and postal address. Ensure all information is accurate.
  3. Provide the child or young person's details, including their full name, date of birth, and gender. If applicable, indicate if they have previously been enrolled in Medicare.
  4. Attach all required supporting documents as specified in sections 1a or 1b, depending on your status as a Child Protection Agency employee or Non-Government Organisation employee.
  5. Complete the Declaration section at the end of the form. Ensure that any young person aged 15 years or older signs this section.
  6. Review all entries for accuracy before submitting. You can return your completed form via email or post as instructed.

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Starting in April 2018, Medicare will begin mailing new cards to everyone who gets Medicare benefits. Why? To help protect your identity, Medicare is removing Social Security numbers from Medicare cards. Instead, the new cards will have a unique Medicare Number.
Medicare beneficiaries or their authorized representatives can ask to change their MBIs; for example, if the MBI is compromised. CMS can also change an MBI. Its possible for your patient to seek care before getting a new card with the new MBI.
To enroll in the Medicare Program, get an NPI through: Online Application: Get an Identity Access Management (IA) System user account. Then apply for an NPI in NPPES. Paper Application: Complete, sign, and mail the NPI Application/Update Form (CMS-10114) paper application to the address on the NPI Enumerator form.

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0:04 1:14 Now we recognize that shutting down and replacing an MBI can be disruptive to people with Medicare.MoreNow we recognize that shutting down and replacing an MBI can be disruptive to people with Medicare. As well as their providers. But sometimes this is necessary to prevent fraud.

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