Medicare for children born via surrogacy in Australia is an abysmal failure of bureaucratic systems and a lack of understanding by the Department of Health and Ageing. Denying access to healthcare and Medicare rebates is a breach of a child’s human rights.

In usual circumstances, the people named on the birth certificate as a child’s parents are caring for the child and able to have their new baby registered on their Medicare cards. Unfortunately, Medicare lacks understanding of surrogacy, such that their policy claims that parents can only have their child named on their Medicare cards after their ‘surrogacy arrangement is finalised.’

Surely a surrogacy arrangement is ‘finalised,’ as far as Medicare is concerned, when the baby goes home with the intended parents – and they need to access healthcare for their child. Healthcare needs and access do not commence when a parentage order is made – it starts at birth.

Medicare policy, published in September 2025, requires intended parents to provide either a copy of a parentage order or a birth certificate listing the intended parents’ names.

This policy does not reflect the reality of a surrogacy arrangement and denies access to healthcare and Medicare for children born via surrogacy. An application for a parentage order cannot be made for at least the first month after a baby’s birth, and oftentimes many more months lapse before an order is made. Some of my clients have celebrated their child’s first birthday before a parentage order was granted. Does Medicare honestly believe this is an appropriate policy, to deny access to healthcare and Medicare for children for that time?

About half of intended parents are able to have their child placed on their Medicare card, in the weeks following the birth. The other half have an uphill battle dealing with Medicare and being refused to have their child on their card, until a parentage order is made. What’s the reason for the discrepancy? Medicare staff simply don’t understand surrogacy.

I am so frustrated for intended parents having to fight Medicare, of all things, while caring for their newborn. Parents-via-surrogacy tell me that dealing with Medicare for children born via surrogacy has been “a nightmare,” “a shocker,” “a constant battle” and that “no one at Medicare knows what they’re talking about.”

Medicare should immediately implement a policy that allows for a child to be added to a parent’s Medicare care in the days after the birth, on provision of evidence of the surrogacy arrangement – a copy of the signed agreement, and/or a Statutory Declaration should be sufficient.

In the meantime – if you are a parent via surrogacy, you can ask Medicare to place the child on your Medicare card, and if they refuse, insist that your child is given their own Medicare card, at least until the parentage order is made. Denying a child access to Medicare is unacceptable; in the least, they can be given their own Medicare card.

I wrote to the federal Minister for Health and Ageing in November 2025, calling on him and the Department to implement a better, more responsive and realistic policy to assist parents via surrogacy apply for Medicare for children and ensure they can access benefits for their child.

This approach by Medicare for children born via surrogacy is further reason why we need a pre-birth recognition of parentage, which would allow parents to be listed on their child’s birth certificate from birth. The Australian Law Reform Commission is reviewing Australia’s surrogacy laws and this is one of their recommendations.

You can read more about surrogacy parental leave and workplace policy application in surrogacy arrangements.

Having trouble with the bureaucrats? Get in touch and see if I can help out.

And if you’re getting ready to apply for a Parentage Order, you can do some preparation – even before baby arrives!