Extended Medicare Safety Net General threshold
This table shows details of the Extended Medicare Safety Net (EMSN) General threshold.
|Threshold amount||Who it is for||How it is calculated||What the benefit is|
|Extended general||$1,221.90||All Medicare cardholders||Out-of-pocket costs||80% of out-of-pocket costs or the EMSN benefit cap for out-of-hospital services|
The EMSN general threshold pays 80 per cent of the out-of-pocket costs or the benefit cap, whichever is the lower amount, for out-of-hospital Medicare Benefit Schedule services, after a threshold of $1221.90 per family or individual per calendar year is reached.
When you pay the account in full, you will receive the Medicare benefit and the additional 80 per cent or the benefit cap.
When you don’t pay the account in full, we’ll send you a cheque payable to the doctor. To receive the additional 80 per cent benefit or the benefit cap you must:
- take the cheque to your doctor with any outstanding balance you owe, and
- pay the remainder of the account in full and provide proof of payment to us.