Medicare Safety Net
If you see a doctor often, or have tests regularly, your medical costs could be high.
The Medicare Safety Net may help you with this. Once you reach the relevant threshold, the Medicare Safety Net may provide an additional benefit for eligible services, in addition to the standard Medicare benefit. This may mean that visits to your doctor or having tests could cost you less for the rest of the calendar year. The Medicare Safety Net covers a range of out-of-hospital doctor visits and tests listed on the Medicare Benefits Schedule.
For example, once you reach the Medicare Safety Net threshold, you still pay the same amount upfront to your doctor, however you may be eligible for an additional benefit from Medicare. If you are eligible for the Medicare Safety Net, you will receive the standard Medicare benefit plus an additional Medicare benefit.
As an individual, you do not need to register for the Medicare Safety Net. We will keep a total of the medical expenses you have. Just keep your contact details up to date with the Department of Human Services.
Families and couples do need to register even if all of your family members are listed on the one card. You need to tell us who is in your family so we can link you together to track your combined medical expenses.
Once you reach a Medicare Safety Net threshold, you may be eligible for additional Medicare benefits.
You need to know
2013 Medicare Safety Net thresholds
Read about the current Medicare Safety Net thresholds.
Extended Medicare Safety Net benefit cap
An Extended Medicare Safety Net (EMSN) benefit cap is the maximum amount you can get back under the Medicare Safety Net for some out-of-hospital Medicare services. Not all Medicare items have a benefit cap.
For more information about the benefit cap go to the Extended Medicare Safety Net fact sheet on the Department of Health and Ageing's MBSOnline website.
Medicare Safety Net benefits
Visiting a doctor or having tests may cost you less once you reach a Medicare Safety Net threshold.
The Medicare Safety Net covers a range of out-of-hospital doctor visits and tests covered by the Medicare Benefits Schedule (MBS). If you have surgery, see a doctor or have a test while you are in hospital, these services don’t count towards the Medicare Safety Net. Medical services which aren’t included in the MBS also don’t count towards the Medicare Safety Net.
Some examples of out-of-hospital services where costs count towards the Medicare Safety Net are:
- GP and specialist consultations
- blood tests
- CT scans
- pap smears
- tissue biopsies
Keeping a tally of medical expenses
If you pay your doctor in full and then claim your Medicare benefit, we’ll automatically keep a tally of your out-of-pocket medical expenses.
The Medicare Safety Net for families
For Medicare Safety Net purposes, a family consists of:
- a couple who are legally married and not separated, or a couple in a de facto relationship, with or without dependent children
- a single person with dependent children.
Note: a dependent child is a person under 16, or a full-time student under 25 who is attending school, college or university, who you support financially.
Children who are members of two registered families
If your child is a member of two registered families—because of separation or divorce for example—the family that pays the cost of the medical service receives the benefit. Any out-of-pocket costs will count towards that family’s Medicare Safety Net. This is based on the Medicare card used to claim the benefit.
Medicare Safety Net Original threshold
Find out more about the Medicare Safety Net Original threshold.
Extended Medicare Safety Net Concessional and FTB (A) threshold
Find out more about the Extended Medicare Safety Net Concessional and FTB (A) threshold.
Extended Medicare Safety Net General threshold
Read about the Extended Medicare Safety Net General threshold.
Confirming who is in your Medicare Safety Net family
We want to make sure your family gets the highest benefits possible. If you are approaching a Medicare Safety Net threshold, and you are registered as a couple or family, we will ask you to confirm each year the members of your Medicare Safety Net family in writing. Confirming your details allows us to check your family’s eligibility for higher Medicare benefits.
Only families need to register for the Medicare Safety Net
Find out who needs to register for the Medicare Safety Net.