Medicare Safety Net

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What is the Medicare Safety Net?

The Medicare Safety Net allows you to lower out-of-pocket (gap) fees for out-of-hospital medical charges. In other words, it will enable you to claim more and get a higher rebate for health care services.


Suppose you or your family must see your doctor or allied health professional regularly or have expensive medical tests; the Medicare Safety Net could lower your out-of-pocket costs.


Why is the Medicare Safety Net important?

You may be out-of-pocket thousands of dollars a year if you have to spend a lot of money on GP, psychiatry, and other specialist appointments, not to mention MRI scans or expensive blood tests.


In 2004, to ease the financial burden of health care, the Australian Government introduced the Medicare Safety Net program as we now know it. Over 1 million Australians benefit from the Medicare Safety Net each year. After your out-of-pocket expenses go above a certain threshold each calendar year, you will be eligible for an extra rebate/payback


Healthcare costs are undoubtedly rising. Millions of Australians delay seeing doctors and having important medical investigations (such as sleep studies for sleep apnea, heart scans for chest pain) because they think they just can't afford it. While the Medicare Safet Net doesn't solve all the problems, it can help and makes a difference for over 1 million Australians each year.

Mental Health Care & Medicare Safety Net

Knowing if you and your family have registered for the Medicare Safety Net is important. You may be able to optimise your family's health care spending during a calendar year (1st January-31st December) so that you receive the benefits of the Medicare Safet Net.


Medicare covers our routine mental health services. Sessions done with our psychiatrists and psychologists contribute towards you and your family's Medicare Safety Net threshold.


Often our clients see our psychologists and psychiatrists for multiple sessions. If you/your family are registered and eligible for the Medicare Safety Net benefits, i.e., you have passed the threshold, you will receive a higher rebate until 31st December.

How does the Medicare Safety Network?

When an individual or family meets a certain threshold of out-of-pocket payments in a calendar year, you become eligible for higher Medicare benefits. You won't pay less for doctor visits, but you will be reimbursed more after reaching the threshold.


Appointment Cost = Medicare Rebate Amount + Out-of-Pocket Costs


There are two key threshold amounts for the Medicare Safety Net, each matching how much an individual or family has to spend before they can start receiving the higher rebates for the rest of the year.

Which thresholds apply to you depending on your circumstances
  • The Extended General thresholds apply to everyone with a Medicare card.
  • The Extended Medicare Safety Net (EMSN) is only available to concession card holders and families eligible for the Family Tax Benefit. The EMSN offers a lower threshold, meaning they can get access to higher rebates without having to spend as much.
    •
    The threshold renews every calendar year, i.e. on 1st January. Therefore it would help if you kept a close eye on your medical spending and when you incur these costs. The sooner you reach your Safety Net limit, the sooner you will be eligible for the extra rebate.


    How to check if you are eligible for a higher rebate

    You can check by:
    1. Logging into your online Medicare account
    2. Using the Express Plus Medicare mobile app
    3. Calling Medicare on 132 011

    Medicare Safety Net as an individual or as a family

    You can either qualify for the Medicare Safety Net as an individual (single person) or as part of a couple or family. If you qualify for the Medicare Safety Net as a family, everyone's costs are combined so that the family can reach the threshold sooner

    How to check if you are eligible for a higher rebate

    You do not have to do anything if you are single with no dependents. You will automatically be eligible for the Medicare Safety Net program. You will start receiving the extra rebate once you surpass the threshold.
    1. Logging into your online Medicare account
    2. Using the Express Plus Medicare mobile app
    3. Calling Medicare on 132 011

    Should you register for the Medicare Safety Net?

    You do not have to do anything if you are single with no dependents. You will automatically be eligible for the Medicare Safety Net program. You will start receiving the extra rebate once you surpass the threshold.

    If you are in a couple or a family, you will need to register to receive the Medicare Safety Net. You will only have to register once for the service and all your family members listed will be eligible to receive the Medicare Safety Net benefit.

    If you register as a family, the chances of reaching your threshold will sooner be high. Once your family gets the threshold, each family member will receive a higher rebate for the rest of the year.

    How to register

    There are two ways to register your family for the Medicare Safety Net
    1. You can apply online via the Services Australia website (Make sure to register under the correct plan type)
    2. Call the Medicare general line on 132 011

    Confirming your family

    When your family is close to reaching a Medicare Safety Net threshold, Medicare will ask you to confirm who's in your family. Medicare will notify the nominated contact person for your family either by a myGov Inbox message or by post. The contact person maybe you or someone else in your family.
    If you're the contact person or their partner, you can confirm your family online by using either:
  • your Medicare online account through myGov
  • the Express Plus Medicare mobile app
    • If you can't confirm your family online, you can either:
  • Calling Medicare
  • Complete the Family Safety Net Confirmation form Medicare would have sent to the contact person by post.

    • Letting Medicare know when your family situation changes

    If there are any changes to who's in your registered Medicare Safety Net family, it's important to let Medicare know. You should let Medicare know if any of the following happens:
  • you become a member of a couple
  • you have a baby
  • you adopt a child
  • you and your partner separate
  • your dependent child leaves your care
    • You can notify Medicare about the above changes via;
  • Filling in the Medicare Safety Net registration and amendment for couples and families form. You can find the form on the Services Australia website.
  • Calling the Medicare Programme on 132 011

    • 2023 Medicare Safety Net thresholds

    Thresholds Threshold amount Who it is for What counts towards the threshold What benefit you wll get back
    Original Medicare Safety Net (OMSN) $531.70 Everyone Your gap amount for the calendar year 100% of the schedule fee for out of hospital services
    Extended Medicare Safety Net (EMSN)- General $2249.80 Everyone Your out of pocket amount for the calendar year 80% of out of pocket costs or the EMSN benefit caps for out of hospital services
    Extended Medicare Safety Net (EMSN) - Concessional and Family Tax Benefit Part A $770.30 Concession cardholders and families eligible for Family Tax Benefit Part A Your out of pocket amount for the calendar year 80% of out of pocket costs or the EMSN benefits caps for out of hospital services