Extended Medicare Safety Net

If you’re enrolled in Medicare you’re eligible for the Extended Medicare Safety Net (EMSN).

Each time you pay an out of pocket cost, it’s calculated towards the EMSN threshold. Out of pocket costs are the difference between both of the following:

  • the Medicare benefit you get back
  • the doctor’s fee for out of hospital medical services.

The EMSN has 2 thresholds:

  • General
  • Concessional and Family Tax Benefit Part A.

Reaching the General Threshold

When you reach the General Threshold, your benefit will apply to out of hospital medical services. This will apply for the rest of the calendar year. You’ll get the Medicare benefit and the lowest of either:

If you’re an individual we’ll pay you the higher Medicare benefit when you reach the threshold.

If you’re part of a registered family, you’ll need to confirm who’s in your family before you reach the threshold. We’ll let you know when you need to do this and how. Once your safety net family is confirmed, we’ll start paying you a higher Medicare benefit.

Reaching the Concessional and Family Tax Benefit Part A Threshold

You may be eligible for the lower threshold if you’re any of the following:

  • a Commonwealth Seniors Health Card holder
  • a Health Care Card holder
  • a Pensioner Concession Card holder
  • eligible for Family Tax Benefit Part A.

The date you become eligible for the EMSN Family Tax Benefit Part A depends on your payment.

You may be part of a registered Medicare Safety Net family and eligible for the concessional threshold. When this happens you may also be part of a concessional family.

When you reach the concessional threshold, your benefit will apply to out of hospital medical services. This will apply for the rest of the calendar year. You’ll get the Medicare benefit and the lowest of either:

If you’re an individual we’ll pay you the higher Medicare benefit when you reach the threshold.

If you’re part of a registered family, you’ll need to confirm who’s in your family before you reach the threshold. We’ll let you know when you need to do this and how. Once your safety net family is confirmed, we’ll start paying you a higher Medicare benefit.

Page last updated: 7 July 2022