How they work
Understand the Safety Nets and the dollar amounts that count towards your thresholds.
Medicare Safety Nets have thresholds. These are the dollar amounts you need to reach in gap and out of pocket costs to be eligible. When you’re eligible, you’ll start getting higher Medicare benefits. This means you’ll get more money back from us for certain Medicare services.
A Medicare benefit is the dollar amount we pay you when you’ve made a claim for a medical service. This is usually 85-100% of the schedule fee. A schedule fee is the dollar amount the Australian Government sets for each medical service. The MBS Online website lists the schedule fee amount. You can search the MBS by keyword or item number to find the schedule fee amount.
The Department of Health sets threshold amounts each year from 1 January.
There are 2 Medicare Safety Nets:
If you’re enrolled in Medicare you’re eligible for the Original Medicare Safety Net (OMSN).
If you’re enrolled in Medicare you’re eligible for the Extended Medicare Safety Net (EMSN).
If you’re registered as a Medicare Safety Net family, you may be eligible as a Concessional Safety Net family.
How to check your Safety Net threshold, and let us know if your family situation changes.
Page last updated: 9 June 2021
This information was printed 10 September 2021 from https://www.servicesaustralia.gov.au/individuals/services/medicare/medicare-safety-nets/how-they-work. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.