Your gap amount counts towards your OMSN threshold. A gap amount is the difference between both of the following:
- the Medicare benefit you get
- the schedule fee for out of hospital medical services.
When you reach the OMSN threshold, you’ll get a higher benefit back. You’ll get 100% of the schedule fee for out of hospital services for the rest of the calendar year.
If you’re an individual we’ll automatically pay you the higher Medicare benefit when you reach the threshold.
If you’re part of a registered family, you’ll need to confirm your family members. You’ll need to do this before we pay you a higher Medicare Safety Net benefit.