Medicare Safety Net—2010
Couples and families should register
now for greater savings
Medicare Safety Net
What is the Medicare Safety Net?
The Medicare Safety Net provides families and individuals with
financial assistance for out-of-pocket costs for out-of-hospital
Medicare Benefits Schedule (MBS) services. Once you meet
a Medicare Safety Net threshold, you may be eligible for
additional Medicare benefits for out-of-hospital MBS services
for the rest of the calendar year.
Medicare Safety Net thresholds
as at 1 January 2010
Threshold How it is What the
Who it is for
amount calculated benefit is
Original $388.80 All Medicare Based on gap 100% of
cardholders amount schedule fee for
Extended $562.90 Concession Out-of-pocket 80% of
concession cardholders costs out-of-pocket
and FTB(A) and families costs or the
eligible for EMSN benefit
FTB(A) cap for
Extended $1126.00 All Medicare Out-of-pocket 80% of
general cardholders costs out-of-pocket
costs or the
Out-of-pocket costs—the difference between the Medicare
benefit and what your doctor charges you.
Gap amount—the difference between the Medicare benefit
and the schedule fee.
Schedule fee—a fee for service set by the
What is the Extended Medicare
Safety Net (EMSN) benefit cap?
An EMSN benefit cap is an upper limit on the amount of
Medicare Safety Net benefit payable for an out-of-hospital
MBS service. Not all Medicare items have an EMSN cap.
What are the benefits to me?
For example, once you qualify for a Medicare Safety Net
threshold and then visit your doctor who charges you $60
for a standard consultation, you will receive your Medicare
benefit of $32.80 plus 80 per cent of your out-of-pocket costs
($27.20)—giving you an extra $21.75 in your pocket.
So in this example it will only cost you $5.45 to visit your
doctor. However, if the item is subject to the EMSN benefit cap,
the amount you receive may be less.
What services are covered?
The Medicare Safety Net covers a range of doctor visits and
tests covered by the MBS that you receive out-of-hospital.
Having surgery, seeing a doctor or having tests when you are
in hospital, or medical services not included in the MBS, do not
count towards the Medicare Safety Net.
Some examples of services where costs count towards the
Medicare Safety Net are:
• GP and specialist consultations
• blood tests
• CT scans
• pap smears
• tissue biopsies
Who needs to register?
Individuals—do not need to register for the
Medicare Safety Net. Just keep your contact details up-to-date
with Medicare Australia.
Couples and families—need to register for the
Medicare Safety Net, even if all of your family members are
listed on your Medicare card.
• Each family member needs to be identified so their
medical costs can be counted towards your family’s
Medicare Safety Net.
• You only need to register once.
• Registration is free.
How do I register?
• Call 132 011*.
• Visit your local Medicare office.
• Online at www.medicareaustralia.gov.au then go to
For individuals and families > Services and programs
> Medicare Safety Net
What is a Medicare Safety Net
For Medicare Safety Net purposes a family consists of:
• a couple legally married and not separated or a couple in a
de facto partnership with or without dependant children
• a single person with dependant children.
Note: a dependant child is someone under 16 years of age
or a full-time student under 25 years of age attending school,
college or university, whom you financially support.
What if my child is a member
of two registered families?
If your child is a member of two registered families, for reasons
such as separation or divorce, the family who 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 determined by the Medicare card used to claim the benefit.
Can I add my grandchild
to my Medicare Safety Net
It is important to know that the Medicare Safety Net has
some limitations about whether a child can be added to a
grandparent’s Medicare Safety Net registration. A child can
only be registered on a maximum of two Medicare Safety Net
If the parents have two separate registrations and
the child is registered on each, then the child cannot be
registered on the grandparent’s Medicare Safety Net
Since there are a number of different situations, grandparents
should contact Medicare Australia to confirm their entitlement
to having their grandchild added to their Medicare card and/or
Medicare Safety Net registration.
How do I know when I’ve
reached a threshold?
We will contact you when you are nearing a threshold. To
check your Medicare Safety Net balance:
• visit our Online Services at
• visit your local Medicare office
• call 132 011*.
What happens next?
If you pay your doctor in full and then claim your Medicare
benefit, we will automatically keep a tally of your medical
expenses for you.
If you claim from Medicare Australia before paying your
doctor we will send you a cheque payable to the doctor.
You need to give the cheque to your doctor along with any
outstanding balance you owe. You then take your receipts to
Medicare Australia as proof of payment so that we can keep a
tally of your expenses for you.
We will contact you when you are nearing a threshold and may
ask you to substantiate any unpaid claims.
Once you reach a threshold, all further
out-of-hospital claims you make for that calendar year may
automatically attract a higher benefit.
Note: if you and your partner and/or children are registered
as a family, you must confirm in writing who is in
your Medicare Safety Net family each year before any
Medicare Safety Net benefits can be paid.
Why do I need to confirm?
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 in writing who is in your Medicare Safety
Net family each year. Confirming your details allows us to
check your family’s eligibility for higher Medicare benefits.
Pharmaceutical Benefits Scheme (PBS)
If you or your family need a lot of medicine in a calendar year,
the PBS Safety Net can help you with the cost of medicine. For
information about the PBS Safety Net call the PBS information
line on 1800 020 613**.
Family Assistance Office
The Family Assistance Office delivers payments to families to
help with the cost of raising children, including:
• Family Tax Benefit (Part A)
• Family Tax Benefit (Part B)
• Child Care Benefit
• Baby Bonus
• Maternity Immunisation Allowance.
For information about the payments you may be entitled to,
visit your local Medicare office or Centrelink Customer Service
Centre. You can also call the Family Assistance Office on
136 150* or visit www.familyassist.gov.au
Australian Childhood Immunisation Register
The Immunisation Register is a national register administered
by Medicare Australia that records details of vaccinations
given to children under seven years of age who live in
Australia. For information about the Immunisation Register
call 1800 653 809**.
Remember: you need to give Medicare Australia
all of your receipts for doctors’ accounts to ensure
you get all the benefits that you are entitled to.
For more information
Write Medicare Australia
GPO Box 9822
in your capital city
Call 132 011*
TTY 1800 552 152** (hearing and speech impaired)
TIS 131 450* (Translating and Interpreting Service)
If you need help translating this information call the TIS
on 131 450*.
This figure is adjusted in line with the Consumer Price Index (CPI)
on 1 January each year.
* Call charges apply.
** Call charges apply from mobile and pay phones only.