Medicare Safety Net

What is Medicare Safety-Net

Medicare Safety Nets can help to lower your out of pocket medical costs for out of hospital services.

If you need to see a doctor or get tests regularly, you could end up with high medical costs. Medicare Safety Nets can help to lower your out-of-pocket costs.

These can include:

seeing a doctor or specialist
some tests and scans like blood tests and CT scans.

When you spend over a certain amount in a calendar year, we’ll give you a higher amount back. We calculate the Safety Nets each calendar year, 1 January to 31 December.

Keep in mind, your doctor’s visit or test will still cost the same.

If you’re enrolled in Medicare, you’re eligible for Medicare Safety Nets. If you’re part of a family or couple, you can combine your costs by registering as a family.

How to Register

You can register for Medicare Safety Nets as a family or couple.

Individuals

You don’t need to register if you’re an individual with no dependants. We’ll register you for Medicare Safety Nets. We keep a tally of your out of pocket and gap amounts. We’ll pay you higher Medicare benefits when you reach a threshold. This means you’ll get more money back from us for certain Medicare services. We’ll keep paying you the higher benefit for the rest of the calendar year.

Families and couples

If you’re part of a family or couple, you can register as a family to combine your costs. This means you’re more likely to reach the thresholds sooner. Even if all family members are on the same Medicare card, you’ll still need to register.

You only need to register once.

If you’re registered and your family situation changes, you’ll need to let us know. This includes having a child or separating from your partner.

You can register or tell us about a change in your family situation by either:

filling in the Medicare Safety Net couples and families registration and amendment form
calling the Medicare program.

Families and dependants

For Medicare Safety Nets purposes, a family is any of these:

a married couple, not separated, with or without dependants
a couple in a de facto relationship, with or without dependants
a single person with dependants.

For Medicare Safety Nets purposes, a dependant is someone the family supports financially and either a:

child under 16 years
full time student between 16 and 25 years.

A dependant can be a member of 2 registered Medicare Safety Net families. The dependants out of pocket and gap amounts only count towards one Medicare Safety Net family. They count towards the Medicare Safety Net family that pays for the medical services.

When you’re registered, we keep a tally of your out of pocket and gap amounts. We’ll notify you when you’re close to reaching your Medicare Safety Net threshold. You’ll need to confirm your family members before you’re eligible to get a higher Medicare benefit.

Safety-Net Thresholds

What are the thresholds?

Medicare Safety Nets have thresholds. When you spend certain amounts in gap and out of pocket costs, you’ll reach the thresholds. Once you’ve reached the thresholds, you’ll start getting higher Medicare benefits. This means you’ll get more money back for certain Medicare services.

The threshold amounts are set each year from 1 January.

Please see the link to view current Medicare safety net thresholds https://www.health.gov.au/topics/medicare/about/safety-nets-threshold.