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Medicare Extended Safety Nets

The Extended Medicare Safety Net can help reduce your out-of-pocket expenses for out-of-hospital services.

We recommend that all patients register with Medicare as a family or couple. This way, your combined out-of-pocket expenses will count towards the Extended Medicare Safety Net thresholds and the PBS Safety Net thresholds.

The threshold is calculated annually, from January 1st to December 31st, and resets on January 1st each year.

If you are registered, once you, your partner, de facto, and children have exceeded the threshold amount, the Medicare rebate for subsequent services will increase.

Thresholds as of January 2024

Category Threshold Who is eligible? What counts? What do you get back?
Extended Medicare Safety Net (EMSN)- General $2544.30 Everyone in Medicare Your out-of-pocket amount for the calendar year. 80% of out-of-pocket costs or the EMSN benefits caps for out of hospital services
Extended Medicare Safety Net (EMSN) – Concessional and Family Tax Benefit Part A $811.80 Concession cardholders and families eligible for Family Tax Benefit Your out-of-pocket amount for the calendar year. 80% of out-of-pocket costs or the EMSN benefits caps for out of hospital services

What Does This Mean for You and Your Family next time you visit the GP?

When you see a doctor for a standard consultation, before reaching the threshold, you will pay a private fee of $99.00 and receive a Medicare rebate of $41.40, resulting in an out-of-pocket cost of $57.60.

Once you have reached the threshold, you will still pay a private fee of $99.00, but your Medicare rebate will be $41.40 plus 80% of the gap, totalling $87.48. Your out-of-pocket cost will then be $11.52.

PBS Safety Net Thresholds for Prescription Medication

The PBS Safety Net for medicines is a separate scheme. Once you or your family spend a certain amount on PBS medicine, you’ll reach the PBS Safety Net threshold.

The threshold is calculated over the calendar year (January 1 to December 31) and resets on January 1 each year.

As of January 1, 2024, the PBS Safety Net thresholds are:

  • $277.20 for concession card holders
  • $1,647.90 for everyone else in Medicare

What Does This Mean for You and Your Family when you visit the pharmacist?

Before reaching the threshold, each medicine will cost up to:

  • $7.70 for concession card holders
  • $31.60 for everyone else in Medicare

Pharmacists may offer different brands of the same medicine at varying prices. Choosing a different brand may cost more than the scheduled PBS price.

Once you reach the threshold, you’ll need to apply for a PBS Safety Net card to receive cheaper medicines. Please speak to your pharmacist for more information.