The Medicare Safety Net
How does the Medicare Safety Net work?
If you need to see doctors or have medical testing regularly, it could cost you a lot of money. The Medicare Safety Net helps you when you need it most. Once you reach a safety net threshold, visits to your doctor or medical tests will cost you less.
From 1 January 2009, the definition of a family for Medicare Safety Net purposes will be:
- A couple legally married and not separated, or a couple in a de facto partnership with or without dependant children; or
- A single person with dependant children.
Note: A dependant child is a child under 16 years of age or a full time student under 25 years whom you support. All families and couples need to register via the Medicare Safety Net registration form available online. If you register as a family or couple your medical costs are combined so that you are more likely to reach the thresholds sooner.
- Each family member needs to be identified so their medical costs can be counted toward your family’s safety net
- You only need to register your family once
- Registration is free
The Medicare Safety Net threshold is indexed annually from 1 January and operates on the calendar year 1 January to 31 December.
Please note: if you are registered as a family for safety net purposes, you must confirm your family make-up in writing each year with Medicare before any safety net benefits can be paid for services not already claimed.
Individuals are automatically registered — just keep your contact details up-to-date with Medicare.
What services count towards the safety net?
The Medicare safety net covers a range of doctor visits and tests that you receive out-of-hospital. Fees for having surgery, seeing a doctor or having a test when you are in hospital are not covered.
Some examples of services where costs count towards the safety net are:
- GP and specialists consultations
- ultrasounds
- pap smear
- blood tests
- CT scans
- x-rays
How do I know if I am nearing the threshold?
Medicare will contact you when you are nearing the threshold. You can also check you Medicare Safety Net Balance:
- online — visit the ‘Our Services for You’ section of Medicare Australia’s website
- over the phone — call 132 011
- in person — visit your local Medicare office
What are the benefits for me?
As an example:
The doctor charges you $55.00
You will get back the normal Medicare Benefit of $31.45
So the cost to you is $23.55
When you reach the safety net, Medicare will pay an extra 80% of the cost to you
So the additional cost to Medicare is $18.84
The final cost to you is only $4.71
