2024 Medicare Safety Nets Thresholds

Do you know that there is a Medicare Safety Net that limits your out-of-pocket expenses? This is how it works:

2024 Medicare Safety Nets: What You Need to Know

The Medicare Safety Nets are designed to reduce your out-of-pocket healthcare costs for eligible services. Here’s a simplified guide to help you understand how they work:

Extended Medicare Safety Net (EMSN)

Who’s Included:All Medicare users are part of the EMSN.

How It’s Calculated:The difference between what you pay for a service and the rebate Medicare provides contributes to your EMSN threshold.

Example:

• You pay $102 for a standard consult (Item 23).

• Medicare rebates $42.85.

• The out-of-pocket difference of $59.15 goes toward your EMSN total

Eligible Services: 

The Safety Nets apply to out-of-hospital services covered by Medicare, including:

• GP consultations

• Blood tests

• Radiology scans (e.g., X-rays, CT scans)

Thresholds

General Threshold: $2,544.30

Eligibility: All Medicare card holders

• Individuals

• Couples (registered as a family) will count towards the above threshold

• All family members who do not have a concession card or receive the Family Tax Benefit Part A will count towards the same total threshold above

Note:

• Family must be registered.

• See Services Australia - Families and Dependents for the definition of a family.

Concessional Threshold: $811.80

Eligibility:

• Individuals who hold one of the following concession cards:

  • Health Care Card

  • Commonwealth Seniors Health Card

  • Pensioner Concession Card (includes Disability Support Pension Concession Card)

• Couples who hold any of the above concession cards (registered as a family)

• Families who hold any of the above concession cards:

  • Only members who hold a concession card are eligible for this threshold.

  • Other members adhere to the General Threshold.

  • Family must be registered.

Info: See Services Australia - Concessional Families.

Family Tax Benefit Part A Threshold: $811.80

Eligibility:

• Depends on when you receive your Family Tax Benefit Part A payment as to when you are eligible for this threshold.

More Information:

• See Services Australia - Eligibility for Family Tax Benefit Part A Medicare Safety Net Threshold.

• Threshold applies to registered families receiving this payment from Centrelink

Further information about concession and FTB Part A thresholds available here:Services Australia - Reaching the Concessional and Family Tax Benefit Part A Threshold

How to register as a Medicare Safety Net family:Visit Services Australia - How to Register.

Key Information

• These amounts reset on January 1st each year.

• Once you reach your threshold:

  • Medicare reimburses 80% of your out-of-pocket costs or applies the EMSN benefit cap for eligible services.

What Does This Mean for You?

• Keep track of your out-of-pocket medical expenses for services such as GP visits, specialists, and scans.

• Once you reach the relevant threshold, you may be eligible for higher Medicare rebates, significantly reducing your costs. 

How to Track Your Threshold

Use the Medicare App or myGov:

1. Go to the “Safety Net” section.

2. Check your progress with:

   • The bolded threshold type.

   • A progress bar showing how much more you need to reach the threshold.

3. View totals for the:

   • Current year.

   • Previous years (via the dropdown menu).

Ensure your details are up to date with Medicare, including family members linked to your Medicare card, to maximise your benefits under the family threshold.

For more information, visit the Services Australia website or speak with our team for assistance.