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Medicare Safety Net

The Medicare Safety Net provides a higher Medicare rebate to patients when their out-of-pocket costs exceed the threshold of $447.40 for all Medicare cardholders.

The Medicare Safety Net provides patients with additional financial assistance for out-of-pocket costs for out-of-hospital Medicare funded services. The difference between the doctor's fee and the Medicare rebate is the patient’s out-of-pocket cost.

Once a patient’s out-of-pocket expenses for medical services reaches the safety net threshold of $447.40 (as at 1 January 2016), all future Medicare services are paid at 100% of the Medicare Benefits Scheduled fee (not at the 85% Medicare rebate) for the remainder of the calendar year for all Medicare cardholders. For example:

Before Safety Net ThresholdDoctor’s FeeMBS Rebate(at 85% Scheduled Fee)Out-of-Pocket Cost
Initial specialist consult$141.00$72.75$68.25
After Safety Net Threshold  Doctor’s FeeMBS Rebate(at 100% Scheduled Fee)Out-of-Pocket Cost
Initial specialist consult$141.00  $85.55 $55.45

The threshold is indexed annually from 1 January and operates on a calendar year, 1 January to 31 December.