Medicare Safety Net

31/01/2013

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 $421.70 (as at 1 January 2013), 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 Threshold Doctor’s Fee MBS Rebate(at 85% Scheduled Fee) Out-of-Pocket Cost
Initial specialist consult $126.00 $72.75     $53.25
After Safety Net Threshold   Doctor’s Fee MBS Rebate(at 100% Scheduled Fee) Out-of-Pocket Cost
Initial specialist consult $126.00   $85.55  $40.45

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

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