The Extended Medicare Safety Net can help to lower your out-of-pocket medical costs for out of hospital services.
We recommended that all patients register with Medicare as a family or couple so that your out-of-pocket costs are counted together towards the Extended Medicare Safety Net thresholds and the PBS Safety Net thresholds.
The threshold is calculated over the calendar year (1 January to 31 December) and resets on the 1st January.
If you are registered, once you, your partner, de-facto and children have spent over 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?
You see a doctor for a Standard Consultation. Before reaching the threshold, you will pay a private fee of $92.00 and receive a Medicare rebate of $41.40. Your out-of-pocket cost is $50.60.
If you have reached the threshold, you will pay a private fee of $92.00 and receive a Medicare rebate of $41.40 + 80% of the gap – a total of $81.88.
Your total out of pocket cost is $10.12.
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 (1 January to 31 December) and resets on the 1st January.
On 1 January 2024, the PBS Safety Net thresholds were updated to:
- $277.20 for concession card holders
- $1,647.90 for everyone else in Medicare
What does this mean for you and your family?
Before you meet the threshold, each medicine will cost up to:
- $7.70 for concession card holders
- $31.60 for everyone else in Medicare
If a pharmacist offers you a different brand of the same medicine, they may have different prices. If you choose a more different brand it may cost you more than the scheduled PBS price.
Once you reach the threshold, you’ll need to apply for a PBS Safety Net card to get cheaper medicines. Please speak to your pharmacist for more information.