If you’re enrolled in Medicare you’re eligible for the Extended Medicare Safety Net (EMSN).
Each time you pay an out of pocket cost, it’s calculated towards the EMSN threshold. Out of pocket costs are the
difference between the doctor’s fee for any out of hospital medical service and the Medicare rebate.
At Bungendore Medical Centre the cost for a 15min GP appointment is $95. The Medicare rebate is $41.10. therefore
the out of pocket expense is $53.90. This amount is then added to your Extended Medicare Safety Net.
The EMSN has 2 thresholds:
- General
- Concessional and Family Tax Benefit Part A.
Reaching the General Threshold
When you reach the General Threshold, your benefit will apply to out of hospital medical services. This will apply for the
rest of the calendar year. You will get the Medicare benefit and the lowest of either:
80% of the out of pocket amount ($95 for a standard appointment you will get back $41.10 medicare rebate plus
$43.12 EMSN. Your out of pocket expense will be $10.78)
Extended Medicare Safety Net benefit caps, see the Department of Health and Aged Care website for more
information.
If you’re an individual we’ll pay you the higher Medicare benefit when you reach the threshold.
If you’re part of a registered family, you’ll need to confirm who’s in your family before you reach the threshold. We’ll let
you know when you need to do this and how. Once your safety net family is confirmed, we’ll start paying you a higher
Medicare benefit.
Reaching the Concessional and Family Tax Benefit Part A Threshold
You may be eligible for the lower threshold if you’re any of the following:
- a Commonwealth Seniors Health Card holder
- a Health Care Card holder
- a Pensioner Concession Card holder
- eligible for Family Tax Benefit Part A.
The date you become eligible for the EMSN Family Tax Benefit Part A depends on your payment.
You may be part of a registered Medicare Safety Net family and eligible for the concessional threshold. When this
happens you may also be part of a concessional family.
When you reach the concessional threshold, your benefit will apply to out of hospital medical services. This will apply for
the rest of the calendar year. You’ll get the Medicare benefit and the lowest of either: - 80% of the out of pocket amount
- Extended Medicare Safety Net benefit caps, see the Department of Health and Aged Care website for more
information.
If you’re an individual we’ll pay you the higher Medicare benefit when you reach the threshold.
If you’re part of a registered family, you’ll need to confirm who’s in your family before you reach the threshold. We’ll let
you know when you need to do this and how. Once your safety net family is confirmed, we’ll start paying you a higher
Medicare benefit. https://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-EMSN-1Jan2024
