Medicare Safety Net
Understanding the Medicare Safety Net
Medical costs can add up over a year, especially if you or your family need to see doctors often. The Medicare Safety Net is here to help. It lowers your out-of-pocket costs once you have spent a certain amount on out-of-hospital medical services in a calendar year. Here is an explanation of how it works, what you could get back, and how to keep track of where you stand.
What is the Medicare Safety Net?
The Medicare Safety Net gives you higher Medicare benefits once your medical costs reach a set amount, known as a threshold, within a calendar year (1 January to 31 December). Each year the count starts fresh.
There are two parts that work together:
• The Original Medicare Safety Net (OMSN)
• The Extended Medicare Safety Net (EMSN)
Both apply to out-of-hospital services, such as visits to your GP, specialist appointments, allied health visits under chronic condition management plans and psychology under a mental health treatment plan as well as many tests and scans that have a Medicare rebate. They do not apply to costs you have as an admitted patient in hospital.
The OMSN looks at the gap. The gap is the difference between the 85% Medicare rebate and the Schedule Fee for eligible out-of-hospital services. This gap applies to most non-GP services, such as specialist consultations and diagnostic tests. It is worth knowing that for eligible GP services, Medicare generally pays 100% of the Schedule Fee, so there is usually no gap counted toward the OMSN for those visits.
Once your gap amounts from eligible non-GP services add up to the OMSN threshold for the year, Medicare starts paying a higher benefit, 100% of the Schedule Fee instead of the usual 85%, for those out-of-hospital non-GP services for the rest of the calendar year. GP services already attract 100% of the Schedule Fee, so the OMSN benefit makes the most difference for specialist consultations, diagnostic tests, and similar services.
The OMSN threshold is the same for everyone, whether you are single or part of a family.
The EMSN looks at your actual out-of-pocket costs. These are the amounts you personally pay for out-of-hospital services, over and above the Medicare benefit.
Once your out-of-pocket costs reach the EMSN threshold, Medicare pays back 80% of your future out-of-pocket costs for out-of-hospital services for the rest of the year. Some services have a cap on the maximum EMSN benefit, so there is a limit on how much you can receive back for those particular items.
The EMSN has two thresholds: a lower one for people who hold a concession card or receive certain payments, and a higher general threshold for everyone else.
Current threshold amounts:
The 2026 threshold amounts are as follows:
• Original Medicare Safety Net (OMSN): $594.40 — this applies to everyone enrolled in Medicare.
• Extended Medicare Safety Net (EMSN): $861.20 for people who hold a concession card or receive Family Tax Benefit (FTB)
Part A; $2,699.10 for all other people.
Threshold amounts are adjusted at the start of each calendar year, usually in line with inflation, so the figures above apply for the 2026 calendar year.
You can check the latest thresholds any time at servicesaustralia.gov.au (search "Medicare Safety Net") or by calling Services Australia. Your local practice reception team can often point you to the current figures too.
Who is eligible?
If you are enrolled in Medicare, you are covered by the Safety Net. There is nothing extra to pay to take part.
• Singles are counted automatically.
• Couples and families can register as a family to combine their costs, which usually helps reach the threshold sooner.
The lower EMSN threshold applies to people who hold a Commonwealth concession card or receive Family Tax Benefit (FTB) Part A.
How families can register
If you are counted on your own, your costs are tracked automatically and you do not need to do anything.
If you are a couple or family and want to combine your costs, you need to register as a family. This matters because partners and children are not automatically grouped together for the Safety Net.
To register:
1. Sign in to your myGov account linked to Medicare, or use the Medicare app.
2. Look for the Medicare Safety Net option and follow the steps to confirm your family members.
3. Alternatively, complete a Medicare Safety Net registration form or call Services Australia for help.
It is worth registering early in the year so your costs start combining from the beginning.
How your costs add up toward the threshold
Every eligible out-of-hospital service you claim through Medicare counts toward your running total. This happens automatically whenever a claim is processed.
A few points worth knowing:
• Only out-of-hospital services count.
• The amount that counts depends on whether it is being measured for the OMSN (the gap) or the EMSN (your out-of-pocket cost).
• If you have registered as a family, everyone's eligible costs are added together.
• Your total resets to zero on 1 January each year.
What happens once you reach the threshold
Once you cross a threshold, the higher benefits kick in for the rest of that calendar year:
• Reaching the OMSN threshold means Medicare pays 100% of the Schedule Fee for eligible out-of-hospital non-GP services — such as specialist consultations and diagnostic tests — rather than the usual 85%. Note that eligible GP services already attract 100% of the Schedule Fee, so the OMSN benefit applies specifically to those non-GP services where the 85% rebate would otherwise leave a gap.
• Reaching the EMSN threshold means Medicare returns 80% of your out-of-pocket costs for out-of-hospital services, up to any cap that applies to certain items.
These higher benefits are usually applied automatically when your claims are processed, so in most cases you do not need to ask for them.
How to check your Safety Net balance:
It is easy to see how close you are to a threshold. Choose whichever option suits you:
Using myGov
1. Sign in at my.gov.au and select your linked Medicare service.
2. Go to Medicare Safety Net to view your current balance and threshold.
Using the Medicare app
1. Open the Medicare app on your phone and sign in.
2. Select Medicare Safety Net to see your progress.
By phone
• Call the Services Australia Medicare line on 132 011 and ask about your Safety Net balance. Have your Medicare number handy.
Practical tips for keeping records
A little record-keeping goes a long way:
• Keep your receipts and invoices for medical services, especially where you pay a gap or an out-of-pocket amount.
• Claim promptly so your costs are counted without delay.
• Check your balance a few times a year, particularly if you have had many appointments.
• Register your family early if you want to combine costs.
• If a figure looks wrong, contact Services Australia so it can be reviewed.
Frequently asked questions:
Do hospital costs count toward the Safety Net?
No. The Safety Net applies to out-of-hospital services only, not to costs you have as an admitted hospital patient.
Do I have to pay to join?
No. If you are enrolled in Medicare, you are already covered. There is no fee.
Does my balance carry over to next year?
No. Your total resets to zero on 1 January every year.
Why should my family register together?
Combining your family's eligible costs usually helps you reach the threshold sooner, so the higher benefits start earlier.
Will I automatically get the higher benefits?
In most cases, yes. Once you reach a threshold, the higher benefits are generally applied automatically when your claims are processed.
What is the difference between the OMSN and the EMSN?
The OMSN counts the gap between the 85% Medicare rebate and the Schedule Fee for eligible out-of-hospital non-GP services — such as specialist consultations and diagnostic tests. Once the threshold is reached, Medicare pays 100% of the Schedule Fee for those services for the rest of the year. Note that eligible GP services already attract 100% of the Schedule Fee, so they do not contribute a gap toward the OMSN. The EMSN counts your out-of-pocket costs and then returns 80% of them, sometimes up to a capped amount.
Where can I find the current threshold amounts?
For 2026, the thresholds are: OMSN $594.40 (everyone); EMSN $861.20 for concession card holders or those receiving Family Tax Benefit Part A; and EMSN $2,699.10 for all others. As these figures are updated each year, always confirm the current amounts at servicesaustralia.gov.au (search "Medicare Safety Net") or by calling 132 011.
Please note, this information is indicative only. Threshold amounts, benefits, and rules can change. For the most current details and advice about your own situation, visit servicesaustralia.gov.au or call Services Australia on 132 011.