Medicare Safety Net Threshold in Australia


Australia has the perfect Medicare universal health care system that provides health care available to all Australians. Medicare is financed through a Medicare levy of 2% tax on our wages that enables you an access to general practitioners and public hospitals.

Under normal circumstances, Medicare only covers a major portion of the costs incurred due to the outpatient treatments and procedures as per Medicare Benefits Schedule fee but rest of the cost i.e. ‘Gap’ becomes your responsibility.  

The costs of treatment can really pile up and put extra burden on tour pocket, especially when you have a chronic or ongoing health condition like diabetes or even pregnancy that requires lots many tests.

In such conditions, Medicare Safety Net (MSN) comes in effect and help if these out-of-pocket expenses reach a certain level called your MSN threshold.

How does Medicare Safety Net (MSN) work?

Medicare has a well designed system that automatically tracks all the gap payments made by you in a calendar year. When these out of pocket or gap payments reach a certain point i.e. threshold, additional cover will automatically becomes operative for all future out-of-hospital treatments.

The Medicare Safety Net covers a wide range of out-of-hospital doctor visits and medical tests are included in the Medicare Benefits Schedule. Once you reach the relevant threshold for medical costs, Medicare will pay a maximum of 80% of out-of-pocket costs incurred for out-of-hospital services for the rest of the calendar year. 

However, under new Medicare Security Net that come in force from 2014-15, provides further assistance for patients with high medical costs. Accordingly, increased Medicare benefit amount is payable to you once you have reached the annual threshold for eligible out-of-pocket medical expenses.

Since, Medicare Security Net comes with a cap; the maximum benefit i.e. the MBS benefit plus the Medicare Safety Net benefit that you can receive cannot exceed 150% of the Medicare Benefit Schedule fee.


Comparison of MSN 2019 VS 2020

Medicare Safety Net threshold 2019 vs. 2020 shows marginal increase in threshold in each MSN Threshold type. Threshold for OMSN in 2019 was $470.00 whereas in 2020 for it is $477.90 accrued to all cardholders assured 100% schedule fee for out of hospital services  

For Extended Medicare Safety Net (EMSN) Concessional and FTB Part A, threshold in 2019 was   $680.70 and in 2020 it is $692.20 for Concession cardholders and families eligible for FTB Part A are eligible for 80% of out of pocket costs or the EMSN benefit caps for out of hospital services.

Similarly, for Extended Medicare Safety Net (EMSN) – General, threshold in year 2019 was $2133.00 and in 2010, it is $2169.20 for All Medicare cardholders who will be eligible for 80% of out of pocket costs or the EMSN benefit caps for out of hospital services. 

For assisting Australian government, private health insurance companies like iSelect, play a crucial role in providing required health insurance to all. iSelect can help you in suggesting most suitable health insurance for you and your family and prevent your out-of-pocket medical expenses while enabling you to get treatment from your choicest doctor and hospital.


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