Medicare Safety Nets

Key facts

If you have a lot of medical expenses, you may be eligible for the Medicare Safety Nets.
The Medicare Safety Nets can give more money to people who spend over a certain amount of money on medical services outside of hospital.
You may be eligible for Medicare Safety Nets as an individual or as part of a family.
The Pharmaceutical Benefits Scheme (PBS) Safety Net can help with the costs of medicines — this is separate from the Medicare Safety Nets.

What are the Medicare Safety Nets?

The Medicare Safety Nets are set to support people who spend a lot on healthcare.

If you spend over a certain amount in a calendar year, Medicare can give you a higher amount of money back. This will last until the end of the calendar year. A calendar year is from 1 January to 31 December.

What services are covered by the Medicare Safety Nets?

The Medicare Safety Nets only cover services listed on the Medicare Benefits Schedule. You can look at these at MBS Online (Opens in new tab).

The Medicare Safety Nets do not cover medical services that you get in hospital. If your doctor suggests a service for you, you can ask them:

if the service is done in a hospital
if the service is covered by Medicare
what your out-of-pocket expenses will be

How do the Medicare Safety Nets work?

There are 2 Medicare Safety Nets:

the Original Medicare Safety Net — when you spend over a certain amount on gap expenses
the Extended Medicare Safety Net — when you spend over a certain amount out-of-pocket

Gap expenses are the difference between the Medicare benefit you get and the schedule fee.

The Medicare benefit is the amount of money you get from Medicare when you make a claim for a medical service you have received. This is usually 85% to 100% of the schedule fee.

The schedule fee is the dollar amount the Australian Government sets for each medical service.

You may pay the difference between the Medicare benefit you get and what your health practitioner charges. These are out-of-pocket expenses.

Other Medicare Safety Nets

The amount of money you receive through the Extended Medicare Safety Net may be different if you:

receive the Family Tax Benefit Part A (Opens in new tab)
are a Concessional Safety Net Family (Opens in new tab)

Read more below about what a Concessional Safety Net family is.

How do I get the Medicare Safety Nets?

If you are single and don't have children, you do not need to do anything. You will automatically get the Medicare Safety Nets when you have spent over the threshold.

If you are in a couple or family, you need to register for the Medicare Safety Nets. This will combine the costs of everyone in your family. It means that you are more likely to reach the threshold sooner. You need to register even if your family members are on the same Medicare card.

What is considered a family?

For the Medicare Safety Nets, a family can be any of these:

a married couple, not separated, with or without dependants
a couple in a de facto relationship, with or without dependants
a single person with dependants

A dependant is someone the family supports financially and is either a:

child under 16 years
full time student between 16 and 25 years

How do I register for the Medicare Safety Nets?

You only need to register once for the Medicare Safety Nets. This will apply to everybody listed on the Medicare card.

To register for the Medicare Safety Nets as a couple or family you can:

download and fill in the form (Opens in new tab)
call the Medicare program on 132 011

You can read more on how to register (Opens in new tab) on the Services Australia website.

How do I check my Medicare Safety Nets balance?

You can check your Medicare Safety Nets balance by using your Medicare online account (Opens in new tab).

What is a Concessional Safety Net Family?

You are part of a Concessional Safety Net family if:

2 or more people in your family have an eligible concession card
one of the concession card holders is the Medicare Safety Net family contact or spouse

Only family members with a concession card are eligible for the Concessional Safety Net threshold.

What are the Medicare Safety Net thresholds?

The amount you need to spend before accessing the Medicare Safety Nets depends on your situation. Your situation also affects the benefit you get back from Medicare.

You can find out which threshold applies to you as of 1 January 2025 (Opens in new tab) on the Services Australia website.

What is the PBS Safety Net?

The Pharmaceutical Benefits Scheme (PBS) lets you get prescribed medicines without paying the full price.

If you spend a lot of money on medicines, the Australian Government will support you through the PBS Safety Net (Opens in new tab). Once you reach the PBS Safety Net threshold, the cost of your medicines is reduced.

This is separate from the Medicare Safety Nets.