What is the Extended Medicare Safety Net?
The EMSN helps you with out-of-pocket medical costs once you've spent a certain amount on healthcare in a calendar year. Think of it as extra help with your medical bills after you've paid a lot in healthcare expenses.
What are out-of-pocket costs?
These are the costs you pay after Medicare gives you money back for your doctor's visits. For example, if your doctor charges $100 and Medicare gives you back $40, your out-of-pocket cost is $60.
There are two types of thresholds (spending limits):
- General Threshold - for most people
- Lower Threshold - for people with concession cards or Family Tax Benefit Part A
What happens when you reach a threshold?
- Medicare will pay you back 80% of your out-of-pocket costs for the rest of the year
- Some services have maximum limits on how much you can get back
- This only applies to medical services outside of hospital
Who can get the lower threshold?
You qualify if you have:
- A Commonwealth Seniors Health Card
- A Health Care Card
- A Pensioner Concession Card
- Family Tax Benefit Part A
Important things to know:
- If you're part of a family, you'll need to confirm your family members with Medicare
- Medicare will let you know when you're close to reaching your threshold
- The benefit lasts until the end of the calendar year
- You'll automatically start getting higher Medicare benefits once you reach your threshold
For more information, visit the EMSN section on the Services Australia website: https://www.servicesaustralia.gov.au/extended-medicare-safety-net?context=22001
