If you see the doctor often, the Medicare Safety Net can lower what you pay out of pocket. Once your eligible costs for the year reach the threshold, Medicare may pay a higher rebate for services outside the hospital. Couples and families who register together may get there sooner.
The Medicare Safety Net helps with the cost of eligible medical services provided outside hospital. These can include GP consultations, specialist appointments and some blood tests and scans.
Medicare keeps track of eligible costs throughout the calendar year. Once you reach a threshold, you may receive higher Medicare benefits for the rest of that year.
There are two Medicare Safety Nets. The one that can provide an additional rebate for your out of pocket costs is called the Extended Medicare Safety Net.
The Extended Medicare Safety Net is based on your eligible out of pocket costs. This is the difference between your doctor’s fee and the Medicare benefit you receive.
Once you reach the relevant threshold, Medicare generally pays an additional 80% of your out of pocket cost for eligible services. Some services have a benefit cap, which means the additional payment may be less than 80%.
For example, imagine an eligible consultation costs $200 and your usual Medicare rebate is $100. Your out of pocket cost is $100.
If you have reached the Extended Medicare Safety Net threshold, Medicare may pay an additional $80. You would then be $20 out of pocket, provided no lower benefit cap applies. These amounts are an example only and are not our fees.
The Extended Medicare Safety Net has a general threshold and a lower threshold for eligible patients. The amounts below apply from 1 January to 31 December 2026.
| Patient group | 2026 threshold |
|---|---|
| General patients | $2,699.10 |
| Eligible concession cardholders and families eligible for Family Tax Benefit Part A | $861.20 |
Eligible concession cards include a Pensioner Concession Card, Health Care Card and Commonwealth Seniors Health Card. Medicare can help you check which threshold applies to you.
Thresholds can change each year. You can find the current thresholds online.
If you are enrolled in Medicare, you are automatically registered as an individual. Medicare tracks your eligible costs and pays a higher benefit when you reach a threshold.
However, couples and families need to register as a Medicare Safety Net family if they want their costs combined. This is a separate step, even when everyone is on the same Medicare card.
Combining eligible costs can help your family reach the threshold sooner. Once your registered family reaches the threshold, confirmed family members can receive higher benefits for eligible services.
Medicare recognises several types of families for Safety Net purposes. You can register if you are in one of the following groups.
For Medicare Safety Net purposes, a dependant is someone you support financially who is under 16 years old. A full time student aged 16 to 25 years may also qualify.
You generally only need to register once. However, you should update Medicare if your family circumstances change, such as when you have a child or separate from a partner.
You can register your family by calling Medicare or completing a registration form. You can use the same options to update your family details.
Medicare asks registered families to confirm their members when they are close to a Safety Net threshold. This helps make sure the higher benefit is paid to the right people.
Medicare will contact the nominated family contact through their myGov inbox or by post. The contact person or their partner can confirm the family through Medicare online or by calling 132 011.
Check and respond to this message. Medicare needs your family details confirmed before it can pay the higher family benefit.
You can check your progress through your Medicare online account linked to myGov. The balance shows how much has been counted towards your threshold.
To check, sign in to myGov or the myGov app and select Medicare. You can also call Medicare on 132 011 if you need help.
When you check your account, look for the following information.
The Medicare Safety Net applies to eligible Medicare services provided outside hospital. Not every health expense counts towards the threshold.
Eligible services may include GP and specialist appointments, along with some tests and scans. Medicines are covered by a separate scheme called the Pharmaceutical Benefits Scheme Safety Net.
Only verified payments count towards your Medicare Safety Net threshold. A payment is generally verified when you pay the full account before claiming your Medicare benefit.
If you claim before paying the account, Medicare may ask for proof of payment before counting the expense. Keep your receipts in case you need them.
Once an individual reaches the relevant threshold, Medicare automatically pays the higher benefit for eligible services. The higher benefit continues until the end of the calendar year.
If you are part of a registered family, Medicare needs your family members confirmed before it can pay the higher family benefit. The Safety Net then resets on 1 January.
Reaching the threshold does not change the fee charged by your doctor. It changes the Medicare benefit you may receive for eligible services.
Are individuals and families registered the same way?
No. If you are enrolled in Medicare, you are registered as an individual automatically. Couples and families have to register as a Safety Net family before Medicare will combine their costs.
Which concession cards count towards the lower threshold?
Eligible cards include the Pensioner Concession Card, Health Care Card and Commonwealth Seniors Health Card. Families eligible for Family Tax Benefit Part A also get the lower threshold. Medicare can tell you which threshold applies to you.
What counts towards my Medicare Safety Net threshold?
Verified payments for eligible services outside the hospital. A payment is usually verified when you pay the full account before you claim your Medicare benefit.
Does reaching the threshold reduce my doctor’s fee?
No. Your doctor charges the same fee. What changes is the Medicare benefit you may get back.
When does the Medicare Safety Net reset?
On 1 January. The higher benefit lasts until the end of the calendar year, then your count starts again.
Our reception team can explain our fees and help you understand the usual Medicare rebate for your appointment. Medicare can answer questions about your personal Safety Net balance, registration and eligibility.
If you or your family have regular medical expenses, take a few minutes to check your Medicare account. Registering your family may help you reach the threshold sooner, and keeping your details up to date helps Medicare pay the higher benefit to the right people.
For more information, find out more about Medicare Safety Nets or call Medicare on 132 011.
