What is the Medicare Safety Net (and will it save my wallet)?

The Medicare Safety Net provides extra financial support to people who incur high out-of-pocket medical costs for out-of-hospital services.

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Nicola Middlemiss

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What exactly is the Medicare Safety Net?

The Medicare Safety Net is a government program that helps protect people and families who have high out-of-pocket medical costs - but it only applies to out-of-hospital expenses.

It works via a threshold system. Once you reach certain spending limits, Medicare increases its contribution to your medical expenses for the remainder of the calendar year, making your ongoing healthcare more affordable.

There are two distinct safety nets to be aware of:

  • Original Medicare Safety Net (OMSN): This increases Medicare benefits to 100% of the Medicare Benefits Schedule (MBS) fee once you reach the threshold. It means you won't have to pay anything if you go to doctors who bulk-bill or don't charge above the MBS fee.
  • Extended Medicare Safety Net (EMSN): This provides additional benefits when doctors charge above the MBS fee. Medicare will pay up to 80 per cent of any future out-of-pocket costs for eligible services for the remainder of the calendar year.

Understanding the Medicare Safety Net thresholds

Each safety net has different thresholds, and what counts towards the thresholds are calculated in different ways. The benefit you get back also varies between safety nets. The thresholds below apply for the 2026 calendar year.

Safety netThresholdWho it's forWhat counts towards the thresholdWhat you'll get back
Original Medicare Safety Net (OMSN)$594Everyone in MedicareYour gap amount for the calendar year100% of the schedule fee for eligible out-of-hospital services
Extended Medicare Safety Net (EMSN)$2,699.10Everyone in MedicareYour out-of-pocket amount for the calendar year80% of out-of-pocket costs or the EMSN benefit caps for out of hospital services.
Extended Medicare Safety Net (EMSN) - Concessional and Family Tax Benefit Part A$861.20Concession cardholders, pensioners, and families eligible for Family Tax Benefit Part AYour out-of-pocket amount for the calendar year80% of out-of-pocket costs or the EMSN benefits caps for out of hospital services.

Who benefits most from the Medicare Safety Net?

The Medicare Safety Net provides the greatest value to individuals who incur high out-of-hospital medical costs, including:

  • People with chronic conditions: People managing chronic conditions or in need of ongoing specialist care typically incur significant medical expenses. The Medicare Safety Nets gives them more financial support once they reach the thresholds.
  • Pensioners and concession cardholders: Pensioners typically require more ongoing healthcare but have lower incomes to cover the costs. However, as concession cardholders have a lower threshold for the Extended Medicare Safety Net ($861.20 vs $2,699.10 in 2026), they see savings much earlier than other groups.
  • Patients requiring expensive procedures: Anyone in need of costly diagnostic procedures or multiple specialist consultations can benefit significantly once thresholds are met.
  • Large families: Families can combine their medical expenses, making it easier to reach thresholds when multiple family members require medical care.

How to check and track your safety net status

It's easy to keep track of how close you are to reaching Medicare Safety Net thresholds:

Step 1: Set up online access

  • Create a myGov account at my.gov.au
  • Link your Medicare account to myGov

Create a myGov account

Step 2: Check your current status

  • Log into your Medicare online account through myGov
  • Navigate to the "Safety Net" section and click "View details"

    • Navigate to the

  • You'll be able to see your current out of pocket costs and your relevant threshold.

current out of pocket costs and your relevant threshold

Other ways to check your threshold

  • Download the Express Plus Medicare app: You can access the same information via Medicare's free app, making it easy to check thresholds on-the-go and at medical appointments.
  • Call Medicare directly: Prefer to speak with someone? You can call Medicare on 132 011 for immediate threshold information. Have your Medicare card ready.

Eight-year-old Cilla has cystic fibrosis. Managing Cilla's health condition can get very expensive, due to the ongoing cost of medical equipment, prescription drugs, physiotherapy, psychology, and other specialist doctors fees.

However, Cilla's family is eligible for the Extended Medicare Safety Net (EMSN) - Concessional and Family Tax Benefit Part A. This means once the family's out-of-pocket costs for out-of-hospital Medicare services, such as specialist fees, reach $861.20, Medicare will start to cover 80% of those out-of-pocket costs, or the EMSN benefit caps. Medicines and equipment don't count towards this safety net.

Cilla's family reaches the $861.20 threshold by March. For the rest of the year, they know they can rely on more substantial support from Medicare, which saves them thousands of dollars.

This is a fictional case study for demonstrative purposes only.

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Our expert says

"The Medicare Safety Nets aren't just about saving money. They help people access the healthcare they need, without incurring an unfair financial burden. Keep track of your spending through your Medicare account or the app, to ensure you're getting the benefit if you need it."

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Nicola Middlemiss is a journalist with nearly a decade of experience in personal finance and insurance. She has contributed to Domain, Yahoo Finance, Money Magazine and Insurance Business Australia, offering in-depth insights into commercial insurance in the Australian market. Nicola holds a Bachelor’s degree in English from the University of Leeds and a Tier 1 General Insurance (General Advice) certification, which complies with ASIC standards. See full bio

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Nicola has written 170 Finder guides across topics including:
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