The Medicare safety net is designed to provide people or families with additional financial relief for high medical costs by reducing their out of pocket costs. When an individual or family receives different services in a year, the Medicare safety net limits their out of pocket costs for services received out-of-hospital. To be eligble for the Medicare safety net you have to be registered with Medicare and hold a Medicare card.
So how exactly does the MSN or Medicare Safety Net work?
So when a single or a family’s “gap” payments exceed the certain threshold amount in a calendar year, 100% of the Medicare Benefits Schedule (MBS) fee for out-of-hospital services is given back to the single or family through Medicare. But this is not necessarily 100% of the out of pocket costs as the treatment fee for medical costs and services like doctors appointments for family members may be higher than the schedule fee, which means there could still be some expenses to pay depending on the gap amount.
In this article we will go through the different areas of the Medicare safety net.
Medicare safety net thresholds.
Medicare Safety Nets have thresholds. So when you spend certain amounts in gap and out of pocket costs for different services in a calendar year like x-rays, doctors visits and doctors charges, you’ll reach the thresholds. Once you’ve reached the thresholds, you’ll start getting higher Medicare benefits. This simply means that you will get more money back from for certain Medicare services.
The original Medicare Safety net has a threshold amount of $477.90 and that is for everyone who is in Medicare and covers 100% of the fee for out of hospital services. The general extended Medicare safety net has a threshold amount of $2169.20 and is also for everyone in Medicare in Australia. It covers 80% of the fee for out of hospital services. The last one is the extended Medicare safety net- Concessional and Family Tax benefit part A. The threshold amount is $692.20 and covers people who are Concession cardholders and also families that are eligible for Family Tax Benefit Part A. t covers 80% of out of pocket expenses or the EMSN benefits caps for out of hospital services.
Some medical services allow you to claim medicare rebate after things such as ct scans, blood tests and other medical expenses. It can all be possible thanks to the Australian government and the department of human services in which Medicare now runs through.
There are a couple of questions that generally get raised when talking about the Medicare safety net for singles or families in regards to their health care. The most common question is how do i get it and do i need to do anything?
If you are a single person, you don’t actually need to do anything at all if you are already registered with Medicare. Medicare will automatically pay you the higher benefit when you reach the annual threshold whether that be from doctor’s visits and the doctor charges that come with it.
Couples and families will need to register so that Medicare can keep track of all of the total medical expenses of your family. You will need to do this even if you and your family are all on the same Medicare card, however you will only have to register once.
The other main question people ask is what Medical services count to the Medicare safety net? The services that count toward the Medicare safety net are the following. Your general practitioner and consultations, ultrasounds, Pap tests, blood tests as well as CT scans and x-rays. To go with that the services that are not covered by the Medicare safety net. The Medical services that will not covered by Medicare and any in-hospital services. For example, when you’re admitted to hospital for a medical service, your surgery, doctor visits and any tests are not included in the Medicare Safety net.
The great thing about it all is that the Medicare Safety net threshold is easy to keep an eye on. If you log on to your Medicare online account or through the express plus Medicare mobile app and check exactly where your threshold is currently at.
If you are a family Medicare will let you know when you’re close to reaching a Medicare Safety Net threshold. At that time Medicare will also ask you to confirm who’s in your family . Once you reach the threshold, Medicare will start paying you higher Medicare Benefits for the rest of the calendar year. You will also need to have confirmed with Medicare who your family members are to get the higher benefits.
The other important thing is that you must tell Medicare if your current situation changes. Things like if you and your partner have a baby together, if you adopt a child, if you and your partner seperate from each other and lastly if your dependent child leaves your care whether to stay with your partner or with someone else
So, overall the Medicare Safety net is a great idea by the Australian government. Also with the help of the department of human services it gives singles and families alike piece of mind that if they do have expensive medical services that will be coming up in the calendar year they will be properly covered.