For 2023, these EMSN thresholds are:
If you are an individual, you don’t need to do anything – the higher rebate will automatically occur once you reach the threshold. However, if you are a couple or family, we recommend you register with Medicare as a family or couple so that any out-of-pocket costs occurred, can be combined and counted towards the Extended Medicare Safety Net thresholds and the PBS Safety Net thresholds.
If you are registered as a couple or family; once you, your partner, de-facto and children have spent over the threshold amount (under either the General or Concessional/Family Tax Benefit Part A if eligible); the Medicare rebate for subsequent services will increase. The below table provides this snapshot.
What this means for you and your family?
Before reaching the threshold (and as an example only):
On visiting Carindale Medical you pay your GP’s private fee of $92.00 for a standard consult and receive a Medicare rebate of $41.20 for a standard consultation with your Doctor. Your out-of-pocket cost is $50.80.
Upon reaching the threshold (and as an example only):
On visiting Carindale Medical you pay your GP’s private fee of $92.00 and receive a Medicare rebate of $41.20 + 80% of the gap ($50.80) – which would be a total of $88.84. Your total out-of-pocket cost is now only $10.16.
You can refer to the Carindale Medical fees page to understand appointment fees and out-of-pocket costs more.
Please follow the link to complete the application form at https://www.servicesaustralia.gov.au/ms016
As a guide, if you are a concession card holder or getting the Family Tax Benefit Part A, some 15 visits in a year to Carindale Medical across your entire family will see you reach this threshold. If you include specialist appointments or out-of-hospital treatment being received by a Doctor; it will be significantly less.
Confirming your family and ensuring you are best set-up to receive the EMSN should you reach a threshold, you can confirm your Medicare Safety Net Family by using your Medicare online account or Express Plus Medicare mobile app. Follow the instructions in this link to finalise this process.
If you are part of a registered family, you will need to confirm your family members before you reach the threshold each year.
Whilst Services Australia will remember who has been previously registered within your family, to start receiving the higher benefit / rebates, you need to confirm details with Services Australia. Typically, you will be sent a notification when you need to do this, but you can do this yourself through your Medicare online account at any time throughout the year.
Please ensure you follow the advice and directions outlined on the Services Australia website or contact them directly for further assistance.