Medicare Safety Net and breast cancer

How the Medicare Safety Net works

The Medicare Safety Net provides a higher Medicare rebate for appointments, treatments and tests done outside hospital once you've reached the safety net threshold in a calendar year.

The Safety Net covers a range of doctors' visits and tests that you receive out of hospital. Fees paid for treatment or tests when you are in hospital do not count towards the Safety Net. Once you reach the threshold, you still pay the same amount upfront to your doctor, however you will receive a higher Medicare benefit, reducing your out-of-pocket (gap) expenses.

Services that count towards the Medicare Safety Net include:

• GP and specialists' consultations
• scans and tests such as bone scans, CT scans, X-rays and ultrasounds
• blood tests.

Medicare Safety Net thresholds are changed annually to account for inflation.

There is also a Pharmaceutical Benefits Scheme (PBS) Safety Net, which helps if you have many prescriptions for medications in a calendar year. Read more about the PBS and breast cancer.

Registering for the safety net

Individuals are automatically registered for the safety net, but families and couples need to register to link all individuals as one family. If you have a partner and/or children, you need to register even if you're all listed on the same Medicare card. This is to ensure that the medical costs of all family members are taken into account so that you'll reach the threshold as soon as possible.

For more information, or to register, phone Medicare on 13 20 11, visit your local Medicare office or visit the Services Australia website.

There are different Safety Net thresholds depending on your circumstances. This includes safety nets for concession card holders and families eligible for Family Tax Benefit (A).

You can download the Medicare Express Plus app if you have a smartphone or tablet. The app gives you access to your claim history as well as showing you how close you are to the Safety Net threshold.

Options available to reduce medical costs

If you're concerned about gap fees associated with doctors' appointments and tests, talk to your specialist about whether you can be bulk billed.

Bulk billing is when your health professional accepts the Medicare benefit as full payment for a service. Many health professionals bulk bill pensioners and Health Care Card holders.

You can also talk to your specialist or service provider about whether they're able to claim the Medicare rebate on your behalf when you pay your full account so that you don't need to submit a claim to Medicare. Medicare will pay the rebate to the provider so that you only need to pay the gap amount.