What is the Medicare Safety Net?
The Medicare Safety Net increases your Medicare benefits for out-of-hospital services once your medical costs pass a threshold within a calendar year. It covers things like GP and specialist visits, blood tests, and scans. Your appointments still cost the same at the desk; what changes after you cross a threshold is how much Medicare gives back. Amounts accumulate from 1 January to 31 December, then reset.
Everyone enrolled in Medicare is eligible. Individuals are covered automatically; families and couples can register with Services Australia to combine their costs, which usually reaches a threshold sooner.
Medicare Safety Net thresholds for 2026
Thresholds are set each year from 1 January. These are the current 2026 amounts, verified against Services Australia:
| Safety Net | 2026 threshold | Who it covers | What counts | Benefit after crossing |
|---|---|---|---|---|
| Original Medicare Safety Net (OMSN) | $594.40 | Everyone enrolled in Medicare | Your gap amounts for the calendar year | 100% of the Medicare schedule fee for out-of-hospital services |
| Extended Medicare Safety Net (EMSN), general | $2,699.10 | Everyone enrolled in Medicare | Your out-of-pocket amounts for the calendar year | 80% of out-of-pocket costs, or the EMSN benefit caps, for out-of-hospital services |
| Extended Medicare Safety Net (EMSN), concessional and FTB Part A | $861.20 | Concession cardholders and families eligible for Family Tax Benefit Part A | Your out-of-pocket amounts for the calendar year | 80% of out-of-pocket costs, or the EMSN benefit caps, for out-of-hospital services |
Only verified payments count toward a threshold: a payment is verified when you have paid the provider in full before claiming from Medicare.
Gap costs vs out-of-pocket costs
The two Safety Nets count different things, and the distinction is the part most people find confusing. The gap amount is the difference between the Medicare schedule fee for a service and the Medicare benefit you received. The out-of-pocket amount is the difference between what the provider actually charged and the Medicare benefit. When a provider charges above the schedule fee, your out-of-pocket amount is bigger than your gap amount.
The Original Medicare Safety Net counts gap amounts toward its $594.40 threshold. The Extended Medicare Safety Net counts out-of-pocket amounts toward its $2,699.10 general threshold (or $861.20 for concession cardholders and families eligible for Family Tax Benefit Part A).
How the Safety Net interacts with bulk billing
Bulk billed services have no gap and no out-of-pocket cost, so they add nothing to your Safety Net tally, and they do not need to. The Safety Net exists to soften the cost of services you pay a gap for. A bulk billed consultation costs an eligible Medicare cardholder $0 whether or not any threshold has been reached.
In practice many people mix the two: bulk billed GP consultations where they can find them, and gap-charging specialists or tests that accumulate toward the Safety Net. NewDoc's telehealth GP consultations are bulk billed for eligible Medicare cardholders, $0 out of pocket. If you are checking your card details before booking anything, our Medicare number validator checks the card-number format.
Frequently asked questions
What is the Medicare Safety Net?
The Medicare Safety Net gives you higher Medicare benefits for out-of-hospital services once your gap or out-of-pocket medical costs pass a threshold within a calendar year. It exists so that people who need frequent GP visits, specialist appointments, tests, or scans get more back from Medicare in the second half of their spending year. The thresholds reset every 1 January.
What are the Medicare Safety Net thresholds for 2026?
For 2026: the Original Medicare Safety Net threshold is $594.40 (gap costs, everyone in Medicare), the Extended Medicare Safety Net general threshold is $2,699.10 (out-of-pocket costs, everyone in Medicare), and the Extended Medicare Safety Net concessional and Family Tax Benefit Part A threshold is $861.20. Thresholds are set each year from 1 January; these figures were verified against Services Australia in July 2026.
Do I need to register for the Medicare Safety Net?
Individuals do not need to register: if you are enrolled in Medicare, your gap and out-of-pocket costs count automatically. Families and couples DO need to register with Services Australia to combine their costs toward a shared threshold, even if everyone is on the same Medicare card. Registering as a family usually reaches a threshold sooner than any one member would alone.
Do bulk billed appointments count toward the Safety Net?
No, and that is a good thing. Bulk billed services have no gap and no out-of-pocket cost, so there is nothing to count toward a threshold. The Safety Net exists to soften the cost of services you pay a gap for; a bulk billed consultation costs you $0 in the first place, whether or not you have reached any threshold.
What is the difference between a gap amount and an out-of-pocket amount?
The gap amount is the difference between the Medicare schedule fee and the Medicare benefit you were paid. The out-of-pocket amount is the difference between what the provider actually charged you and the Medicare benefit. If a provider charges above the schedule fee, your out-of-pocket amount is larger than your gap amount. The Original Safety Net counts gap amounts; the Extended Safety Net counts out-of-pocket amounts.
When does the Medicare Safety Net reset?
Every calendar year. Safety Net amounts accumulate from 1 January to 31 December, and the thresholds themselves are re-set (indexed) each 1 January. Costs you accumulated in one year do not carry into the next.
Why has a payment not counted toward my threshold?
Only verified payments count. A payment is verified when you have paid the provider's bill in full before claiming from Medicare. If you claimed before fully paying, the payment sits as unverified and does not count toward your threshold until you finish paying and it is verified with Services Australia.
References
- Medicare Safety Nets, Services Australia
- What are the Medicare Safety Nets thresholds, Services Australia
This content is informational and does not replace individual medical advice. For personal assessment, book a consultation with your GP. In emergencies, call 000.
Last reviewed: 2026-07-17