For many Australian families, medical costs can creep up without warning — specialist appointments, tests, kids getting sick, or ongoing health issues. The good news is that Medicare has an important built-in protection many people don’t fully understand: the Medicare Safety Net. It’s designed to reduce your out-of-pocket costs once they reach a certain level in a calendar year. Knowing how it works — and what the 2025 thresholds are — can save your family real money.
What Is the Medicare Safety Net?
When you visit a doctor who doesn’t bulk-bill, you pay a “gap” — the difference between the doctor’s fee and the Medicare rebate. The Medicare Safety Net kicks in once your out-of-pocket costs reach certain limits, and from then on Medicare pays a higher rebate for the rest of the year.
This is especially useful for families with young children, expectant parents, people seeing specialists regularly, or anyone managing long-term conditions.
How It Works in 2025
Your out-of-pocket expenses accumulate from 1 January to 31 December. Once you hit one of the thresholds below, your rebates increase immediately.
There are two types of safety nets:
- Original Medicare Safety Net (OMSN)
This is the basic safety net and everyone is automatically included.
2025 threshold: $576.00 (gap expenses).
Once your gap payments pass $576 for the year, Medicare pays 100% of the MBS fee for out-of-hospital services.
This removes the MBS-fee gap — although you may still pay extra if your doctor charges above the MBS fee.
- Extended Medicare Safety Net (EMSN)
This is the more powerful version and where most families benefit. It increases the Medicare rebate for out-of-pocket expenses after standard rebates.
There are two EMSN thresholds:
- General EMSN threshold (2025): $2,615.50
Once your family’s out-of-pocket costs exceed this amount, Medicare pays 80% of your additional out-of-pocket costs for the rest of the year (up to capped limits for some services). - Concessional & Family Tax Benefit Part A threshold (2025): $834.50
If you hold a concession card or receive FTB Part A, you hit the EMSN much sooner.
Example:
If a specialist charges $300 and your normal Medicare rebate is $60, you would normally be out-of-pocket $240.
After reaching the EMSN threshold, Medicare covers 80% of that $240 — dramatically reducing your actual cost.
Families vs Individuals: Registration Matters
Couples and families must register with Medicare so their expenses are counted together. Without registration, Medicare treats each person separately — meaning you may miss out on hitting the thresholds.
Registration is free and only needs to be done once.
Who Benefits the Most?
- Parents whose kids see specialists or need ongoing treatment
- Pregnant mothers and families planning for childbirth
- People having regular scans, tests, or private specialist care
- Anyone expecting a period of higher medical costs
Tips to Make the Most of It
- Register as a family with Medicare immediately.
- Track out-of-pocket costs during high-cost periods.
- Ask your doctor whether a service is eligible for the EMSN.
- Remember: the Safety Nets reset every 1 January.
The Medicare Safety Net is one of the simplest and most effective ways Australian families can reduce unexpected medical bills. With a little planning and awareness, it can provide real financial relief — especially in the years when life throws a few extra curveballs.