medicine·saver / Guides / Medicare Safety Net 2026

Medicare Safety Net 2026: How to Track Your Threshold and Save

Updated March 2026 · 12 min read

Most Australians know Medicare covers GP visits and hospital care. Fewer know that Medicare also has a Safety Net that caps your annual out-of-pocket costs for medical services — and once you hit the threshold, you get significantly higher rebates for the rest of the year.

If you or your family see specialists, have regular pathology or imaging, or use mental health services, the Medicare Safety Net could save you hundreds or thousands of dollars per year. The key is knowing it exists and tracking your progress.

What Is the Medicare Safety Net?

The Medicare Safety Net is a government programme that provides higher Medicare rebates once your out-of-pocket medical costs reach a set threshold in a calendar year (1 January – 31 December).

There are two Safety Nets running simultaneously:

1. Original Medicare Safety Net

Detail	2026
Threshold	$560.40 (singles and families)
What counts	Gap amounts on out-of-hospital Medicare services (the difference between the Medicare rebate and the schedule fee)
Benefit after threshold	Medicare pays 100% of the schedule fee for out-of-hospital services (up from 85%)

2. Extended Medicare Safety Net (EMSN)

Detail	2026
Threshold (singles)	$820.30
Threshold (families/concession)	$820.30
Threshold (FTB-A families/concession singles)	$560.40
What counts	Out-of-pocket costs for out-of-hospital Medicare services (the difference between what you paid and the Medicare rebate you received)
Benefit after threshold	Medicare pays an additional 80% of future out-of-pocket costs (subject to per-service caps)

Original vs Extended: What's the Difference?

Feature	Original Safety Net	Extended Safety Net (EMSN)
What it measures	Gap between rebate and schedule fee	Gap between rebate and what you actually paid
Benefit	Rebate increases to 100% of schedule fee	Additional 80% of out-of-pocket costs
Main value	Helps when doctors charge at or near the schedule fee	Helps when doctors charge above the schedule fee (gap charges)
Interaction	Reached first (lower threshold)	Provides further benefit on top

Both Safety Nets can apply to the same person. You might hit the Original first, then the Extended later in the year — each providing incremental savings.

Which Medical Services Count?

Services That Count Towards the Safety Net

Specialist consultations (out-of-hospital)
GP visits (gap amounts, if your GP doesn't bulk-bill)
Pathology (blood tests, biopsies)
Diagnostic imaging (X-rays, ultrasounds, MRIs, CT scans)
Mental health services (psychiatrist, psychologist under Medicare)
Obstetric services
Allied health under Medicare-eligible items
Eye tests

Services That Do NOT Count

Hospital inpatient services (covered separately)
Dental (not covered by Medicare for adults)
PBS prescription costs (covered by the separate PBS Safety Net)
Ambulance
Private health insurance premiums or gap payments through your fund
Services not listed on the Medicare Benefits Schedule (MBS)

How Much Can You Save?

Before the Safety Net

For out-of-hospital services, Medicare typically pays 85% of the MBS schedule fee. You pay the remaining 15% (the "gap"), plus any amount your doctor charges above the schedule fee.

Example — Specialist visit

Schedule fee: $150.00
Medicare rebate (85%): $127.50
Doctor charges: $250.00
Your out-of-pocket: $122.50 ($250 – $127.50)

After the Original Safety Net

Medicare pays 100% of the schedule fee instead of 85%.

Same specialist visit after Original threshold

Schedule fee: $150.00
Medicare rebate (100%): $150.00
Doctor charges: $250.00
Your out-of-pocket: $100.00 ($250 – $150)
Saving vs before: $22.50 per visit

After the Extended Safety Net (EMSN)

Medicare pays an additional 80% of your remaining out-of-pocket costs (subject to per-service caps set by the government).

Same specialist visit after EMSN threshold

Doctor charges: $250.00
Medicare rebate (100% of schedule): $150.00
Remaining out-of-pocket: $100.00
EMSN benefit (80% of $100): $80.00
Your final out-of-pocket: $20.00
Total saving vs no Safety Net: $102.50 per visit

Annual Impact

For someone seeing a specialist monthly at $250 per visit (schedule fee $150):

Scenario	Annual Out-of-Pocket
No Safety Net	$1,470
After Original Safety Net	$1,200
After Original + Extended Safety Net	~$540
Total annual saving	~$930

Estimated. Actual savings depend on services used, doctor's fees, and EMSN per-service caps.

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How to Track Your Safety Net Progress

Option 1: Medicare Online (myGov)

The most reliable and up-to-date method:

Log in to myGov
Go to your Medicare account
Navigate to Safety Net (under Claims or Account)
View your year-to-date out-of-pocket total and how far you are from each threshold

Your Safety Net balance updates automatically as Medicare processes claims.

Option 2: Express Plus Medicare App

Download the Express Plus Medicare app (iOS or Android)
Log in with your myGov credentials
Check your Safety Net progress anytime

Option 3: Call Medicare

Phone 132 011 and ask for your current Safety Net balance.

Option 4: Your Medicare Statement

Medicare sends periodic statements that include your Safety Net progress. Check your myGov inbox or mail.

Family Registration

You can combine out-of-pocket costs from eligible family members into a single Safety Net threshold. This means your family reaches the threshold faster.

Who Can Be Included?

You and your spouse or partner (including de facto)
Your dependent children under 16
Full-time students aged 16-24

How to Register

Log in to myGov → Medicare
Go to Safety Net → Register as a family
Add eligible family members

Or call Medicare on 132 011 to register over the phone.

Important

Family registration is not automatic. You must actively register each calendar year (or confirm your existing registration) to combine thresholds. If you don't register, each family member's costs are tracked separately.

Medicare Safety Net vs PBS Safety Net

These are two separate programmes that are often confused:

Feature	Medicare Safety Net	PBS Safety Net
What it covers	Out-of-pocket costs for Medicare services (GP, specialists, pathology, imaging)	Co-payments for PBS prescription medicines
2026 thresholds	$560.40 (Original) / $820.30 (Extended)	$1,637.20 (General) / $326.40 (Concessional)
After threshold	Higher Medicare rebates	Free PBS prescriptions for rest of year
Tracking	myGov / Medicare app	myGov / Medicare app / pharmacy card
Family pooling	Yes (must register)	Yes (must register)
Resets	1 January each year	1 January each year

Both can save you significant money. Track both via your myGov Medicare account. For the PBS Safety Net, see our PBS vs Medicare Safety Net guide.

Tips to Maximise Your Medicare Safety Net

1. Register Your Family

Combining costs means reaching the threshold sooner. A family where two adults see specialists regularly can hit the threshold in months rather than never reaching it individually.

2. Track via myGov — Don't Guess

Many Australians cross the threshold without knowing it because they're not checking. Set a calendar reminder to check your balance quarterly.

3. Ask About Bulk-Billing

Bulk-billed services have zero out-of-pocket cost, so they don't help you reach the Safety Net — but they also don't cost you anything. If you're nowhere near the threshold, prioritise bulk-billing doctors to keep costs down. If you're close to the threshold, out-of-pocket visits count towards crossing it.

4. Time Non-Urgent Services Strategically

If you're close to the threshold late in the year, scheduling non-urgent services before 31 December means those services contribute to this year's Safety Net — and if you cross it, subsequent services that year cost less. Services in January start a new year and a new threshold.

5. Understand EMSN Caps

The Extended Safety Net has per-service caps to prevent excessive benefit claims. Some services (particularly obstetric and assisted reproduction) have specific dollar caps. Check the Department of Health EMSN caps schedule for current limits.

6. Combine with Private Health Insurance

The Medicare Safety Net covers the Medicare gap. If you also have private health insurance with gap cover arrangements, you may have very low or zero out-of-pocket costs for many specialist services. The two systems complement each other.

Frequently Asked Questions

What is the Medicare Safety Net threshold for 2026?

The Original Medicare Safety Net threshold is $560.40. The Extended Medicare Safety Net threshold is $820.30 (general) or $560.40 (Family Tax Benefit Part A recipients and concession card holders). These thresholds apply to the calendar year and reset on 1 January.

What is the difference between the Original and Extended Medicare Safety Net?

The Original Safety Net increases your Medicare rebate to 100% of the schedule fee (from 85%). The Extended Safety Net provides an additional 80% rebate on your remaining out-of-pocket costs above the schedule fee. Both can apply to the same person.

How do I check my Medicare Safety Net balance?

Log in to your Medicare account via myGov or the Express Plus Medicare app. Navigate to the Safety Net section to see your year-to-date out-of-pocket total and progress towards the threshold. You can also call Medicare on 132 011.

Can I combine family members’ costs towards the Safety Net?

Yes. You can register as a family to combine out-of-pocket costs from you, your spouse, and dependent children (under 16 or full-time students aged 16–24). Registration must be done each calendar year through myGov or by calling Medicare.

Is the Medicare Safety Net the same as the PBS Safety Net?

No. The Medicare Safety Net covers out-of-pocket costs for Medicare services (GP, specialists, pathology, imaging). The PBS Safety Net covers prescription medicine co-payments. They are separate programmes with different thresholds, but both can be tracked via your myGov Medicare account.

Do bulk-billed services count towards the Medicare Safety Net?

No. Bulk-billed services have zero out-of-pocket cost, so they don’t contribute to your Safety Net threshold. Only the gap amounts you actually pay count towards the threshold.

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General information only, not personal financial advice. Medicare Safety Net thresholds are set by the Australian Government and are subject to annual indexation. Always confirm your Safety Net status via myGov or by calling Medicare on 132 011. Data sourced from Services Australia, Health.gov.au.