Medicare Safety Net

• Benefits
  
  If you see a doctor often, or have tests regularly, your medical costs could be high. Visiting a doctor or having tests may cost you less once you reach a Medicare Safety Net threshold.
  
  Once you reach the relevant threshold, the Medicare Safety Net may provide a higher Medicare benefit for all eligible services for the rest of the calendar year. This may mean that visits to your doctor or having tests could cost you less. For example, once you reach the relevant threshold, you still pay the same amount upfront to your doctor, however you may receive a higher Medicare benefit, making your out of pocket expenses much less.
  
  
• Confirming who is in your family
  
  If your family is close to reaching a Medicare Safety Net threshold, we will ask you to confirm the members of your Medicare Safety Net family for that year. Confirming your details allows us to check your family’s eligibility for higher Medicare benefits.
  
  
• Services covered
  
  The Medicare Safety Net covers a range of out of hospital doctor visits and tests covered by the Medicare Benefits Schedule.
  
  These include:
  
  
  • Healthcare professional consultations
    
  • blood tests
    
  • CT scans
    
  • pap smears
    
  • psychiatry
    
  • radiotherapy
    
  • tissue biopsies
    
  • ultrasounds
    
  • x-rays
  
  
  If a service is not in the Medicare Benefits Schedule it does not count towards the Medicare Safety Net. If you have surgery, see a doctor or have tests while you are in hospital, these services don’t count towards the Medicare Safety Net.
  
  
• Keeping a tally of medical expenses
  
  If you pay your doctor before claiming your Medicare benefit, we’ll automatically keep a tally of your out of pocket medical expenses.
  
  If you claim from us before paying your doctor:
  
  we will send you a cheque made payable to the doctor, which you take or send to your doctor with any outstanding balance you owe
  bring us the doctor’s receipt and the Medicare statement you received with our cheque and we will add your out of pocket amount to your Medicare Safety Net balance
  we will contact you when you are nearing a Medicare Safety Net threshold and may ask you to verify any unpaid claims
  If you only pay the gap amount to the doctor we usually add your out of pocket amount to your Medicare Safety Net threshold for you.
  
  Once you reach the relevant threshold, the Medicare Safety Net may provide a higher Medicare benefit for all eligible services for the rest of the calendar year.