# Medicare safety net calculations

There are different thresholds for the Medicare Safety net and the benefit paid differs depending on which threshold has been reached. See below:

table
tr
th
th
 Threshold amount
th
 Who it is for
th
 How it is calculated
th
 What the benefit is
tr
td
Original
td
$421.70
td
All Medicare cardholders
td
Based on gap amount
td
100% of schedule fee for out-of-hospital services
tr
td
Extended Concessional and FTB (A)
td
$610.70
td
Concession cardholders and families eligible for FTB (A)
td
Out-of-pocket costs
td
80% of out-of-pocket costs or the EMSN benefit cap for out-of-hospital services
tr
td
Extended general
td
$1,221.90
td
All Medicare cardholders
td
Out-of-pocket costs
td
80% of out-of-pocket costs or the EMSN benefit cap for out-of-hospital services
Under the extended thresholds, rather than paying 100% of the MBS, Medicare will pay 80% of the out of pocket expenses OR either the entire cap, or 80% of the cap (language is unclear). For an item 23, the extended Medicare safety net (EMSN) cap is $108.90.

### Example

A patient classed as Extended General is entitled to 80 % of the out-of-pocket expenses they incur when visiting the doctor, if they have exceeded the yearly threshold ($1221.90). If the doctor charges $100 for the fee then the rebate would be calculated as follows:

Total Practice Fee ($100) = MBS Item 23 ($36.30) + Practice Gap ($63.70)

Patient's Total Out of Pocket Expenses ($63.70) = Practice Gap ($100) - MBS Item 23 ($36.30)

Total Rebate to Patient ($87.26) = 80 % of Patient's Out of Pocket Expenses ($50.96) + MBS Item 23 ($36.30)