The original Medicare safety net<\/a> covers the gap between the \u201cschedule fee\u201d (what the government deems the appropriate amount for the service) and the Medicare rebate (75-100% of the schedule fee<\/a>). It means that once a patient\u2019s yearly gap costs reach $576 (the threshold set for 2025), Medicare pays 100% of the schedule fee for each additional service that year.<\/p>\n The extended Medicare safety net, introduced by then-health minister Tony Abbott in 2004<\/a>, covers out-of-pocket fees, which is the difference between the Medicare rebate and what the doctor or health professional actually charges. Once a patient pays $2,615.50 (the threshold for 2025) in out-of-pocket costs in a year, Medicare will pay for up to 80% of future out-of-pocket costs.<\/p>\n While government spending on the original safety net has risen more modestly from $14.1m in 2010 to $20.9m in 2025, extended safety net spending has nearly tripled.<\/p>\n The government spent $850.4m in 2024 compared with $324.9m in 2010.<\/p>\n Sign up: AU Breaking News email<\/a><\/p>\n Peter Breadon, the health program director at the Grattan Institute, described this growth as \u201cexplosive\u201d during a period when specialist fees have \u201cgone up really fast, and much faster than inflation or the cost of providing care\u201d.<\/p>\n Breadon said the system has two key problems. First, the costs are surging because it\u2019s a badly designed subsidy with money going to fee-charging specialists and the wealthiest patients<\/a> who can afford to repeatedly see them. In addition, specialist fees are soaring, pushing more patients over the threshold each year.<\/p>\n Q&AHow do I get money back from the Medicare Safety Net? Show<\/p>\n For individuals, the government will automatically pay you the higher Medicare benefit when you reach the thresholds for both the original and extended safety nets. This applies even if you are an individual eligible for the lower extended safety net threshold as a concession card holder.<\/p>\n \u00a0<\/p>\n However, if you are part of a family or couple, you need to register as a family to combine your costs, which may help you reach thresholds sooner. Even if your family members are already on the same Medicare card, you still need to register through Services Australia as a family so they can record your combined expenses. <\/p>\n If you are in a registered family you will also need to confirm who\u2019s in your registered Medicare Safety Net family before you can get Safety Net benefits. When your family is close to reaching a Medicare Safety Net threshold, Services Australia will notify the nominated contact person for your family either by a myGov Inbox message or by post.<\/p>\n \u00a0<\/p>\n Families eligible for the lower extended safety net threshold are those that are Commonwealth concession cardholders and\/or families who receive Family Tax Benefit (Part A).<\/p>\n \u00a0<\/p>\n Further information on the safety net, including registration processes, is available from Services Australia\u2019s website<\/a>.<\/p>\n Thank you for your feedback.<\/p>\n A 2009 article in the Australian Economic Review<\/a> found the extended Medicare safety net \u201chas possibly created greater inequities in Australia\u2019s healthcare financing arrangements\u201d.<\/p>\n The Albanese government is reviewing the <\/a>Medicare safety nets, and caps on extended safety net benefits for some items first introduced in 2010 to curb fee inflation have been expanded.<\/p>\n A spokesperson for the Department of Health, Disability and Ageing said it has established a working group to discuss the operation of the safety nets, issued a consultation paper<\/a> for feedback and is now considering options for reform.<\/p>\n Addressing the underlying issue of rising specialist fees<\/a> requires addressing workforce shortages, improving access to public healthcare, and regulating excessive fees, Breadon said.<\/p>\n After Guardian Australia\u2019s series highlighting Australians\u2019 struggles to access specialist care,<\/a> former chief medical officer Prof Brendan Murphy said while safety nets had provided some relief for patients, the extended safety net had proven \u201c\u2026 inflationary and required additional caps to limit further fee escalation\u201d.<\/p>\n High fees have left patients unable to afford specialist consultations and pushed them into the \u201covercrowded public hospital system\u201d, his comments published in<\/a> the Medical Journal of Australia said.<\/p>\n \u201cThis, sadly, is a failure of one of the original aims of Medicare, that even uninsured people could access private outpatient care with an affordable copayment,\u201d he said in the article.<\/p>\n He said high specialist incomes, and the fees that generate them, have created challenges and that the disparity between the income of GP specialists and most other non-GP specialists is now \u201cunjustifiable\u201d.<\/p>\n While some have proposed redirecting extended safety net savings from caps towards higher specialists rebates, Murphy argued any new Medicare investment should focus on primary care and that \u201cadditional investment in specialists is harder to justify when incomes are high\u201d.<\/p>\n \u201cGiven the community and government angst about this issue, specialists would do well to reflect on the impact of their fees on patients and potentially consider a minor trade\u2010off in income,\u201d he said.<\/p>\n Read more:<\/p>\n Quick GuideContact Guardian AustraliaShow If you have something to share about this story, you can contact the Guardian Australia news teams using one of the following methods.<\/p>\n Secure Messaging in the Guardian app<\/p>\n The Guardian app has a tool to send tips about stories. 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Click on a person to see their details.\u00a0<\/p>\n – For end to end encrypted email you can create a free Protonmail<\/a> account and email\u00a0gaus.contact@protonmail.com<\/a>.<\/p>\n Messaging apps<\/p>\n You can also use the encrypted messaging apps Signal or WhatsApp to message us at +61 490 758 250.<\/p>\n SecureDrop and other secure methods<\/p>\n If you can safely use the tor network without being observed or monitored you can send messages and documents to the Guardian via our SecureDrop platform<\/a>.<\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2025\/11\/1764480363_293_4000.jpg\")
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