As we approach the end of the calendar year, many patients discover they’ve reached theirExtended Medicare Safety Net (EMSN) threshold – often without realising it.
If this applies to you, it could mean significantly reduced out-of-pocket costs for a wide range of out-of-hospital medical services until 31 December.
This can apply to services such as:

• Specialist medical care
• Paediatrics
• Allied health (including physiotherapy and psychology)
• Certain diagnostic services
• And more

  Once you reach the EMSN, Medicare pays 80% of the out-of-pocket cost (the gap) for eligible services for the remainder of the year.
  Patients are often surprised at the difference this can make to their healthcare costs.
  What does this look like in practice?
  Approximate examples once the EMSN applies:

• A $80 physio gap →around $16
• A $600 psychiatric gap →around $120
• A $150 paediatric specialist gap →around $30
• A $91 gap specialist consultation →around $18

  For individuals or families with regular care needs, this can provide meaningful financial relief at a time when healthcare spending can quickly add up.
  What is the Extended Medicare Safety Net?
  The EMSN is a government initiative to support people with high medical costs across the year for eligible out-of-hospital services.
  Each time you pay a gap fee, that amount is tracked by Medicare and counts toward your annual threshold. Once you reach that threshold,rebates increase automatically.
  There are two thresholds for 2025*:

• $834.50 for concessional individuals/families eligible for Family Tax Benefit Part A
• $2,615.50 for all other individuals/families

  Who is most likely to benefit?
  People who access regular or ongoing care, including:

• Patients with chronic conditions or complex medical needs
• Individuals receiving frequent specialist services
• Families with young children
• Those undergoing psychological or allied health services
• Patients requiring regular diagnostic imaging

  How to maximise your entitlements
  If you think you may benefit from the safety net, here are some quick steps to check your status and ensure you’re set up correctly:
  1. Confirm your registration as a family
  If you have a partner or dependents, register as a family with Medicare so your combined spending contributes to the same threshold.
  2. Monitor your progress
  Log in to your Medicare account via myGov to check how close you are to the threshold, it’s updated automatically.
  3. Claim all eligible services
  Make sure you submit claims for every eligible consultation or service you’ve paid for throughout the year.

  Why this matters now
  The EMSN resets every year on 1 January.
  If you’ve reached your threshold, or are close, it may be worth reviewing any recommended or ongoing care needs before the year ends.
  Need support?
  If you’re unsure whether you’ve reached the threshold, or whether your upcoming appointments may be eligible, please speak with our team. We’re happy to help you navigate what can be a complex system and make informed decisions about your care.
  The safety net is designed to support you when healthcare costs are high. Taking a moment to understand your eligibility may help you access the care you need – without unnecessary financial stress.
  *The information in this News article is correct as of 8th December 2025