Medicare Safety Nets (MSN) 011-43080000

MSNs:

• support customers that have high out-of-hospital medical costs
• helps customers by paying a MSN benefit in addition to the standard Medicare benefit, once a threshold is met
• are calculated on a calendar year basis, 1 January - 31 December

All customers enrolled in Medicare are automatically eligible for MSN as individuals. Families can choose to register as an MSN family so their combined expenses count toward the thresholds. This allows them to reach the threshold faster.

There are 2 MSN's:

• Original Medicare Safety Net (OMSN) - reached through gap expenses
• Extended Medicare Safety Net (EMSN) - reached through out of pocket expenses

The Resources page includes terms and definitions related to MSN.

The MSN does not apply to:

• services that are not listed on the Medicare Benefits Schedule (MBS)
• MBS services that are provided in hospital
• Child Dental Benefits Schedule (CDBS) items

Customers must meet thresholds before MSN benefits are paid. See Medicare Safety Net thresholds for more details.

Reaching MSN thresholds

When a claim is submitted to Medicare with MSN eligible services, the system automatically calculates the:

• gap amount, and
• out of pocket (OOP) expenses

Services Australia keeps a record of these amounts in CDMS and accumulates them toward the relevant MSN threshold.

To receive a MSN benefit:

• a MSN threshold must be reached
• any OOP expenses or gap amount are verified (if applicable), and
• registered MSN families must have confirmed their members

The MSN benefit is payable on eligible services for the remainder of the calendar year.

Previous versions of MSN forms that have a signature are acceptable. Customers can complete forms:

• digitally using Adobe Acrobat Reader
• on some browsers, or
• by printing and completing by hand

The relevant declarations must be completed by:

• a person over 14 years
• ticking the check box
• writing their full name:
• providing a middle name or date is not mandatory
• can be completed digitally or by hand

If a customer has not completed a form correctly in all required fields, Service Officers must return the form with an appropriate letter.