Medicare Safety Net letters 011-43080110

Letter A is sent to individuals who are not in a registered Medicare Safety Net (MSN) family.

The purpose of this letter is to advise the individual they are nearing the MSN threshold, and there are services on their patient history requiring verification that may take them over the threshold and potentially qualify them for MSN benefits for a specific calendar year.

This letter lists all unverified services recorded for the individual for that calendar year.

Letter A is a system generated letter and is triggered when a patient claim is processed and the individuals combined verified and unverified out of pocket expenses are nearing the MSN threshold.

If the individual has myGov Inbox as their mailing preference, Letter A is directed to their myGov inbox. Otherwise, the letter will be mailed to their recorded address.

Letter A can only be produced for the current and previous calendar year.

Letter B is sent to individuals who are not in a registered Medicare Safety Net (MSN) family.

The purpose of this letter is to advise the individual they have reached/exceeded the MSN threshold for a specific calendar year.

This letter lists all unverified services recorded for the individual for that calendar year.

Letter B is a system generated letter and is triggered when a patient claim is processed and the individuals verified out of pocket expenses exceed the MSN threshold.

If the individual has myGov Inbox as their mailing preference, Letter B is directed to their myGov inbox. Otherwise, the letter is posted to their recorded address in the Consumer Directory Maintenance System (CDMS).

Letter B can only be produced for the current and previous calendar year.

Letter F is sent to the family contact (FC) of the registered Medicare Safety Net (MSN) family when the family is nearing the MSN threshold for that calendar year.

The purpose of this letter is to advise the family they are nearing the MSN threshold for that calendar year and they are required to confirm the composition of their family before MSN benefits can be paid.

Letter F is a system generated letter triggered when a patient claim is processed and the families combined total of verified and unverified out of pocket expenses reaches 70% (or above) of the MSN threshold.

Letter F is posted to the FC recorded address in the Consumer Directory Maintenance System (CDMS).

Letter F can only be produced for the current and previous calendar year.

Letter U is sent to members of a registered Medicare Safety Net (MSN) family or individuals not in an MSN family upon request.

The purpose of this letter is to list all unverified services for a specific calendar year.

Letter U is manually requested by service officers in the Consumer Directory Maintenance System (CDMS).

If the requestor has myGov Inbox as their mailing preference, letter U is directed to their myGov inbox. Otherwise, the letter is posted to their recorded address in the CDMS.

Where individuals or Medicare Safety Net (MSN) family members have no unverified payments, a Letter U cannot be issued.

Requesting Letter U for a member 14 years of age or over

Any member of a registered MSN family 14 years of age or over, can request a letter for themselves and/or any other member/s of the MSN family who are 14 years of age or over.

Where the letter is for a person 14 years of age or over, it will contain details of all their unverified payments for claims made on any Medicare card they are associated with within the requested calendar year. This is because the letter is Medicare PIN based.

If the letter has been requested for another member, and that member is 14 years of age or over, the letter will be addressed and issued to the member that the unverified payments relate to.

Requesting Letter U for a member under 14 years of age

Only the family contact (FC) or spouse/partner (SP) of the registered MSN family can request a letter for a child dependant under 14 years of age. Service Officers must verify that the requester is the parent or guardian of the child dependant.

Only unverified payments recorded against the Medicare number of the requester, i.e. SP or FC, will be listed. This is to ensure the child’s privacy y not listing any services claimed against another Medicare card.

The letter will be addressed and issued to the requesting person, i.e. either the FC or SP.

If the requester and the dependant are not on the same Medicare card, the Release of information for Medicare process must be followed.

Customers are able to view and print an Unverified Payment Statement via Medicare online services. The Unverified Payment Statement lists all unverified payments for an individual or a Medicare Safety Net (MSN) family member.

The family contact (FC) or spouse/partner (SP) of a registered MSN family will be able to access a dependant’s unverified payment information where the dependant is under 14 years of age and is listed on the logged in Medicare number.

Unverified Payment Statements cannot be displayed for anyone aged between 14-17 years old. For these customers, a Letter U will need to be requested.

Due to privacy requirements, a request must be made to the agency’s Information Release Section if the request is:

• for a person 14 years of age or over, and
• made by someone other than that person, and
• requested to be sent to the requesting person

or

• for a person under 14 years of age, and
• made by a parent or guardian on the same Medicare card who is not registered as part of the Medicare Safety Net family with the child, or
• made by someone who is part of the registered Medicare Safety Net family but not on the same Medicare card

A request cannot be made by or for a person who has a Date of Death recorded against their consumer record.

The details of Medicare Safety Net letters are recorded in the Inquiry Medicare Safety Net Details screens in CDMS for customer enquiry and audit purposes if they are either:

• requested via CDMS, or
• automatically generated through patient claiming

Service Officers can view these details under the Letters Details tab within each consumer’s record.