Concessional Safety Net (CSN) threshold for Medicare 011-43080010

The CSN threshold is a lower Medicare Safety Net threshold for Commonwealth concession card holders and is indexed by the Consumer Price Index (CPI) on 1 January each year.

The CSN threshold amounts can be found in Medicare Safety Net thresholds.

A person may be eligible for the CSN threshold if they are a:

• Commonwealth Seniors Health Card holder
• Health Care Card holder
• Pensioner Concession Card holder

A person’s eligibility for the CSN commences from the first date that the concessional entitlement payment is received during the calendar year.

A person only has to be concessional for one day in a calendar year to be eligible to receive the CSN threshold for the rest of that calendar year, even if their concessional entitlement ceases.

Eligibility for the CSN threshold can be for an individual or for a family.

Eligibility information is stored within Services Australia’s Pharmaceutical Benefits Scheme (PBS) patient database. This data is sent to Medicare nightly from Centrelink.

Gold or White Cards issued by DVA are not eligible for the CSN. However, if a Gold or White Card holder also holds a recognised Commonwealth concession card and chooses to be treated under the Medicare arrangements, then that patient is an eligible concession card holder.

The Process page contains the procedure on how to check concessional status.

If a family is registered for the Medicare Safety Net (MSN) and a person within that registered family has a concessional entitlement, that concessional person is eligible for the Concessional Safety Net (CSN) threshold amount as an individual.

The concessional person's out-of-pocket (OOP) amounts will accumulate to the CSN threshold, however, the concessional persons OOP will also accumulate towards the registered EMSN family threshold.

When a concessional individual within a non-concessional MSN family reaches the CSN threshold, that individual will be paid the additional Medicare benefits (that is, an additional 80% of the OOP or the EMSN benefit cap) for all future claims where the necessary criteria is met and the remaining 20% OOP will attribute to the family's EMSN threshold.

See the Resources page for an example of an eligible concessional individual.

To be considered a family for the Concessional Safety Net (CSN), the CSN family must consist of:

• 2 or more people in the registered Medicare Safety Net (MSN) family have an eligible concession card, and
• 1 of the people with a concession card must be the MSN family contact (FC) or spouse (SP)

Only registered MSN family members with a concession card are eligible for the CSN threshold. All other members of the registered MSN family without a concession card aren’t part of the concessional family. This means they’re not eligible for the Concessional threshold.

Where 1 or more dependents within an MSN family are concessional, and the FC or SP are not, then the dependants are treated as individuals for the CSN.

Where an individual in a registered family is concessional and another member within the same family becomes concessional at a later date, the two concessional members will form a CSN family (provided at least one individual is not a child or student dependant).

The family concessional status will only be recognised from the date the second family member became concessional, and not from the date the first individual became concessional.

See the Resources page for an example of an eligible concessional family.