Extended Medicare Safety Net (EMSN) concessional threshold 011-43080010
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Medicare Consumers Program Support - Medicare Consumers Section - Medicare Branch
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Medicare Safety Net escalation form
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Examples
Table 1: examples of Extended Medicare Safety Net (EMSN) Concessional threshold eligibility and which threshold out-of-pocket (OOP) expenses accumulate towards
|
Eligibility type |
Example |
Members whose OOP expense accumulates to EMSN General |
Members whose OOP expense accumulates to EMSN Concessional |
|
Eligible EMSN Concessional individual |
Dylan, partner Sam and daughter Grace register as a Medicare Safety Net family. Dylan has an eligible concession card, but Sam and Grace do not. Sam and Grace are not eligible for the EMSN Concessional threshold. Dylan is a concessional individual. Dylan’s OOP expenses contribute towards both the family EMSN General threshold and his individual EMSN Concessional threshold. |
Dylan Sam Grace |
Dylan |
|
Eligible EMSN Concessional family |
Dylan, partner Sam and daughter Grace register as a Medicare Safety Net family. They all have eligible concession cards. Dylan, Sam and Grace are all eligible for the EMSN Concessional threshold. Their combined OOP expenses contribute towards the family EMSN Concessional threshold. |
Dylan Sam Grace |
|
|
Eligible EMSN Concessional sub-family |
Dylan, partner Sam and daughter Grace register as a Medicare Safety Net family. Only Dylan and his daughter Grace have eligible concession cards. Dylan and Grace form an EMSN Concessional sub-family and are eligible for the EMSN Concessional threshold. Both Dylan and Grace’s OOP expenses contribute to the family EMSN General threshold and their sub-family EMSN Concessional threshold. Sam doesn’t have a concession card. This means Sam isn’t part of the EMSN Concessional sub-family and isn’t eligible for the EMSN Concessional threshold. Sam’s OOP expenses only contribute towards the family’s EMSN general threshold. |
Dylan Sam Grace |
Dylan Grace |