Can some please explain the medicare safety net. My main confusion is with the years. I'm due in August 2007 so will being visiting my OB in both 2006/07 and 2007/08 years. Does this put me at a disadvantage? I think the safety net is per calendar year or am I incorrect?
From what I have heard, the Safety Net resets on the first of Jan.
Which is a bugger for us because we only hit ours a few months ago, and will have to go back to paying full price again soon.
Hi There,
I have just researched this myself whilst crunching some figures...
Ok, here are my findings: (sorry if TMI, as you probably already know most of this)
Medicare Safety net (SN) is available to all Medicare card holders - Singles are automatically registered for SN, couples and families need to register.
The SN year is per calendar year Jan - Dec. So it does put those who fall pregnany half way through the year at a huge disadvantage! :frown:
Once you reach $1000.00 out of pocket expenses, or Gap fees and after your medicare rebate (which is the scheduled fee Medicare says your doctor should be charging) you are entitled to a 80% discount on all futher services providing they are out of hospital.
EG. My Ob is going to charge me $3112.00 in Jan, so minus $1000.00 (safety net), minus $97.00 medicare rebate = $2015.00 out of pocket, Safety Net rebate is 80% of this amount. Any future trips to the OB in 2007 which usualy cost $80.00 are then going to cost me $16.00. SN can be used for specialists, sonographers, blood test etc, anything done out of hospital.
So to sum up - you have to loose $1000.00 out of pocket before you can get the discount of 80%.
AND now for the Tax rebate. You can claim 20% of all out of pocket expenses in your tax return once you are $1500.00 out of pocket- these expenses do not include monies you have recived in rebates from Medicare, including SN, they are the difference between the 80% rebate and the 100% cost.
The ATO website has more info on this.
Sorry if ive confussed anyone, please ask and i will try to clarify anything, im not the best at explaining sometimes!
Caro - I am in the same position - I am 20 weeks on the 2nd January! So far this year i am only $360 out of pocket so to ask to be billed this year is not good for us, seeing the visits will step up alot more next year as will the tests, scans etc...
WOW i wish my OB charged $1850.00 for planning and management! he is charging us $3112.00! I had to laugh, the Medicare shedule fee is advised at only $97.00!
I think no matter which way you look at it, we are all going to loose at least $1000.00. Our OB also charges another $1500.00 which is payable by week 32 and is NOT claimable on Medicare or Health insurance, it is the gap fee he charges for delivery, so basicaly, we are out of pocket $2900.00. Which is as we are very very happy with him and for a first bub, we just wanted the best, maybe next time if everything goes well, we will use the midwifes/share care as it probably won't be so daunting!
So are you saying that they can change the rebate from $97.00 to something higher? ive called Medicare and basically recorded verbatim what they told me. It is so confusing isn't it?
The lady told me that until i had spent $1000.00 (lost, gone, never to be seen again) i could not start to claim the 80% rebate.
Thanks everyone for your responses, very confusing but what i have worked out is that it is all good for as my first OB appointment is 2nd Jan so all expenses will be in the one year.
Just thought I'd add that if you already have a child and you are receiving Family Tax Benefit Part A then your Medicare threshold is $500.
Once your baby is born and then as long as you are eligible for Family Tax Benefit Part A your Medicare threshold will be adjusted.
Hope you can understand that
MSN definitely resets each calendar year, which is a good thing for DH and I, as we hit the safety net in the first quarter of the year with our IVF bills, and I paid my $1082 OB management fee yesterday. The receptionist said that I could pay it next year if I wanted ... but no way
Babushka - I hope your OB's delivery gap fee includes champagne and chocolates for the new parents
I know its a little steep isn't it, but after all we can afford it, really is only giving up 1 weeks pay each and wanted the best care (well based on opinion) for our first pregnancy and baby. I understand that our OB might not even make the birth due to other circumstances, but i think knowing we are under his care for the 9 months is reassuring.
If I had fallen pregnant early 2007, we would be much better of SN wise, but its not something that is always that easy to plan for! which really makes me mad about the Jan-Dec year, why can't they base it on the estimated date of conception???? arggghh
Ive found that this subject is one that everyone has a different opinion, so please don't take my advice as gospel - its the info i got and the way i perceived the info from Medicare, however im sure if i rang Medicare back and spoke to someone else, i may have different info - will just have to wait and see what i get back next year.
He charges $200.00 First Visit
Then $80.00 every visit thereafter, $3112.00 for Management of Pregnancy (20 weeks), then $1500.00 delivery gap fee ( I don't have the full cost of his delivery fee, i just know that we have to pay $1500.00 by 32 weeks and the amount is not claimable)
You are lucky that you are due 6/8/07! most of your bills will be next year? We fell in August, so ive already had my dating scan and Nuchal fold scan and Blood work so we are already $360.00 out of pocket - which we won't reach safety net this year ) :
I understood it to work out about the same whether you claim in the old year or the new year. If you claim the lump sum in the new year, then yes, initially you don't get much back compared to if you claimed in the previous year. But then all medical expenses from then on for that new year are a the 80% discount, so you end up with similar savings at the end of the day.
I'm glad I did ours at the end of last year tho.. coz the threshold went up from $750ish to $1000! So we WOULD have missed out on some money. hehe.
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