Medicare safety net arrangements have changed since their introduction. The following tables offer a brief history of existing schemes and a simple comparison of their mechanisms.
Overview of Medicare safety net arrangements from 1974.
Greatest Permissible Gap (GPG)
- 1974 Medibank introduced with GPG of $5
- 1984 Medicare introduced with GPG of $10
- 1986 GPG increased to $20
- 1996 GPG Increased to $50
Original Medicare Safety Net (OMSN)
- 1984 original MSN introduced for individuals
- 1991 families' threshold added to the original MSN
Extended Medicare Safety Net (EMSN)
- 2004 EMSN introduced thresholds of $300 (concessional and Family Tax Benefit (FTB)) Part A and $700 (general non-concessional). Thresholds are increased by CPI (Consumer Price Index) each January using the September quarter index as published by the Australian Bureau of Statistics
- 2006 EMSN thresholds increased to $500 and $700 respectively
- 2010 benefits capped for obstetrics, Artificial Reproductive Technology (ART) and selected other services
- 2012 capping extended to all consultation items and some other items
- 2015 general non-concessional threshold increased to $2,000
Comparison of existing Medicare safety net arrangements
| Key features | Greatest Permissible Gap (GPG) | Original Medicare Safety Net (OMSN) | Extended Medicare Safety Net (EMSN) |
|---|---|---|---|
| Eligibility | All out-of-hospital (OOH) Medicare services where the difference between the Medicare Benefit Schedule (MBS) fee and MBS rebate exceeds the GPG amount. | All out-of-hospital (OOH) Medicare services. Counts gaps between Medicare Benefit Schedule (MBS) fee and MBS rebate. |
All out-of-hospital (OOH) Medicare services. Counts the out-of-pocket expenses for each service. |
| Benefit | MBS rebate is increased to the MBS fee less the GPG amount. | All further services are rebated at the level of the MBS fee. | Benefits increased to 80% of out-of-pocket costs except where a cap applies. |
| Thresholds | 2019: GPG amount $84.70* Affects MBS items with fee greater than $565.00 |
2020: $477.90 | 2020:
|
*GPG amount is indexed annually on 1 November in line with the Consumer Price Index (June quarter).
**OMSN threshold is indexed annually on 1 January in line with the Consumer Price Index (September quarter).
^EMSN threshold is indexed annually on 1 January in line with the Consumer Price Index (September quarter).