2025 Medicare Safety Net: New Thresholds & How to Avoid Extra Gap Fees

The Medicare Safety Net is becoming increasingly important in 2025 as more Australians face higher out-of-pocket costs for GP, specialist and diagnostic services. While there is no major policy overhaul this year, the annual indexation has lifted all thresholds — meaning many households will reach the Safety Net later than they expect.

This guide breaks down the new 2025 thresholds, how the Safety Net actually works, and the practical steps you can take to avoid unnecessary gap fees.

1. What Changed in 2025?

Medicare Safety Net thresholds increase every 1 January. For 2025, Services Australia has confirmed the following:

Original Medicare Safety Net (OSN) threshold increased
Extended Medicare Safety Net (EMSN) family and concession thresholds increased
EMSN caps remain in place for high-cost specialist items
No legislative changes — only indexation

This means your household may need to spend slightly more on out-of-hospital Medicare services before receiving higher rebates.

2. 2025 Medicare Safety Net Thresholds

These are the updated amounts for 2025:

Original Medicare Safety Net (OSN)

$* (threshold updated annually — applies to all individuals)

Extended Medicare Safety Net (EMSN)

General families & individuals: $*
Concessional & Family Tax Benefit Part A: $*

(*Use the latest values from Services Australia; these updated thresholds are indexed each January.)

Once you reach the OSN, Medicare increases your rebate for out-of-pocket costs. After reaching EMSN, you receive even higher reimbursement — up to the EMSN cap.

3. Why Gap Fees Are Rising in 2025

While the Safety Net rules themselves have not changed, several factors have impacted gap fees across Australia:

More specialists charging above the MBS fee
Higher operating costs for clinics
Bulk billing incentives applied unevenly
Greater demand for diagnostic imaging (MRI, ultrasound)

This is why many households hit the Safety Net earlier — or face higher costs before reaching it.

4. How to Avoid Extra Gap Fees in 2025

1 — Always Ask for the “Medicare Fee + Gap” Breakdown

Providers must disclose:

The Medicare Benefits Schedule (MBS) item
The fee they charge
Your out-of-pocket cost

2 — Use a Bulk-Billing GP Wherever Possible

Bulk billing remains uneven across suburbs, but many clinics still offer free visits to:

Children
Concession card holders
Patients with chronic conditions (via care plans)

3 — Request the “No-Gap or Known-Gap” Option for Specialists

Some specialists participate in known-gap arrangements through private health insurers.

4 — Combine All Family Members Under One Medicare Safety Net

To activate EMSN faster, register as a family:

Partners
Dependent children
Carers in eligible households

5 — Track Your Spending in MyGov

Medicare now updates Safety Net totals automatically. Check it frequently to avoid unexpected bills.

6 — Ask for a “Written Financial Consent” Before Procedures

Hospitals and specialist clinics must provide an estimate before treatment.

5. What the Safety Net Does NOT Cover

Hospital admissions (covered under separate rules)
Cosmetic procedures not listed on the MBS
Non-MBS allied health services
Pharmaceutical costs (separate PBS Safety Net)

Sources

Services Australia — Medicare Safety Net
Department of Health — MBS Indexation
Medicare Benefits Schedule (MBS) 2025 Update
Australian Institute of Health and Welfare Reports

2025 Medicare Safety Net: New Thresholds and Higher Gap Fees Explained