Two counters in your household go back to zero at the end of 31 December, and if you have been meaning to look at them, you’re in good company. One is the Medicare safety net, which only works for a couple or a family once Services Australia knows who is in the family. The other is the PBS safety net, which only works if somebody keeps a record of what you have spent on prescriptions, and that somebody is you.
Your safety net checklist before 31 December
0 of 15Medicare, once only
Medicare, this month
PBS, all year
Year-end review
Our position is to register the family with Services Australia now, because it does not happen by itself, even when everyone sits on one Medicare card. Keep your own PBS record, pay your doctors in full so the costs count, and let your doctor decide when care happens. Please don’t buy care to cross a threshold. The safety net pays back extra only after you have spent the threshold yourself, so spending to reach it costs you more than it returns. That is how Services Australia and the Department of Health, Disability and Ageing describe the net.
This is general information, not medical or financial advice. Every threshold below comes from an official page as it stood on 11 November 2026, and each carries its year.
Two safety nets, two jobs
The Medicare safety net covers out-of-hospital services that are on the Medicare Benefits Schedule (MBS), the official list of services Medicare pays towards. It has two parts. The Original Medicare Safety Net (OMSN) counts your gap, which is the schedule fee minus the Medicare benefit. The Extended Medicare Safety Net (EMSN) counts your out-of-pocket costs, meaning what you pay after Medicare’s share, including any charge above the schedule fee.
The PBS safety net is a separate counter for prescriptions on the Pharmaceutical Benefits Scheme. People often assume that hitting the Medicare limit makes your medicines cheaper too. It doesn’t. They are tallied separately, by different rules.
The Medicare safety net does not cover hospital services or anything that isn’t on the MBS. The PBS net covers PBS prescriptions only, and brand premiums and special patient contributions still apply after you reach it. On the Medicare side, dental is the everyday example, because most routine dental work isn’t an MBS service, so it doesn’t count. Our guide to what happens at a dental check-up covers what to expect there.
The Medicare thresholds, year by year
Both Medicare nets are reviewed each 1 January using CPI. Here are the figures the Department of Health, Disability and Ageing prints, as updated on 6 November 2026.
| Threshold | 2026 | 2027 | Rise |
|---|---|---|---|
| OMSN (everyone) | $594.40 | $617.50 | $23.10 |
| EMSN, concession card holders or families getting Family Tax Benefit Part A | $861.20 | $894.70 | $33.50 |
| EMSN, everyone else | $2,699.10 | $2,804.30 | $105.20 |
On our arithmetic each rise works out at about 3.9 per cent.
What you get after the line differs between the two. After the OMSN line, Medicare pays 100 per cent of the schedule fee instead of 85 per cent on the services that normally pay 85. After the EMSN line, Medicare pays up to 80 per cent of your later out-of-pocket costs, and some items are capped. In 2026, for instance, consultation attendance items are capped at 300 per cent of the MBS fee or $500, whichever is lower, according to the MBS Online factsheet.
A ruling on conflicting figures. If you’ve searched this and felt the numbers wouldn’t agree, you weren’t imagining it. One comparison page, last updated in June 2025, still prints the 2025 figures, including $2,615.50 for the general EMSN. The MBS Online factsheet prints the OMSN as $594.00, while the Department and Services Australia both print $594.40. We use $594.40, because two of the three official sources agree on it. And many pages don’t mention the 2027 thresholds at all, even though the Department has already published them. The table above gives each figure with its year, so you can check it against the source.
One more number, to give the OMSN some shape. It counts only the gap, and on a service paid at 85 per cent the gap is 15 per cent of the schedule fee. So you would need about $3,960 of schedule fees to reach $594.40 (our calculation).
Register the family
Individuals are tallied automatically. Couples and families are not. Services Australia is clear that even if all family members are on the same Medicare card, you will still need to register. You only do it once, unless your family changes.
Services Australia treats a family as a married or de facto couple, or a single person with dependants. A dependant is a child under 16 or a full-time student aged 16 to 25. To register, fill in the Medicare Safety Net couples and families registration and amendment form, or call Services Australia on 132 011. Your Medicare online account in myGov is for checking your tally and confirming your family, not for registering.
If something changes, such as a new baby, a separation or your dependent child leaving your care, tell Services Australia so the tally stays right. You may also be asked to confirm your family details as you get close to a threshold, so it’s worth keeping them up to date.
A family year (hypothetical)
Here is a worked example with made-up numbers, to show why the form matters. It isn’t a forecast.
Take a hypothetical family with no concession card and no Family Tax Benefit Part A, so the 2026 general EMSN threshold of $2,699.10 applies. Say parent A has $1,600 of verified out-of-pocket costs this year, parent B has $1,100 and their child has $400. No one person reaches $2,699.10. Together the family’s $3,100 does.
Then, in December, the child sees a specialist and the bill leaves $300 out of pocket. If the family is registered and has crossed the line, Medicare pays 80 per cent, which is $240, and the family pays $60. That assumes the item’s cap doesn’t bite. Consultation items are capped at 300 per cent of the MBS fee, so a $240 benefit needs a schedule fee of $80 or more (our calculation). If the family never registered, the tally never joined up, and they pay the full $300.
Paid in full, or it does not count
Services Australia counts only verified payments. An unpaid account does not count until it is paid, so a bill sitting in a drawer isn’t doing anything for your tally yet.
If you paid an account yourself and claimed afterwards, the receipt may need to go to a Services Australia service centre so it can be recorded. You can check what has been counted in your Medicare online account. Keep receipts and statements for specialist, imaging and pathology bills, because those are often the larger ones.
None of the official pages we read say whether a service counts by the date it happened or the date you paid. We won’t guess. If you’re unsure whether a bill has been recorded, ask the practice or Services Australia before the end of December, while the receipt is still easy to find.
The PBS side: you keep the record
The PBS safety net has its own thresholds, set from 1 January 2026. For general patients it is $1,748.20, and for concession card holders it is $277.20. Before you reach it, you pay up to $25 per script as a general patient, or up to $7.70 with a concession card. After it, general patients pay up to $7.70 and concession card holders pay nothing. The PBS thresholds are usually updated each 1 January, so check the Services Australia page for the 2027 figures then.
Your family’s amounts combine, and the counting is largely up to you. Ask your pharmacy to keep your family’s record on its computer, or use the PBS record form, and ask each pharmacy you use for a printout. People often complain that the PBS side is manual, and they have a point. Services Australia does say to keep track of your own medicines.
Community pharmacy scripts count, as do scripts from approved private hospitals and public hospital outpatient pharmacies. Early supply doesn’t count, and an extra brand cost may not count either. A medicine that isn’t PBS-listed generally doesn’t count, with one exception Services Australia names: non-PBS medicines from a public hospital outpatient pharmacy can count. Outside that exception, it is worth asking about listing before you start something new. Our guide to weight-loss injections in Australia goes through what to know before you ask your GP. When you reach the line, apply for a Safety Net card. If you paid over before you had the card, there is a refund form.
A household (hypothetical). Say a general-patient household fills six scripts a month, and every one costs the full $25. That is $150 a month, or $1,800 a year. Because $1,748.20 divided by $25 is 69.9, it takes 70 scripts to reach the line, which this household does only in December. A household filling fewer than 70 scripts at $25 in a year never reaches it. The same arithmetic for a concession household is $277.20 divided by $7.70, which is 36 scripts. The Department of Health, Disability and Ageing says that because of the lower co-payment and 60-day scripts, some families may no longer reach the PBS Safety Net, or may reach it later. That isn’t a reason to stop keeping the record. It only means your household may not reach the line.
Timing, and the one thing not to do
It is tempting, with a counter about to reset, to look for a way to make it work harder. Please don’t bring forward elective care, and please don’t buy care to cross a line. You have to spend the threshold before Medicare pays 80 per cent of the rest, so spending extra to get there costs more than it returns. Let your doctor decide when care happens.
If you have already crossed the line this year, a needed appointment before 31 December still gets the higher rebate. The rebate a front desk quotes may be the standard rate, so ask what applies to you.
You may also come across a tactic: asking a practice to bill after 1 January so a fee counts towards the new year’s tally. Others point out that the fee gets little back anyway. The official pages say nothing about billing dates, so we can’t tell you it works, and we won’t tell you it doesn’t. The side that favours asking has a fair point, because if a needed visit falls either side of 1 January, the date can change what it costs. So ask the practice, plainly, what service date will be recorded. Beyond asking, a visit you need shouldn’t wait for a counter.
What changes on 1 January
Your tally goes back to zero, for both the Medicare and the PBS nets. The Medicare 2027 thresholds in the table above start to apply. The PBS thresholds are usually updated each 1 January too. Your family registration stays, so you don’t register again, though you do need to let Services Australia know about any change in who is in your family.
What to settle before 31 December
You don’t need to do it all this week, and it is a short list.
Register the family with Services Australia if you haven’t, even on one Medicare card. Check your tally in your Medicare online account. Pay any doctor’s account that is still open, because unpaid ones don’t count. Start your PBS record, with the pharmacy or the record form, and ask each pharmacy for a printout. And if a visit falls near 1 January, ask the practice about the date, then book what you need when you need it.
That is our verdict. Register now, keep the PBS record yourself, pay in full and leave the timing to your doctor. The other side’s fair point is that a date can matter. It is a reason to ask the practice, never a reason to delay care.
Sources: Medicare safety nets, Department of Health, Disability and Ageing (https://www.health.gov.au/topics/medicare/about/safety-nets); What are the Medicare Safety Nets thresholds, Services Australia (https://www.servicesaustralia.gov.au/what-are-medicare-safety-nets-thresholds); How to register for Medicare Safety Nets, Services Australia (https://www.servicesaustralia.gov.au/how-to-register-for-medicare-safety-nets); Verified and unverified payments, Services Australia (https://www.servicesaustralia.gov.au/verified-and-unverified-payments); PBS Safety Net thresholds, Services Australia (https://www.servicesaustralia.gov.au/pbs-safety-net-thresholds); Keep track of your PBS medicines, Services Australia (https://www.servicesaustralia.gov.au/keep-track-your-pbs-medicines); PBS Safety Net and cost savings, Department of Health, Disability and Ageing (https://www.health.gov.au/cheaper-medicines/safety-net-and-cost-savings); Medicare Safety Net Arrangements factsheet 1 January 2026, MBS Online (https://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-Medicare+Safety+Net+Arrangements+-+1+January+2026)