Understanding Medicare Safety Net

[Cubs]

Hi everyone

My husband and I are TTC and I'm trying to work out costs and put some kind of budget together for private hospital.

I have worked out the fees for a few of the obs I'd like to use. The cheapest 'pregnancy management fee' I've found for an ob I like is around 1200.

If we get pregnant soon, I'd say we'll need to pay that fee this year. I'm trying to work out if the Medicare Safety Net Threshold thingy will play a part in how much we get back. This fee will take us over the 1100 threshold, but only just. What I'm trying to understand is - do I need to have reached the threshold completely before paying this fee in order to get a decent amount of it back?

Sorry for the confusion, I've searched the forums trying to work it out and just can't get my head around it.

Thanks for any help!!

[kylza]

From what I understand the answer to your question is yes, you would have had to have reached the safety Net to get the majority back.
For example if you were to pay the management fee today (hypothetically) you would reach your safety net and get a small amount back (say $200) now for the rest of the year you would get the majority of any bills you pay like scans, obs appointments, Dr's appts etc back.
My experience was I paid my management fee in August which put me over the threshold, I think I recieved $200 back. Then for the rest of the year I only had a small amount of out of pocket expenses as I had reached the saftey net threshold. IYKWIM????
So hard to understand:confused: maybe you could call medicare.
And to make it harder to understand I think medicare also is assessed by income as to what your saftey net threshold is.

[Cubs]

Hi Kylza

Thanks so much for your response. That makes sense. I had tried calling Medicare and the person 'helping' me confused me even more.

Thanks again :)

[MMelissa]

This is an issue I've been wondering about too.

With the medicare safety net, do you need to apply for it or are your refunds automatically adjusted once you exceed the threshold?

Does anyone know?

[bjj79]

You and your partner (if you have one) both need to register as a family. This way whenever one of you claims it goes towards your total. Medicare does the recording about how much you have spent out of pocket and will automatically start giving you 80% back when you hit the target.

I believe that once you register you don't need to re-register each year - but don't quote me on that.

B