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  1. #1
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    Default Medicare Safety Net??? Help!

    Hi, can someone please explain the Medicare safety net to me?
    Some OB's are saying I will get around 500 back for the management fee, while others are saying 250...
    If the management fee is 2000, does that mean I automatically reach the threshold? There will also be an initial consult of $230 out of pocket and the the 30 week cost of 1000 which I can't claim.

    The other one that said $500 has a management fee of 2500 - is this why I get more back, because it's over the $2000?

    Normally we see bulk billing doctors so I would imagine our threshold is close to 0.

    Thanks!

  2. #2
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    The pmf will put you over and you'll be enjoying the benefits for the rest of the year $500 could be because you have reached the level

  3. #3
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    We received $493 back for our pmf. We had not reached the safety net threshold prior paying it - but obviously have now. Our pmf was $4000.

    You can log in to Medicare and see what your safety net threshold is and what your current balance is.

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    Thanks guys, I am starting to get my head around it!

    Just to clarify - if we go with the cheaper OB, our initial consult out of pocket will be 228 and then the pmf will be 2000 BEFORE a rebate, so I think we would only get 250ish back as the total out of pocket will be just less than 2000. (Please correct me if I have interpreted this wrong).

    Is there any fees for the 12 week scan? Or does this get bulk billed? Trying to see if there are any additional fees that will bump us up. I guess in the end it all balances out, I just like to know what my costs are up front.

    Thanks again!

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    Ps. For what it's worth, my current balance is $0

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    Are you pregnant now or just researching? The reason why i ask is because some oby book out really quick ( especially cheap ones) so you need to be booking almost as soon as you get your BFP.
    I would also go with the oby you're comfortable with not just one that will save you a few $$.
    Things to consider:
    Are they no gap ( at delivery)
    What is their consultant costs per visit?

    Things that count towards safetynet:

    https://www.humanservices.gov.au/cus...are-safety-net

    Healthcare professional consultations
    blood tests
    CT scans
    pap smears
    psychiatry
    radiotherapy
    tissue biopsies
    ultrasounds
    x-rays
    If a service is not in the Medicare Benefits Schedule it does not count towards the Medicare Safety Net. If you have surgery, see a doctor or have tests while you are in hospital, these services don’t count towards the Medicare Safety Net

    My understanding is basically anything with an item number,

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    Also worth mentioning that the safety net goes by calendar year. So if you have a baby late in the year (ie you pay your OB fees early in the calendar year), you'll get most benefit. If you have your baby early in the year (ie pay your OB fees late in the calendar year, it's usually done around 20 weeks), you won't get to benefit much from the safety net as it goes back to 0 as of Jan 1st.

  8. #8
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    Default Medicare Safety Net??? Help!

    Quote Originally Posted by Llee1703 View Post
    Thanks guys, I am starting to get my head around it!

    Just to clarify - if we go with the cheaper OB, our initial consult out of pocket will be 228 and then the pmf will be 2000 BEFORE a rebate, so I think we would only get 250ish back as the total out of pocket will be just less than 2000. (Please correct me if I have interpreted this wrong).

    Is there any fees for the 12 week scan? Or does this get bulk billed? Trying to see if there are any additional fees that will bump us up. I guess in the end it all balances out, I just like to know what my costs are up front.

    Thanks again!
    I had to pay $190 out of pocket for 12 week scan and morph scan. Also, my ob charged a higher amount for first appointment, then $100 per appointment (before Medicare). So for appointments before management fee I was getting about $40 back from Medicare. After the safety net was reached I think it was about $60 or $70 back
    Last edited by Lil Smurfy; 20-05-2016 at 09:16.

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    I am 4 weeks now - due end of Jan 17, so will have those expenses paid? I will book next week.. Both OB's said that should be ok, I hope! My period isn't due till sat so I found out a bit earlier? That's what I am hoping anyway... I need to confirm that my insurance will cover me if my due date changes as my due date is currently on the day my waiting period is finished - talk about cutting it fine!
    I WISH I did the research prior, I really had no idea how quickly they book out or any of this information!

    It's hard to tell which OB I will be more comfortable with as I need to book them before I can meet them... From what I have read both have good reviews, the more expensive one just has more posts. I'm sure either one will be great.

    Thank your for also bringing to my attention the no gap at delivery - I just assumed that their cost for delivery would have been included? Or is this for the anethetist etc?

    I was also told I may be charged for an anethetist for epidural depending on who is on. What are these costs roughly?

    So many questions sorry

  10. #10
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    Quote Originally Posted by Llee1703 View Post
    I am 4 weeks now - due end of Jan 17, so will have those expenses paid? I will book next week.. Both OB's said that should be ok, I hope! My period isn't due till sat so I found out a bit earlier? That's what I am hoping anyway... I need to confirm that my insurance will cover me if my due date changes as my due date is currently on the day my waiting period is finished - talk about cutting it fine!
    I WISH I did the research prior, I really had no idea how quickly they book out or any of this information!

    It's hard to tell which OB I will be more comfortable with as I need to book them before I can meet them... From what I have read both have good reviews, the more expensive one just has more posts. I'm sure either one will be great.

    Thank your for also bringing to my attention the no gap at delivery - I just assumed that their cost for delivery would have been included? Or is this for the anethetist etc?

    I was also told I may be charged for an anethetist for epidural depending on who is on. What are these costs roughly?

    So many questions sorry
    My friend got charged $600 for her epidural. I never got charged when I had DD.

    I got charged $600 for the Paed as well

    I'm due January too. Which is a bit of a bugger, because being in a new calendar year, I won't get as much back for the anaesthetist and Paed.


 

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