Fees

Kaleidoscope Clinic charges fees according to time spent with the patient. You will be charged for what occurs, which may be different to what is booked.

Fees are subject to change, and are reviewed annually. Please see additional information available on the Medicare Safety Net below.

Understanding the Medicare Safety Net

The Medicare Safety Net is designed to help Australians with out-of-pocket medical costs by providing additional rebates once they reach a certain threshold in a calendar year.

How It Works

Medicare covers a portion of the cost of doctor visits, tests, and procedures listed under the Medicare Benefits Schedule (MBS).
If your out-of-pocket costs (the difference between the MBS fee and what Medicare reimburses) reach a set threshold within a year, you receive higher rebates for the rest of the year.

Thresholds & Benefits

There are two main Medicare Safety Net thresholds:

1. Original Medicare Safety Net (OMSN):

Once your total medical costs (before rebates) reach this threshold, Medicare increases the rebate but does not fully cover the gap.

2. Extended Medicare Safety Net (EMSN):

Once your out-of-pocket costs hit this threshold, Medicare covers 80% of any further out-of-pocket costs for eligible services (up to a cap).

Who Benefits Most?

Patients with frequent medical appointments
Those managing chronic illnesses or serious conditions.
Families, as their costs are combined to reach the threshold faster. How to Register
Individuals are automatically eligible, but couples and families must register with Medicare to have their expenses combined.

For more details or to check your threshold status, visit Medicare Services Australia or call Medicare directly or log into the Medicare App on your phone/device

For Medicare Safety Net information, see here.

What are the current Safety Net Thresholds?

Threshold	Threshold Amount ($)	Who	What counts towards the threshold	What benefit you'll get back
Original Medicare Safety Net (OMSN)	$576.00	Everyone in Medicare	Your gap amount for the calendar year.	100% of the schedule fee for out of hospital services.
Extended Medicare Safety Net (EMSN) - General	$2615.50	Everyone in Medicare	Your out of pocket amount for the calendar year.	80% of out of pocket costs or the EMSN benefit caps for out of hospital services.
Extended Medicare Safety Net (EMSN) - Concessional and Family Tax Benefit Part A	$834.50	Concession cardholders and families eligible for Family Tax Benefit Part A	Your out of pocket amount for the calendar year.	80% of out of pocket costs or the EMSN benefits caps for out of hospital services.

Scenario

A consultation item has a:

MBS Fee of $100;
100 per cent out-of-hospital rebate of $85 (for GP attendance items)
300% EMSN benefit cap of $300.

Example 1 – Once you are at your ‘safety net’

If the doctor charges $120 for the service, the patient will receive:

- Rebate of $85; and
- 80 per cent of their remaining out-of-pocket amount or $300, whichever is the lesser amount. In this example, their initial out-of-pocket cost is $35 (i.e. $120 – $85 = $35). Eighty percent of that out-of-pocket cost is $28 (i.e. 80% x $35 = $28). As such, they will receive an EMSN benefit of $28.
- This means that the patient will receive a total benefit of $113 (i.e. $85 + $28 = $113) from Medicare, and will have a final out-of-pocket $7 (i.e. $120 – $113 = $7).

The full list of MBS items is available online. Use the search function on the website to find any Medicare item and its associated MBS fees and benefits. If an item has an EMSN benefit cap, it will appear in the item description.

None of our fees are above the Medicare EMSN limits; therefore, the 300% cap isn’t applicable for any of our fees or services at this time.