Medicare rebates are the amounts the Australian Government contributes toward the cost of medical services listed on the Medicare Benefits Schedule (MBS). This guide explains rebates, how to claim them, and how the Safety Net protects you from high out-of-pocket costs.
What Is a Medicare Rebate?
A Medicare rebate is the portion of a doctor's fee that the Government covers. The MBS sets a schedule fee for each service. Medicare pays 100% of the schedule fee for GP services and 85% for specialist services in most cases.
If your doctor charges more than the schedule fee, you pay the difference (the gap or out-of-pocket cost).
Example
| Item | Doctor's Fee | Schedule Fee | Medicare Rebate (85%) | Out-of-Pocket |
|---|---|---|---|---|
| Specialist consultation | $250.00 | $100.00 | $85.00 | $165.00 |
Bulk Billing
When a doctor bulk bills, they accept the Medicare rebate as full payment for the service. This means you pay nothing out of pocket. Many GPs bulk bill for:
- Standard GP consultations
- Health assessments and care plans
- Pregnancy-related care
- Children under 16 and concession card holders
How to Claim a Medicare Rebate
Option 1: Online Claiming (via myGov)
- Log into myGov and go to Medicare
- Select "Manage claims" then "Make a claim"
- Upload your itemised receipt (must show provider name, item number, date, fee, and the gap amount if applicable)
- Enter your bank details for payment and submit
- Rebate is usually paid within 2–5 business days
Option 2: Express Plus Medicare App
- Download the Express Plus Medicare app
- Use the "Claim a benefit" feature to photograph and submit your receipt
- Track claim status and payment history
Option 3: In-Person
- Visit a Services Australia service centre with your completed claim form (MS014) and original receipts
- Rebate is processed while you wait or deposited within a few days
Medicare Safety Net
The Medicare Safety Net provides extra financial protection once you reach certain out-of-pocket thresholds in a calendar year.
Original Medicare Safety Net (OMSN)
- Threshold: $593.60 (concession card holders) / $2,150.40 (general)
- Benefit: Once reached, Medicare pays 100% of the MBS schedule fee for further services in the same calendar year
Extended Medicare Safety Net (EMSN)
- Threshold: $793.20 (concession card holders) / $2,542.00 (general)
- Benefit: Once reached, Medicare pays 80% of the out-of-pocket cost (up to the EMSN cap) for further services
Note: Thresholds are updated on 1 January each year. Check Services Australia for current figures.
What Services Are Covered by Medicare?
- GP and specialist consultations
- Pathology tests (blood tests, urine tests, etc.)
- Medical imaging (X-rays, CT scans, MRIs, ultrasounds) — outpatient only
- Eye tests (but not glasses or contact lenses)
- Most surgery and hospital treatment (as a public patient)
- Some dental procedures (for children under the Child Dental Benefits Schedule)
What Is NOT Covered?
- Ambulance services (varies by state — check your state's policy)
- Cosmetic surgery
- Physiotherapy, podiatry, and allied health (unless you have a Chronic Disease Management plan or are in hospital)
- Dental care (except CDBS for children)
- Glasses, contact lenses, and hearing aids
Medicare Online Account
Through your Medicare online account in myGov, you can:
- View your Safety Net balances and thresholds
- Track claim history and payment status
- Update bank account details
- Request replacement Medicare card
- View and update your Medicare details
This guide is updated for 2026. Check Services Australia website for latest rates.
← Back to Centrelink Guide Australia
How Rebates and the Safety Net Work
Every service on the Medicare Benefits Schedule (MBS) has a schedule fee, and Medicare rebates cover 100% of that fee for most GP services and 85% for most out-of-hospital specialist services. The rebate is a fixed dollar amount — it does not automatically cover the full fee you are charged. Bulk billing is the arrangement where your doctor accepts the rebate as full payment, so you pay nothing out of pocket.
Once your out-of-pocket costs for Medicare services pass a yearly threshold, the Medicare Safety Net kicks in: under the Extended Medicare Safety Net (EMSN), you get back 80% of your out-of-pocket costs for the rest of the calendar year. The EMSN threshold is around $2,500 per year for most singles and families (lower for concession card holders) and resets every 1 January. Registering your family as a single safety net unit means the whole family's out-of-pocket costs count toward one threshold, which is faster to reach.
Action Plan: Claiming Rebates Faster
- Ask your provider to claim on your behalf at the time of service — most practices do this electronically, and the rebate lands in your bank account within days.
- If you paid upfront, claim online through myGov or the Medicare app by uploading the receipt — no paper forms needed.
- Register your family for the Medicare Safety Net before big expenses (like dental surgery or fertility treatment) so out-of-pocket costs accumulate against one threshold.
- Check whether your doctor bulk bills — a bulk-billing clinic means zero out-of-pocket and no claim to make.
- Keep receipts for services not claimed at the counter; you generally have two years to claim a rebate.