▁Medic are ▁safety ▁net ▁Under ▁the ▁original ▁Medic are ▁safety ▁net , ▁once ▁an ▁annual ▁threshold ▁in ▁gap ▁costs ▁has ▁been ▁reached , ▁the ▁Medic are ▁reb ate ▁for ▁out - of - h ospital ▁services ▁is ▁increased ▁to ▁ 1 0 0 % ▁of ▁the ▁schedule ▁fee ▁( up ▁from ▁ 8 5 %). ▁ ▁G ap ▁costs ▁refer ▁to ▁the ▁difference ▁between ▁the ▁standard ▁Medic are ▁reb ate ▁( 8 5 % ▁of ▁the ▁schedule ▁fee ) ▁and ▁the ▁actual ▁fee ▁paid , ▁but ▁limited ▁to ▁ 1 0 0 % ▁of ▁the ▁schedule ▁fee . ▁The ▁threshold ▁applies ▁for ▁all ▁Medic are ▁card hold ers ▁and ▁is ▁$ 4 7 0 . 0 0 ▁for ▁calendar ▁year ▁ 2 0 1 9 . ▁ ▁Ext ended ▁Medic are ▁safety ▁net ▁The ▁extended ▁Medic are ▁safety ▁net ▁( E MS N ) ▁was ▁first ▁introduced ▁in ▁March ▁ 2 0 0 4 . ▁ ▁Once ▁an ▁annual ▁threshold ▁in ▁out - of - po cket ▁costs ▁for ▁out - of - h ospital ▁Medic are ▁services ▁is ▁reached , ▁the ▁Medic are ▁reb ate ▁will ▁increase ▁to ▁ 8 0 % ▁of ▁any ▁future ▁out - of - po cket ▁costs ▁( now ▁subject ▁to ▁the ▁E MS N ▁fee ▁cap ) ▁for ▁out - of - h ospital ▁Medic are ▁services ▁for ▁the ▁remainder ▁of ▁the ▁calendar ▁year . ▁ ▁Out - of - po cket ▁costs ▁are ▁the ▁difference ▁between ▁the ▁fee ▁actually ▁paid ▁to ▁the ▁pract ition er