10ADSafety‑net—individuals

#### 10AD Safety‑net—individuals (1) Expressions used in this section have the same meaning as in section 10AC. (2) Subject to subsection 10AB(3), this section applies to a person who is not a member of a registered family. (3) Subject to this Act, if: (a) a claim (in this subsection called the threshold claim) for benefit is made by a claimant in respect of a relevant service: (i) which was rendered to the claimant; and (ii) in respect of which the medical expenses are incurred by the claimant in a year; and the claim is accepted by the Chief Executive Medicare; and (b) the claimant has made other claims (in this subsection called the prior claims) for benefit in respect of relevant services: (i) which were rendered to the claimant; and (ii) in respect of which the medical expenses were incurred in that year; and the prior claims were accepted for payment by the Chief Executive Medicare before the time when the threshold claim was accepted for payment (in this subsection called the relevant time); and (c) the Chief Executive Medicare is satisfied at the relevant time that: (i) the medical expenses of the services relating to the threshold claim and some or all of the prior claims have been paid; and (ii) the sum of the patient contributions that have been paid in respect of those prior claims is less than the safety‑net amount for that year; and (iii) the sum of the patient contribution in respect of the threshold claim and the patient contributions referred to in subparagraph (ii) is equal to or exceeds the safety‑net amount; the benefit payable in respect of a relevant service rendered to the claimant and in respect of which medical expenses were incurred in respect of that year (being the service to which the threshold claim relates or any service that is not the subject of a prior claim referred to in paragraph (b)) is increased by the amount of the patient contribution in respect of that service. (3A) The patient contributions under subparagraph (3)(c)(ii) (including for the purpose of paragraph (3)(c)(iii)) are to be reduced by so much of those patient contributions as have been paid as increased benefits under section 10ADA. For this purpose, an amount of a patient contribution is taken to have been paid as an increased benefit under section 10ADA to the extent that the amount of the increase in the benefit payable for the relevant service exceeds the difference between the total medical expenses incurred in respect of the relevant service and the Schedule fee for the relevant service. (4) For the purposes of this section, without affecting the meaning of an expression in any other provision of this Act: (a) if a person to whom benefit is payable in respect of a relevant service is given or sent a cheque under subsection 20(2) or (2A) for the amount of the benefit, the person is taken to have paid so much of the medical expenses in respect of that service as is represented by the amount of the benefit; and (b) despite anything else in this Act, the question when medical expenses are incurred in respect of relevant services relating to prescribed items is to be determined under the regulations. (5) For the purposes of this section, disregard section 19AD when determining whether medicare benefit is payable. However, this section does not authorise payment of medicare benefit contrary to section 19AD.