Document ID: chunk:federal_register_of_legislation:C2025C00156:section:10aca:p2
Version: federal_register_of_legislation:C2025C00156
Segment Type: section
Provision Reference: s 10ACA (pt 2/4)
Character Range: 95970–98575

the current claim was accepted for payment that the sum of the out‑of‑pocket expenses for the current claim and all relevant prior claims for a safety‑net for the expense year is equal to or exceeds the applicable safety‑net amount.
 (6) A claim is a relevant prior claim for a safety‑net for the expense year if:
 (a) the claim has been made for benefit in respect of relevant services which were rendered to:
 (i) for the concessional safety‑net—any member of the family who is a concessional person in relation to the expense year at the time that the current claim is made; and
 (ii) for the FTB(A) safety‑net or the extended general safety‑net—any person who is a member of the family at the time that the current claim is made; and
 (b) the claim is related to medical expenses incurred during the expense year; and
 (c) the claim was accepted for payment by the Chief Executive Medicare before the time when the current claim was accepted for payment; and
 (d) the Chief Executive Medicare is satisfied at the time when the current claim was accepted for payment that the out‑of‑pocket expenses for the claim have been paid.
 (7) If:
 (a) this section applies to the current claim; but
 (b) the sum of the out‑of‑pocket expenses for all relevant prior claims for the expense year is less than the applicable safety‑net amount;
the benefit payable in respect of the claim is not increased under subsection (2) but is instead increased by the amount worked out using the formula:

where:
balance of safety‑net means the amount by which the sum of the out‑of‑pocket expenses for all relevant prior claims for the expense year is less than the applicable safety‑net amount.
 (7A) Despite subsections (2) and (7), if the current claim is for a service specified in an item determined under section 10B to be an item to which this subsection applies, the increase under this section in the benefit payable in respect of the claim cannot exceed the amount determined under section 10B as the maximum increase for that item.
Note: This subsection does not limit the increase payable in respect of a claim for a service specified in an item not determined under section 10B to be an item to which this subsection applies.
 (7AA) If:
 (a) 2 or more services (the original services) that are each specified in an item are deemed to constitute, or are treated as, one service (the deemed service) under this Act (other than a provision of this Act prescribed by the regulations); and
 (b) all of the items in which the original services are specified are items determined under section 10B to be items to which