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Ambulance Health Insurance

Avoid spending thousands on emergency and non-emergency ambulance fees with ambulance health cover.

Most health funds will offer some sort of protection for Ambulance transport but what is actually covered can vary considerably between funds. Cover can be available under hospital, extras or as a standalone policy and may include protection for emergency only or all ambulance use.

Whether you are entitled to ambulance cover will depend on what state you live in and the concessions you are entitled to. This article will explore who is entitled to ambulance cover without private health insurance and discuss what is provided from cover from private health funds.

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How does ambulance only health insurance work?

If you choose to take out ambulance cover through a private health fund, there are multiple options available. You could either:

  • Take out a hospital plan that includes cover for ambulance services
  • Take out an extras plan that includes cover for ambulance services
  • Take out ambulance only cover

The main benefit of choosing a standalone ambulance only policy is that it can include comprehensive cover for ambulance services Australia-wide but is generally more affordable than a hospital or extras policy. This means that policyholders can be covered when travelling in states where ambulance cover is already provided, i.e. a NSW policyholder travelling in QLD.

Ambulance only policies might provide cover for both emergency and non-emergency ambulance services provided by state government ambulance service, or for emergencies only depending on the provider.

If you decide to choose a hospital or extras plan that includes ambulance cover, the level of cover provided may vary. While some funds provide cover for emergency and non-emergency ambulance, many will only cover the cost of emergency ambulance services.

Hospital and extras policies also cost more than ambulance only cover, but they do include a much wider range of benefits. Hospital policies cover a wide range of services and procedures in private and/or public hospitals, while extras policies help you cover the cost of things like visits to the dentist or physio. It’s up to you to decide whether this cover is worth the extra expense.

What am I covered for with Ambulance Insurance?

While cover does differ between private health funds, some funds will offer two types of ambulance cover: comprehensive cover and emergency ambulance cover.

Emergency only provides cover for:

  • Air and road transport in emergency situations. Unlimited cover is typically provided for incidents such as;
    • Major accidents
    • Severe blood loss
    • Sudden onset of pain
    • Broken bones
    • Heart attack and more

What usually won’t be covered?

  • Non-emergency medical transport or treatment. This may include if you have a non-critical ongoing illness/injury and the ambulance is not required to use lights or sirens when transporting you.
  • Routine treatment for ongoing illnesses and require specialised transport. An example of this may be sever ongoing mobility.
  • If you hold a subscription with your state or territory ambulance service.
  • Treatment or transport provided by an ambulance service that is not recognised by your private health fund.

Under a comprehensive ambulance cover policy, the following cover will typically apply:

  • Emergency road, air and sea transport.
  • On-the-spot ambulance treatment right across Australia at any time.
  • Ambulance transport between hospitals when it is medically necessary.
  • Some policies off Ambulance paramedic attendance whereby you are covered for attendance from a paramedic but do not need to be transported to hospital.

What usually won’t be covered?

  • If your state government provides ambulance coverage or if already have a subscription with state ambulance provider
  • Air and road transport services that are not operated by a government or are not recognised by the health fund
  • Non-emergency ambulance transport that you receive during your policy waiting period.

Essential questions to ask about your ambulance cover

  • Will I be covered if I travel interstate? Some policies only cover ambulance costs incurred in your state of residence.
  • Does the policy cover emergency-only ambulance services? Some policies limit their cover to emergency ambulance services only, while others cover non-emergency transport and treatment as well. Check to see what sort of situation your fund defines as an emergency.
  • Is the call-out fee covered? The call-out fee refers to when you need ambulance treatment but do not require transportation, so check whether your health fund covers this.
  • What is the waiting period? How long will you have to wait after taking out a policy before your ambulance cover begins?
  • Is there a co-payment required? Check with your health fund to find out whether you will need to make any co-payments to contribute towards the ambulance fee.
  • Are all types of ambulance transport covered? For example:
  • Will air transport be covered?
  • What about road and sea transport?
  • Will ambulance transport provided by state ambulance services and other private funds be covered?

Ambulance driving in street

Am I already covered by Medicare for ambulance use?

Many Australians believe that just like so many other medical expenses, the cost of ambulance transport will be automatically covered by Medicare. Unfortunately, this is simply not the case. However, certain people and the residents of some states will receive cover for the cost of ambulance services and not need to take out ambulance insurance from a private health fund. See the list below to see what options are available in your state or territory.

State by state comparison of complimentary Ambulance cover

Department of Veterans Affairs Gold Card holders are covered for state ambulance services in every state by the Department.

Victorian residents who want full cover for emergency and non-emergency ambulance services can take out an Ambulance Victoria membership, which provides Australia-wide cover. You also have the option of taking out cover through your private health fund, though many funds will only cover emergency ambulance services.

As of July 2014, eligible Centrelink Health Care card or Pensioner Concession Card holders in Victoria are entitled to free clinically necessary ambulance coverage around Australia. This covers the cost of transport to the nearest and most appropriate medical facility.

Because the ambulance service in NSW is offered under a levy-based scheme, it is not possible to take out a membership or subscription with NSW Ambulance. However, all health fund hospital cover in NSW automatically includes a levy for ambulance services. Without it, however, people may need to purchase ambulance cover (either as a standalone policy or as part of an extras policy) from a private health fund.

A range of pensioner card and concession card holders are entitled to free ambulance services in NSW, including people who hold a:

  • Health Care Card
  • Pensioner Concession Card
  • Commonwealth Seniors Health Care Card
  • Department of Veterans Affairs Repatriation Health Card, also known as a Gold Card (excluding non-emergency ambulance services)
  • Department of Veterans Affairs Repatriation Health Card, also known as a White Card (only for services relating to a specific condition that is funded by the Department of Veterans Affairs)

If you live in the Sunshine State, the Queensland Government covers the cost of emergency ambulance services not only in Queensland, but also right around the country. In order to be covered under the Community Ambulance Cover scheme, you’ll need to be able to demonstrate that your principal place of residence is in Queensland.

South Australian residents can purchase a subscription with the South Australian Ambulance Service. This subscription covers all ambulance attendance within South Australia, including both emergency and non-emergency services.

For a small additional fee you can also purchase interstate ambulance cover, which provides cover for all ambulance attendances Australia-wide.

Alternatively, SA residents may purchase standalone ambulance cover or look for health insurance that includes it.

Western Australian residents who want cover for ambulance services need to purchase an ambulance cover policy. If you live in the Perth metropolitan area, you can contact a private health fund to arrange a sufficient level of ambulance cover for your needs. However, if you live in regional WA you can either contact a private health insurance fund to purchase ambulance cover or pay for a subscription to the St John Ambulance Service.

WA Full Aged Pensioners are entitled to free ambulance transport whenever it is medically necessary, except if you are being transferred between hospitals and one or both is a private hospital. Residents who are 65 and over but do not receive a Centrelink pension receive a 50% discount off their ambulance account.

WA residents under the age of 65 who receive a Disability, Single Parent or Carers pension or other Centrelink pension may also be entitled to this 50% discount.

If you live in the Northern Territory and want full ambulance coverage, you’ll need to purchase a subscription from St John Ambulance NT. Alternatively, you can purchase a policy that provides ambulance cover from the health fund of your choice.

Holders of a Pensioner Concession Card or a Commonwealth Seniors Health Card are entitled to free ambulance transport services.

The Tasmanian Government provides cover for the cost of ambulance treatment and transport in the Apple Isle for its residents. However, this cover applies in Tasmania only; Tasmania has informal reciprocal arrangements in place to cover emergency road ambulance transport for its residents when in most other Australian states or territories, but no such arrangement exists with the governments of South Australia or Queensland.

ACT residents who want cover for ambulance services can purchase a policy from the private health fund of their choice.

Residents who hold a Pensioner Concession or Health Care card are entitled to free emergency ambulance services within the ACT. When travelling interstate, these cardholders can only access free emergency ambulance services in those states and territories that participate in reciprocal arrangements with the ACT, so no cover is available if you’re travelling in Queensland, SA or WA.

It’s also important to check with your health fund, concession card provider or state ambulance service to find out what cover applies when you travel interstate.

If you don’t have any form of ambulance cover in place, you can find yourself facing a hefty bill if you receive ambulance transport. If air ambulance transport is involved, you could even be looking at costs of around $5,000 — which could be very difficult to meet at the best of times, let alone when you’re recovering after some sort of health scare.

Given the different approach that each state and territory takes to ambulance services, the ambulance costs you’ll have to pay if you don’t have cover in place can vary quite substantially. Check the table below for more information about the costs that apply to you.

StateService and cost
ACT
  • Emergency ambulance service (treatment and transport): $918 (+$12/km for every km travelled outside the ACT)
  • Emergency ambulance service (treatment but no transport): $637
  • Non-emergency ambulance service by an Ambulance Paramedic or an Intensive Care Paramedic: $656 (+$12/km for every km travelled outside the ACT)
  • Non-emergency ambulance service (treatment and transport) by Patient Transport Service resource: $237 (+$5/km for every km travelled outside the ACT)
NSWFor road ambulance emergency

  • Call-out fee: $364
  • Variable rate: $3.29/km
  • Maximum charge: $5,971

For road ambulance non-emergency

  • Call-out fee: $287
  • Variable rate: $1.77/km
  • Maximum charge: $5,971

For fixed wing aircraft

  • Call-out fee: $364
  • Variable rate: $3.29/km
  • Maximum charge: $5,971

For helicopter

  • Call-out fee: $364
  • Variable rate: $3.29/km
  • Maximum charge: $5,971
Northern TerritoryCovered for emergency ambulance services only: $700-$900Paramedic response fee: $31.00

Life threatening emergency callout:

  • Call-out fee (first 10 km): $745
  • Per kilometre greater than 10 km rate: $4.80/km

Non-life threatening emergency callout:

  • Call-out fee (first 10 km): $340
  • Per kilometre greater than 10 km rate: $4.80/km

Non-emergency callout:

  • Call-out fee (first 10 km): $340
  • Per kilometre greater than 10 km rate: $4.80/km

Clinic transport:

  • Pre booked (per patient km): $2.15/km
  • Clinic transport under 10 km: $19.10 per minute

 

QueenslandThe cost of ambulance services for Queensland residents is covered by the state government.
South Australia
  • Emergency call out: $934
  • Non-Emergency call out: $208
  • Treat no Transport (flat rate): $205
  • Plus Kilometre charges: $5.40/km
TasmaniaThe cost of ambulance fees for Tasmanian residents is covered by the state government.
Victoria
  • Emergency attendance fees (no transport): $507
  • Emergency road transport fees (metropolitan): $1,174
  • Emergency road transport fees (regional and rural): $1,732
  • Non emergency road transport (metropolitan): $317 for stretcher or $104 for clinic car
  • Non emergency road transport (rural and regional): $536 for stretcher and N/A for clinic car
  • Fixed wing air transport: Variable charge $2,082 and Fixed charge $2,816
  • Rotary air transport: Variable charge $10,475 and Fixed charge $23,842
Western AustraliaMetro

  • Life threatening: $932
  • Urgent: $932
  • Non-urgent: $500
  • Patient Transfer Vehicle: $458

Fees vary for country ambulance services

Ambulance fees and charges were taken from the official website of each state and territories ambulance service and were accurate when this article was published. Please note the costs above may be subject to change.

 

Some final questions about ambulance cover you might have

Though the approach to this scenario differs between funds, many private health funds will reimburse some or all of the cost of your state ambulance subscription.

Although cover differs between policies, many ambulance only policies will not include cover for non-emergency transfers between hospitals.

According to a Productivity Commission report on government emergency services, 3,197,826 Australians were attended to by ambulance personnel around the country in 2013–14. This figure is well worth considering when assessing your ambulance cover needs.

Yes, you are entitled to automatic cover for emergency ambulance services Australia-wide.

No. The patient who receives treatment or transportation from an ambulance service is responsible for paying the bill.

Ambulance costs vary between states and territories. As an example, a NSW road ambulance in an emergency situation attracts a call-out fee of $364 plus a variable charge of $3.29 per kilometre. The maximum charge is $5,971. In Victoria, a fee of $1,174 applies to metropolitan emergency road transport, while a fee of $1,732 is charged for regional and rural emergency road transport.

These figures were taken from the official website of each state and territories ambulance service and were accurate when this article was published. Please note the costs above may be subject to change.

No, the state governments of Queensland and Tasmania cover ambulance costs for their residents.

No, this option is not provided in NSW or the ACT. Residents can instead purchase ambulance cover through a private health fund if they wish.

State by State Ambulance Service Details
ACT

  • ACT Ambulance Service
  • http://esa.act.gov.au/actas/
  • Phone 000 in an emergency
  • For general enquiries, phone 13 22 81 or email esahaveyoursay@act.gov.au

NSW

Northern Territory

  • St. John Ambulance Australia Northern Territory
  • http://www.stjohnnt.org.au/
  • Phone 1300 ST JOHN in an emergency
  • Fill out the online form available through the St. John Ambulance website for general enquiries

Queensland

SA

  • SA Ambulance Service
  • http://www.saambulance.com.au/
  • Phone 000 in an emergency
  • For general enquiries and information about the SA Ambulance Service, phone 1300 13 62 72 or email healthsaasenquiries@sa.gov.au

Tasmania

Victoria

WA

Not covered for ambulance transport or looking to switch from current policy?

Whether you already have private hospital insurance in place or are looking to switch policies, it’s crucial to ensure you have the level of ambulance cover in place suitable to your situation. An insurance consultant can help you review your current policy or see what other options are available to ensure you have adequate cover at the right price.

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2 Responses

  1. Default Gravatar
    DarylMarch 20, 2017

    I am on an aged pension which entitles me to free ambulance in nsw. How do I go if travelling interstate and incur costs in relation to ambulance services. Would I be covered as a pensioner of nsw or would I need to take out private cover.

    • Staff
      ZubairMarch 27, 2017Staff

      Hi Daryl,

      Thank you for your question.

      finder.com.au is a comparison and information service and we are not permitted to provide our users with personalised financial advice or product recommendations.

      According to Ambulance Services of New South Wales frequently asked questions, cover for concession card holders is provided for emergency ambulance services for all other States/Territories.

      You should contact Health Ambulance Service of NSW directly for clarification and if you have any further questions.

      All the best,
      Zubair

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