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Last Updated on 22 October 2018

Ambulance Chasing: How to Get the Best from the Ambulance-Cover Market


Imagine the terror that comes with an emergency, from calling 000 to seeing your loved one packed away in an ambulance. Now imagine the added stress that could come with getting a whopping big bill for the service.

Though we all hope that we’ll never end up in an ambulance, the truth is that plenty of people do. The fees for ambulance services across Australia varies by state and territory, and the cost can be significant. Ambulance cover can give you peace of mind and save you money if you or someone in your family needs an ambulance.

Key Points
  • Medicare does not cover the cost of ambulance services.
  • Ambulance services are free in Queensland and Tasmania; the cost in other states and territories varies.
  • Ambulance cover can be purchased as a standalone policy or as part of private hospital cover.

What is Ambulance Cover?

Ambulance cover generally covers the cost of treatment and transport in an ambulance. Your level of coverage will determine whether you’re covered for both emergency and non-emergency transport. Don’t worry, we’ll cover that in more detail a little further on.

Do I Need Ambulance Cover?

Not every Australian needs ambulance cover; it depends on where you live. Each state and territory in Australia has its own set of rules that decide if there’s a fee for ambulance services, and how much that is. Find your state or territory below for more information.

Queensland

If you’re a Queensland resident, you’re in luck, because your tax dollars have you covered for emergency pre-hospital ambulance treatment and transport all over Australia. If you or a dependent receives an ambulance service in another state, simply send the invoice to the Queensland Ambulance Service along with proof of your Queensland residency.

Tasmania

Residents of Australia’s island state can also breathe easy, because the state is currently willing to pick up the tab for your ambulance services. Tasmania has reciprocal arrangements in place for all states and territories except South Australia and Queensland. These reciprocal arrangements only apply to emergency road ambulance services. Tasmanian residents visiting South Australia and Queensland will be responsible for any ambulance incurred in those states.

New South Wales

Pensioners and concession card holders in NSW are exempt from ambulance fees. Everyone else is billed for 51% of the fee; the rest is subsidised by the NSW government. Fees are made up of a call out charge plus a per-kilometre charge for the round trip from the ambulance station, including any stops in between. Members of an eligible hospital cover are automatically covered by their health insurance for emergency ambulance transport.

Australian Capital Territory

In general, ACT residents are responsible for paying their own way when it comes to ambulance cover. There is a base fee plus a per-kilometre charge for emergency callouts and booked non-emergency services. However, the following people are exempt from paying for ambulance services in the ACT:

  • School students
  • Pensioners and concession card holders
  • Residents injured in a motor vehicle accident
  • Good Samaritans injured while performing a good Samaritan act

Victoria

Victorians with a valid Pensioner Concession or Health Care Card can receive free clinically necessary transport. However, this doesn’t always apply when transport is from a private facility. Otherwise, cover is available through an Ambulance Victoria membership or some private health funds.

South Australia

South Australians need to get covered through SA Ambulance Service or a private health fund. Anyone who isn’t covered will be liable to pay the invoice for services.

Northern Territory

Ambulance services in the NT are provided by St John Ambulance, and fees are charged based on a call out fee plus a per-kilometre fee. NT residents can avoid the fees by becoming a member of St John Ambulance or by taking out private health insurance that includes ambulance cover.

Western Australia

WA’s ambulance services are also provided by St John Ambulance. Certain concession card holders in WA are eligible for full coverage of standard ambulance transport fees, while other concession card holders receive a 50% concession. For everyone else, a fee will be incurred unless you have private cover or take out a policy with St John’s Ambulance Service WA.

Types of Ambulance Cover

You have two options when it comes to buying ambulance cover, and one isn’t necessarily better than the other. The type you choose is up to you, and depends on where you live and the type of private health cover you prefer.

Hospital Cover

The main purpose of hospital cover is to cover the cost of hospital stays and associated medical procedures and services. However, emergency ambulance cover is sometimes offered as part of hospital cover. This can be a convenient option if you’ve already got private health insurance (or if you’re looking to get it), plus you’ll still be eligible for the federal government’s health insurance rebate.

For more information on the rebate, click here.

Ambulance-Only Cover

If you rely on Medicare and don’t have private health insurance, you may be able to buy ambulance-only cover. Some states and territories offer ambulance-only cover directly through the state ambulance service. Otherwise, it may be available as a standalone policy through a private health insurer.

What to Consider When Buying Ambulance Cover

Not all ambulance policies are created equal. It pays to read the fine print so you know exactly what you’re covered for. Here are five factors to consider when you’re shopping around for ambulance cover.

  1. Do You Have an Emergency?

Ambulance responses are generally classified as emergency or non-emergency services, and they may not be covered equally under insurance. Some funds may actually charge a co-payment for non-emergency services.

Check whether your cover extends to the following circumstances:

  • Emergency ambulance services including treatment with no transport
  • Non-emergency services
  • Air Ambulance services
  1. Exclusions

It’s unlikely that your policy will cover every type of transport. Many policies won’t let you claim for transport between health-care facilities; after all it’s an ambulance, not a taxi service. You can also expect a cap on the number of times you can be transported by ambulance each year.

  1. Waiting Periods

Most private ambulance policies come with a seven-day waiting period before you can claim. Ask your insurer about waiting periods when you sign up so you know what to expect.

  1. Out-of-State Coverage

If you need an ambulance when you’re traveling interstate, find out whether your policy will cover the cost. It usually depends on reciprocal agreements between where you’re a resident and where you are when you need the ambulance. The type of transport (emergency or non-emergency) can also be a factor.

  1. Emergency Air Transport

Not all ambulances travel by road! Air ambulances are common across Australia, particularly in remote areas. As you might expect, emergency helicopter or fixed-wing transportation is not exactly pocket change. For example, the cost of air transport in Victoria can go as high as $25,559—and that doesn’t include the road transport.

It’s impossible to know whether or not you’ll ever need an ambulance, but the fact remains that it can be very expensive without insurance. Ambulance cover can provide assistance in paying for ambulance services, leaving you to focus on the people you love, not the bill.

Frequently Asked Questions About Health Insurance

There are three types of health insurance in Australia. They are:

  • Hospital Cover
  • Extras Cover (also known as general or ancillary cover)
  • Ambulance Cover

Hospital cover can ensure any unexpected surgeries, treatments or hospital stays you may require will be covered. With appropriate cover you will have the flexibility to choose your own doctor and the option of receiving treatment in a private hospital.  Most hospital covers allow you to stay in a private room. One other perk is skipping the public hospital systems’ waiting list, which can be lengthy for non emergency treatment.

Extras cover pays benefits for a a range of services, often including treatments and procedures related to the fullowing:

  • Dental/oral health
  • Glasses and contact lenses
  • Podiatry
  • Physiotherapy
  • Psychulogy
  • Acupuncture
  • Remedial massage
  • Chiropractic
  • Hearing aids
  • Travel vaccinations

Ambulance cover, as the name suggests, will cover you should you require emergency ambulance transport. In an emergency, there is enough to worry about. Having the expenses covered for provides security and peace of mind. Many hospital covers include emergency ambulance transport If yours doesn’t, you will need to shop for this separately.

Life is unpredictable. You never know when you might need cover. No matter what life stage you’re in, there’s a policy out there for everyone. You can select as much or as little cover as you want, depending on your health needs and requirements. It’s a small price to pay for the peace of mind health cover provides.

There is no one answer here. Costs vary across providers and policy types. Just because a policy is cheap, that does not mean it is ‘value for money’ and vise versa. Make sure you check what’s included and excluded in a policy before signing up, as you want to purchase a policy that best fits your specific needs.

Premium: A premium is the price you pay for your insurance policy (it may be paid annually or on an ongoing basis).

Policy: An insurance plan. In other words, it is the type of insurance you choose to select.

Policy Holder: The owner, or ‘holder’ of a policy.

Claim: In the event that you require treatment for a service covered by your policy, you can lodge a claim for reimbursement of all or part of the cost of that treatment.. These days, most claims are submitted electronically by the health care provider (dentist, physio etc)

Lifetime Health Cover: Lifetime Health Cover was put in place to encourage young Australians to seek out and maintain ownership of private health insurance early in their lives. If you do not take out a policy before you turn 31, extra charges will be applied should you take out a policy at a later time.

This means you will pay a 2% loading on top of your premium for every year that passes after you turn 30. For example, if you take out a policy for the first time at age 32, you will be charged 4% of your premium as an extra, then at age 40, 20% and so on, up to a maximum loading of 70%.

The loading is payable for 10 consecutive years of cover - after which it is removed and you premiums will be reduced.

Pharmaceutical Benefits Scheme (PBS): Medicare offers assistance for Australians with many of their their prescribed medication costs through the PBS. This assistance is in the form of subsidies towards the cost of many medications. You can check if your prescribed medication is on the list of subsidised items here.

Medicare Levy Surcharge: The Medicare Levy Surcharge is an additional charge (tax) applied to single Australian taxpayers who earn over the income threshold of $90,000 per year, or families/couples who earn over $180,000 per year. This surcharge is only applied to those who choose not to have a private health insurance policy.

The surcharge is designed to reduce pressure on the public health system by encouraging those with higher incomes to invest in private health cover.

Private Health Insurance Rebate: The government’s Private Health Insurance rebate lowers premiums for most Australians with private health insurance Older Australians may enjoy an even higher rebate. Our calculator can help you estimate the Government health insurance rebate you may receive.

Disclaimer: The above information is correct and current at the time of publication


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