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

Jonathan December 15th, 2014 0 comments

Ambulance cover is something most Australians will have to deal with at some point, since treatment and transport by ambulance is not covered by Medicare. And depending on where you live you will at some point in your life be forced to decide whether you need it and how to get covered for it.

Although each state either runs its own ambulance services or contracts to private companies like St. John’s Ambulance, charges and coverage for the service vary significantly (see table). So we’ll need to break the landscape down first state-by-state and then cover some of the coverage issues themselves.

First, here’s the good news. Although ambulance fees charged to the uninsured can be frighteningly expensive, ambulance cover can be bought surprisingly cheaply. Depending on the state you live in, you can buy yearly ambulance cover directly from the provider or indirectly through a health fund from less than $100 per family.

The Country’s Lucky States: QLD and TAS

As with most aspects of Australian life, geography is everything. If you live in either Queensland or Tasmania, you do not have to concern yourself with ambulance coverage. State taxpayers pick up the tab for QLD residents nationwide and Tasmania has reciprocal agreements with all states except SA and QLD. Queenslanders previously paid for the service through a Community Ambulance Cover Levy of $24 per quarter but this charge was scrapped in 2011.

That is generous considering the cost of an ambulance ride can vary from an average of a few hundred dollars up to more than $10,000 for ambulance services depending on location. Air ambulance services – a more familiar sight in rural Queensland than most other parts of Australia – cost $5,000 per trip upwards.

The Somewhat Lucky Two: NSW and ACT

NSW and ACT residents who hold a concession card in either of these states or who have eligible hospital cover are covered for emergency ambulance services within most of Australia – excluding SA and QLD. Residents without hospital cover or a concession card must pay for emergency ambulance costs through health insurance or ambulance only cover.

The Other Four: WA, SA, NT and VIC

In Western Australia, South Australia, Victoria and the Northern Territory, the situation is different.

  • SA residents need to cover themselves, through a direct subscription with South Australia Ambulance Service or through a private health fund.
  • Some NT and WA residents can access St John Ambulance Australia services but those in the Perth metropolitan area must buy ambulance cover with a health fund. WA Aged Pensioners and concession card holders can access ambulance services for free. Residents without a concession card can cover themselves through a health fund or subscribe to the state ambulance schemes.
  • VIC residents can cover themselves through a subscription to Ambulance Victoria or through a health fund.

Private ambulance coverage: the four things to watch for

  • Emergency vs. non-emergency
  • Exclusions
  • Out-of-state coverage
  • Air ambulance
  1. Emergency vs. Non-Emergency

    Ambulance services charge more for call outs to emergency vs. non-emergency cases, charging fees ranging from just over $200 for non-emergency in SA compared to an average of $1100 for an emergency in Victoria.  Air ambulance charges in Victoria start at just over $2000 for fixed-wing aircraft and can be over $10,000 for helicopter transport.

    Despite this, some private health funds actually charge a co-payment for non-emergency ambulance services while fully covering emergency services. For example, HIF covers 100% of emergency ambulance cover and requires a co-payment of $50 if the case is deemed non-urgent.

  2. Exclusions

    In nearly all ambulance policies, some ambulance transport is not covered. For example, policies may exclude ambulance transportation between hospitals and other health-care facilities or from hospital to the patient’s home. Others will also put a cap on how many ambulance visits a policyholder is allowed per year. Most private ambulance policies also have a seven-day waiting period.

  3. Out-of-State Coverage

    Whether policyholders are covered when interstate depends on whether there is a reciprocal arrangement between the state the transport occurred in and the state the patient is a resident of. Emergency transport is covered in a lot of cases but the situation is more complicated for non-emergency transport between states. Check these arrangements before buying a policy.

  4. Air Ambulance

    Australia’s outback-based air ambulance service is iconic but national symbols don’t come cheaply. Most such services fly patients from remote outback locations to local hospitals, but in recent times the more common usage has been flying patients by helicopter onto rooftop landing pads of major city hospitals.

    Air ambulance charges in NSW for both fixed wing aircraft and helicopters are capped at $5,716 per call-out. In Victoria, smaller in both area and population, the charges are just over $2000 per fixed-wing aircraft transport to a hospital up to a whopping $10,000 or more for helicopter transport.

Ambulance-Only Cover

Since Medicare doesn’t cover ambulance charges, Australians who rely only on Medicare for their health-care cover can buy ambulance-only cover. This is, in effect, a subscription fee to the state-run or state-contracted ambulance service and can be bought purchased directly or through a private health-insurer. In NSW and the ACT ambulance cover must be purchased with all private cover whereas in VIC, WA, SA and the NT it can also be bought directly from the ambulance service itself (see chart 1)

The typical cost of an ambulance-only policy in most Australian states on average is surprisingly cheap – around $50 per person or $100 per couple. Private ambulance-only cover is priced similarly to the direct subscription fees to the ambulance service. Remember that the couples rate includes children, so kids get a free ride at their parents’ expense (as usual).

Remember the Rebate

The Federal government’s variable rebate applies to all privately-purchased hospital cover – which often includes emergency ambulance services.

Table 1: Ambulance charges by state – 2014/2015

Call fee Transport fee per km.
Emergency Non-Emergency Emergency Non-Emergency
NSW $357 $281 $3.22 $1.74
VIC $1146-1690 $309-53 N/A N/A
SA $918 $205 $5.30 $5.30
WA $916 $492 N/A N/A
NT $340 to $745 $340 $4.80 $4.80
ACT $904 $646 $12 $12

Table 2: Ambulance coverage by Australian state

Full by state? Included in private cover? Direct subscription?
NSW For Health Care Concession Card, Pensioner Concession Card, and Commonwealth Seniors Health Card holders Yes Available (state)
VIC For Pensioner Concession Card and Healthcare Card holders Depends on fund Available (state)
QLD All residents N/A N/A
SA N/a Depends on fund Available (state)
TAS All residents N/A N/A
WA For Aged Pensioner concession holders Depends on fund Available (St. John?s)
NT For Pensioner Concession Card and Commonwealth Seniors Health Card holders Depends on fund Available (St. John?s)
ACT For Health Care Concession Card and Pensioner Concession Card holders Yes Not available

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

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