Ambulance Chasing: How to Get the Best from the Ambulance-Cover Market
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
- Out-of-state coverage
- Air ambulance
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.
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.
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.
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.
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.|
|NT||$340 to $745||$340||$4.80||$4.80|
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)|
|SA||N/a||Depends on fund||Available (state)|
|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|
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
- Remedial massage
- 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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