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What is ambulance cover?

Ambulance insurance covers certain expenses incurred when being treated by paramedics and transported in ambulances. Emergency transportation and ambulance services are essential for urgent medical care, but are not covered by Medicare.

According to the Productivity Commission’s report on government emergency services for 2015-16, there were 3.4 million emergency incidents recorded. This resulted in 4.3 million ambulance service responses attending to 3.2 million patients across Australia. With a population of roughly 24 million people, that’s a lot of Aussies relying on this crucial service we often take for granted.

Unfortunately, there is no way (yet) of predicting the future, so if you don’t want to be left with a hefty ambulance bill, you may want to consider taking out ambulance cover.

ambulance service nsw waiting

 

Do Queenslanders and Tasmanians have to take out ambulance cover?

Ambulance costs are covered by the Queensland and Tasmanian state governments, so you are not required to organise your own cover if you reside within either of these two states.

Your ambulance coverage in Queensland extends across the entire country too, so that’s one less thing Sunshine State residents won’t need to worry about when holidaying interstate. If you do need to claim for treatment in another state or territory, you can do so by forwarding any invoices you receive, as well as proof of Queensland residency, to the Queensland Ambulance Service.

Ambulance Tasmania provides a free service to Tasmanian residents within the state and its islands. The only exemptions from free ambulance cover are those related to motor vehicle or workplace accidents where insurance provisions cover costs, including cases involving veterans where the Department of Veterans’ Affairs (DVA) meets the cost of ambulance transport.

What should you know about ambulance cover in ACT and NSW?

If you reside in (or close to) the nation’s capital, chances are you’ll need to take out ambulance cover unless you’re a specific concession card holder or meet certain criteria requirements respective to the ACT Ambulance Service’s terms and conditions. These specified groups are entitled to free ambulance services throughout the ACT, and would not require separate ambulance cover.

For anybody living in New South Wales it’s worth noting that you’re only billed “51% of the actual (emergency service) charge, as the NSW government subsidises the service for its residents” if you don’t have cover, according to Ambulance Service of NSW. However, when you glance at the table below, you’ll see that 51% could still end up being costly if you don’t have ambulance cover.

Anyone not eligible for free ambulance services should consider taking out cover through a registered Australian health fund. Fortunately, emergency ambulance cover is included under policies widely available in ACT and NSW, so you can enjoy these benefits alongside a health insurance policy tailored to you.

What cover should residents in VIC, NT, SA, and WA take out?

If you reside in Victoria, the Northern Territory, South Australia, or Western Australia, you can organise ambulance cover through an ambulance authority respective to your state/territory or through a registered health fund. Additionally, Victorians who hold a current concession card (Pensioner Concession Card, Healthcare Card) are entitled to free ambulance cover.

Department of Veterans’ Affairs (DVA) Gold Card holders can use ambulance services in all states and territories at no cost.

What to expect if you don’t have ambulance cover

If you currently do not have ambulance cover, some of the potential costs you could pay in the event of an emergency are troublesome (in addition to sickness or injury).

State/Territory Callout fee Per kilometre charges Current as of:
ACT $936.00 (treatment & transport) $12 per km travelled outside of ACT 1 July 2017
NSW $372.00 $3.35 1 July 2017
NT $745.00 $4.80 1 September 2015
SA $955.00 $5.50 1 July 2017
VIC $1,204.00 (Metropolitan Emergency Road)

$1,776 (Regional and Rural Emergency Road)

N/A 1 July 2017
WA $949.00 (life threatening/urgent conditions) N/A Unknown

What types of ambulance cover are available?

Many health insurers include ambulance cover as part of their policies (depending on the state or territory you take cover in). Alternatively, you may be able take this cover out on its own, although you would then miss out on some of the great benefits of health insurance, like dental cover and private hospital rooms.

There are two types of ambulance cover available (emergency and comprehensive) through registered health funds, with both types varying depending on your policy brochure. Some offer cover for all ambulance transportation, while others may only provide for ground travel. Others may set further limitations, such as, cover in your state of residence only, or may not cover call out fees associated when an ambulance treats you at the scene without transporting you to hospital.

What should you look out for with ambulance cover?

It is important to be aware of any other limitations on your policy. For example, does the cover include all forms of emergency transport, or is it only for ground services? Does your policy cover ‘call out’ fees (when the ambulance treats you at the scene but isn’t required to transport you to hospital)? Make sure you read the policy description carefully to understand your entitlements and restrictions.

Ambulance cover for pensioners

Are pensioners covered for ambulance insurance?

Depending on your state of residence, most ambulance transport services and treatments are covered for pensioners across the country. Please note that the information provided only applies in your state of residence and may not apply if you are interstate (unless you’re lucky enough to be a Queenslander).

Information and provisions regarding pensioner’s ambulance cover is listed by states and territories below:

Pensioners receive free ambulance services in New South Wales. If you are a current holder of any of the listed cards below, and received a benefit entitlement at the time of receiving your ambulance service in NSW, you are not required to pay for ambulance transport or urgent ambulance services:

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

Click here for further information on ambulance services in New South Wales.

Under the State Concession Scheme, eligible Victorian residents holding particular concession cards receive free, clinically necessary ambulance coverage throughout Australia. Transport is also provided to the nearest and most appropriate medical facility.

If a Victorian Pensioner Concession Card holder is transported from a private healthcare facility, the sending private facility is responsible for payment. This includes registered private hospitals and day procedure centres. The private healthcare facility decides whether or not to pass this cost onto the patient.

Concession benefits do not apply if:

  • A patient only holds a Commonwealth Seniors Health Card
  • The patient requests to be repatriated or relocated to or from Victoria for non-clinical reasons, or when the transport is not clinically necessary
  • Another party is responsible for the account (including Department of Veterans’ Affairs, Transport Accident Commission and Victorian WorkCover Authority – all subject to the conditions under the scheme)

Click here for further information on ambulance services in Victoria.

Permanent Queensland residents are automatically covered for emergency pre-hospital ambulance treatment and transport Australia-wide. You will need to provide proof of Queensland residency with your current Queensland issue Centrelink Pension Concession Card.

When interstate, you have to ensure that your documentation covers the date of the ambulance treatment/transport provided. If you receive an invoice for interstate ambulance services or transportation, you can forward the bill and your proof of Queensland residency to:

Interstate Accounts

Queensland Ambulance Service (QAS)

GPO Box 1425

Brisbane QLD 4001

You can also send documentation via email, and if eligible, Queensland Ambulance Service will arrange to pay the invoice on your behalf.

Western Australian aged pensioners are entitled to free primary ambulance services. Senior citizens aged 65 and over only have to pay 50% of the normal fee of both emergency and urgent ambulance transport.

You have to purchase ambulance cover insurance from a private health fund or a subscription through the state ambulance service. According to South Australia Ambulance Service, annual ambulance cover for a single pensioner is $49 or $97.50 for a pensioner family. You need to refer to SA Ambulance Service’s terms and conditions, or phone them on 1300 136 272.

The State Government covers ambulance services to all Tasmanian residents within the state and its islands who require treatment/transport by ambulance. The Tasmanian state government has reciprocal agreements in all states and territories except Queensland and South Australia. Other exceptions may apply in motor vehicle or workplace accidents where the insurance policies of the agreed parties cover the cost.

Most Health Care Concession Card and Pensioner Concession Card holders are entitled to free emergency ambulance services within the ACT. If you are not eligible for a concession and require urgent ambulance cover, you can purchase insurance from various private health funds.

It is recommended that you check your entitlements with Centrelink and/or the Department of Veterans’ Affairs (DVA), as some concession card holders may not be covered for all services, such as DVA Orange Card holders.

Although pensioners are entitled to free ambulance services within the ACT, at times you may be sent an invoice. If this occurs you must photocopy the front and back of your concession card and return a copy with your ambulance invoice to the address provided or contact Shared Services Ambulance Finance.

Northern Territory (NT) pensioners who hold a current Pensioner Concession Card, Health Care Card, NT Pensioner and Carer Concession Card or Veterans Affairs Card are entitled to free ambulance transport in the NT.

The NT ambulance provider, St John Ambulance, requires a copy of your valid card at the time of transport.

Family ambulance cover

Ensuring your family is covered with health insurance is a smart move, as it offers peace of mind and is financially worthwhile. The last thing on a parent’s mind (in or after an emergency situation) should be worrying about if they’re covered for ambulance transport and services.

Most health insurance policies include ambulance cover, and cannot be added on or taken off to reduce the price. All state and territory ambulance services across the country (along with registered private health funds) offer discounted rates for families (as opposed to single’s rates), but fluctuate depending on where you live.

To ensure your family is covered for urgent ambulance services and transport, call one of our experts on 1800 456 981 to compare a variety of different health providers, and find the right health insurance deal that includes ambulance cover? Simples.

Is it worth being covered for ambulance insurance?

Absolutely! Unless you live in certain states, or are otherwise exempt, the alternative is a very steep bill following a traumatic incident, which is not an ideal time to be rearranging your finances. Given the relatively low cost for cover, acquiring ambulance insurance is a no brainer.

Please remember to always check with your state/territory ambulance service, and/or your private health fund to ensure you’re covered for ambulance services as terms and conditions may change over time. 

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