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What is ambulance cover?

Ambulance cover takes care of certain expenses incurred when being treated by paramedics and transported in ambulances. Emergency transportation and ambulance services are essential for urgent medical care but you might be surprised to learn they aren’t covered by Medicare. Instead, ambulance cover differs across the states and territories, so we’ve broken it down in this guide.

Note: Ambulance services for the Department of Veterans’ Affairs (DVA) cardholders are covered in every state and territory.1

Ambulance cover in NSW

Residents of NSW who require ambulance treatment or transport services are billed 51% of the actual charge, and the NSW government subsidises the remaining 49% of the cost.2 Charges include a call-out fee plus additional charges per kilometre when transported by road, aircraft, helicopter or a combination of these ambulance services. Alternatively, NSW residents can purchase health insurance or a stand-alone ambulance cover from a private health insurer to be covered for ambulance transport.

Ambulance cover in VIC

Charges for VIC residents who require ambulance services can vary depending on whether the event is an emergency (or non-emergency), the mode of transport (e.g. road or air ambulance) and the location of the call out.3

You can be covered by purchasing ambulance cover through an Ambulance Victoria membership or a registered health fund.4

Ambulance cover in QLD

The QLD state government covers all ambulance costs for QLD residents, so you aren’t required to organise your own cover.5 Ambulance coverage in QLD extends across the entire country too, so that’s one less thing Sunshine State residents need to worry about when holidaying interstate.

If you 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 QLD residency, to the Queensland Ambulance Service (QAS).

Ambulance cover in SA

Like VIC, SA operates on a user-pays ambulance service where residents are charged based on the type of services required.6 Residents can purchase ambulance cover through their state’s ambulance authority (SA Ambulance Service) or a private health insurance policy.

Ambulance cover in WA

In WA, charges for ambulance services vary depending on whether you’re treated in a metro or country location. You can get ambulance cover through your health insurance provider or WA’s ambulance service (St John WA).8

Ambulance cover in TAS

The TAS state government provides free ambulance services to TAS residents within the state and its islands.9 The only exemptions to this are ambulance services related to motor vehicle or workplace accidents, where you’ll be required to send the ambulance invoice to the Motor Accidents Insurance Board and your workplace or WorkCover respectively.

Ambulance cover in the NT

Similar to NSW, ambulance charges in the NT are based on a call-out fee plus a charge per kilometre.  Ambulance services can be covered by membership with St John Ambulance or private health insurance. St John Ambulance also provides cover for its Territorian members Australia-wide.10

Ambulance cover in the ACT

If you reside in or close to the nation’s capital, chances are you will need to take out ambulance cover to avoid charges unless you’re a specific concession cardholder or meet ACT Ambulance Services’ exemption criteria.11 These specified, exempt groups are entitled to free ambulance services throughout the ACT and don’t require separate ambulance cover.

If you’re not eligible for free ambulance services, you should consider taking out cover through a registered Australian health fund.

Fortunately, emergency ambulance cover is included in policies widely available in the ACT.

How ambulance cover works

Ambulance cover for pensioners and concession cardholders

Depending on your state of residence, most ambulance transport services and treatments are covered for pensioners and concession cardholders across the country.

Information and provisions regarding pensioners and concession cardholders ambulance cover are listed by states and territories below:

Please note: The information provided may only apply in your state of residence (unless you’re a QLD resident).

NSW

If you’re a NSW resident who is the current holder of any of the listed cards below, you’re not required to pay for ambulance transport or urgent ambulance services:1

  • Health Care Card
  • Pensioner Concession Card
  • Commonwealth Seniors Health Care Card

VIC

VIC residents holding either a Health Care Card or Victorian Pensioner Concession Card can receive free, clinically necessary ambulance services around Australia, as well as transport to the nearest and most appropriate medical facility.1

If a cardholder is transported by ambulance from a private healthcare facility (including private hospitals and day surgery clinics), that facility is responsible for payment. However, it may choose to pass the cost onto the patient.

There may be eligibility requirements for pensioners and concession cardholders when obtaining free ambulance cover. Be sure to check with Ambulance Victoria to see if you’re eligible.

QLD

Permanent QLD residents are automatically covered for emergency ambulance treatment and transport Australia-wide.1 If you were interstate when you required ambulance services, you need to forward the ambulance invoice to QAS along with proof of QLD residency and your current QLD-issued Centrelink Pension Concession Card.5

You can also send documentation via email and, if eligible, the QAS may pay the invoice on your behalf.

SA

Pensioners are eligible for discounted membership with the SA Ambulance Service; otherwise, ambulance cover can be purchased through private health insurance.7

WA

WA residents aged 65 years and over who receive a government pension are entitled to free emergency ambulance services and non-urgent ambulance services that are deemed to be medically necessary.1

TAS

The state government covers ambulance services to all TAS residents within the state and its islands who require treatment and transport by ambulance.9 The TAS state government has reciprocal agreements in most states and territories (except QLD and SA), so Tasmanians can forward ambulance invoices from interstate services to the government for payment.

Other exceptions may apply in motor vehicle or workplace accidents where the insurance policies of the agreed parties would cover the cost.

NT

NT residents who hold a current NT Centrelink Pensioner Concession Card or Health Care Card don’t need to subscribe to St John Ambulance NT.1

ACT

Most Health Care Concession Card and Pensioner Concession Cardholders are entitled to free emergency ambulance services within the ACT.1 The ACT also has a reciprocal agreement in place with some states and territories (except for QLD, SA and WA), through which your interstate ambulance services are covered by the ACT Government.11

Although pensioners and healthcare concession cardholders are entitled to free ambulance services within the ACT, you may be sent an invoice mistakenly. If this occurs, you should photocopy the front and back of your concession card and return the copy with your ambulance invoice to the address provided.11 Alternatively, you can contact Shared Services Ambulance Finance.

What to expect if you don’t have ambulance cover

If you don’t have ambulance cover, these are some of the potential costs residents could pay for transport in the event of an emergency:

State/TerritoryCall out fee ($)Per kilometre charges ($)
ACT11$1,000$14 (travel outside of ACT)
NSW2$407$3.67
NT12$815 (first 10km)$5.25 (per km greater than 10km)
QLDFreeN/A
SA6$1,064$6.10
TASFreeN/A
VIC3$1,284 (Metropolitan)

$1,894 (Regional)

N/A
WA13$1,021 (Perth)N/A
Note: All fees are current as of October 2021. All fees represented in the table are for emergency road ambulance services (transport and treatment).

 

What types of ambulance cover are available?

Depending on the state or territory you live in, many health insurers include ambulance cover as part of their policies. Alternatively, you may be able to 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 (subject to availability).

There are two types of ambulance cover available through registered health funds: emergency and comprehensive. Both cover types vary depending on your policy and provider. Some offer cover for all ambulance transportation (such as helicopters), while others may only provide for road travel.

What’s more, some ambulance insurance policies may set further limitations, such as cover in your state of residence only or no cover for call-out fees if you’re treated at the scene without being transported to hospital.

Things to look out for in ambulance cover

It’s important to be aware of any other limitations or exclusions on your policy. For example, does your cover include all forms of emergency transport or is it only for road services? Does your policy cover ‘call out’ fees (when the ambulance treats you at the scene but doesn’t transport you to hospital)? Some ambulance services won’t treat you if they don’t think you clinically need it or will only transport you to the nearest medical centre.17 Make sure you read the policy description carefully to understand your entitlements and restrictions.

Family ambulance insurance

Ensuring your family is covered with health insurance is a smart move, as it offers peace of mind and can be financially worthwhile. The last thing that should be on any parent’s mind during an emergency is worrying about how they’ll pay for ambulance transport and services.

Most health insurance policies include ambulance cover, so it can’t be added on or taken off to adjust your premiums. To ensure your family is covered for urgent ambulance services and transport, you can compare various health providers.

Is it worth having ambulance insurance?

Absolutely! Unless you live in certain states or are otherwise exempt, the alternative could be a very steep bill following a traumatic incident. Given the relatively low cost for cover, purchasing ambulance insurance is a great idea.

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

Anthony Fleming, General Manager

Meet our health insurance expert, Anthony Fleming

As General Manager for Health Insurance and Life Insurance at Compare the Market, Anthony Fleming’s goal is to help Australians navigate the private health system, make it work for them and avoid large out-of-pocket medical expenses. He believes ambulance cover is a vital part of your overall cover. For the peace of mind it offers at a time when you’re likely to be suffering an emergency, it really shouldn’t be overlooked.

Anthony has more than 17 years’ experience working in various roles across the health and general insurance industries. He’s also a Board Member of the Private Health Insurance Intermediaries Association. You’ll often find him in the press and on television helping Australians navigate this sometimes confusing terrain.

Anthony’s expert tips for ambulance cover

  • Instead of purchasing an ambulance subscription, you could potentially save money in the long run by including ambulance cover in your private health insurance policy. Keep in mind that this does depend on what level of coverage you need, as it can vary between health funds. Many policies only cover you in the event of an emergency, while others may cover you more comprehensively (e.g. inter-hospital transport or non-emergency services).
  • For those seeking the peace of mind of having coverage immediately, you may be glad to know that many health funds provide ambulance cover with minimal waiting periods, sometimes as little as just one day. Prior to signing up, it’s essential to check the fund’s policy brochure for more details on waiting periods.
  • The main benefit of having ambulance cover is that it insures you against the potentially high costs of ambulance services. According to the Productivity Commission’s Report on Government Services 2021, there were 4.9 million ambulance service responses attending to patients in need across Australia during the 2020 financial year.14 That’s a lot of people relying on this crucial service and, in many instances, being exposed to the associated charges and fees.

Sources

1 PrivateHealth.gov.au – Ambulance. Accessed October 2021.
2 NSW Government: NSW Ambulance – Accounts & Fees. Accessed November 2021.
3 Victoria State Government: Department of Health – Ambulance fees. Last reviewed July 2018. Accessed November 2021.
4 Victoria State Government: Department of Health – Ambulance cover. Last reviewed October 2015. Accessed November 2021.
5 Queensland Government – Interstate ambulance treatment and transport information for Queensland residents. Last updated December 2020. Accessed October 2021
6 SA Ambulance Service – Ambulance fees. Accessed November 2021.
7 SA Ambulance Service – Ambulance cover. Accessed November 2021.
8 St John WA – Frequently Asked Questions. Accessed November 2021.
9 Tasmania Government: Department of Health – Ambulance Tasmania: Fees and Accounts. Accessed November 2021.
10 Northern Territory Government – Ambulance services. Last updated May 2016. Accessed November 2021.
11 ACT Government: ACT Emergency Services Agency – Fees and charges. Accessed October 2021.
12 St John Ambulance Australia (NT) Inc. (St John NT) – Ambulance cover: Transport charges. Accessed October 2021.
13 St John WA – Metro Ambulance Fees. Accessed November 2021.
14 Australian Government: Productivity Commission – Report on Government Services 2021: part E, Section 11, Ambulance services. Published January 2021. Accessed November 2021.

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