Ambulance cover
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Ambulance cover explained
Ambulance cover explained by Dr Ginni Mansberg.
Dr. Ginni Mansberg
Health
Video Transcript
Hi, it’s Dr. Ginni Mansberg, GP and health commentator in the media.
Today we’re going to cover when to call an ambulance.
It can be so hard to know when the symptoms you or your loved ones are experiencing are serious enough to call 000 for an ambulance.
Here are some, but not all, of the situations that always need an ambulance.
Chest pain or chest tightness, a sudden onset of weakness or numbness of the face, arm or leg, finding it hard to breathe.
a sudden fall or loss of consciousness, severe burns or seizures in children.
When you call 000, the operator will need you to be calm enough to answer some important questions like your name and where you are so, the ambulance can find you.
They will also ask you some questions about the patient. They will not ask you how you’re going to pay for the ambulance, and they won’t tell you the cost.
They just get the ambulance on the road to you as soon as possible.
In many states in Australia, the cost of an ambulance is not covered, which can leave you facing call-out costs that can run into hundreds of dollars.
But if you have private health insurance, you may be covered for an ambulance.
Talk to the experts about whether you have ambulance cover included in your private health insurance.
Why take out ambulance cover?
There are a few reasons why someone may want to take out ambulance cover, but one of the most common reasons is that they live in a state where it’s required. Other reasons include:
- If you live in a state where you can get cover through a subscription or private health insurance, you may pay less with a health fund.
- Not all states have a reciprocal ambulance agreement. This means you may need cover for ambulance services while travelling interstate.
- Many hospital cover policies include some ambulance cover at little to no additional cost, so if you’re looking for hospital cover, you may as well consider a policy with an ambulance component, as you never know when you’ll need it.
Choosing ambulance cover
If you live in a state where you need ambulance cover or you’d prefer cover through a health fund, here are a few things to consider while you browse:
- Many ambulance cover policies come with limitations or exclusions that you’ll want to understand before signing up. For example, you may only be covered for emergency transport.
- Some ambulance services won’t treat you at the scene if it’s not necessary, which may affect the cover you want.
- One of the convenient ways to find an ambulance cover policy that works for you is to compare your options online. With our free comparison tool, you can compare policies with an ambulance cover component side-by-side.
Expert tips for choosing the right ambulance cover
Our health insurance expert, Steven Spicer, has some great tips on how to choose the right ambulance cover for you.
Steven Spicer
Executive General Manager – Health, Life & Energy
You could save money by taking out 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 depends 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). If you’re looking at a more comprehensive ambulance cover than what’s included in your health insurance policy, it may be worth taking out a separate subscription.
Ambulance cover has minimal waiting periods
For those seeking the peace of mind of having coverage immediately, it’s good to know that many health funds provide ambulance cover with minimal waiting periods. Depending on the health fund, this period may be as little as one day, or no time at all. Prior to signing up, it’s essential to check the fund’s policy brochure for more details on waiting periods.
Ambulance cover protects you from high-cost ambulance services
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 2022, there were more than 4 million ambulance service responses attending to patients in need across Australia during the 2021 financial year.1 That’s a lot of people relying on this crucial service and, in many instances, being exposed to the associated charges and fees.
How ambulance cover works
What is ambulance cover?
Ambulance cover helps take care of the cost of paramedic treatment and patient transport in an ambulance. 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.
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 about the provisions for pensioners and concession cardholders’ ambulance cover are listed under the relevant states and territories below. Ambulance services for the Department of Veterans’ Affairs (DVA) cardholders are covered in every state and territory.2
Please note: This information may only apply in your state of residence (unless you’re a QLD resident).
Ambulance cover by state and territory
Ambulance cover in New South Wales (NSW)
NSW residents 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.3 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 stand-alone ambulance cover from a private health insurer to be covered for ambulance transport.
Pensioners and concession cardholders
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:2
- Health Care Card
- Pensioner Concession Card
- Commonwealth Seniors Health Care Card
Ambulance cover in Victoria (VIC)
Charges for ambulance services in VIC vary between emergency and non-emergency transport, the mode of transport (e.g. road or air ambulance) and the location of the call out.4
You can get ambulance cover through an Ambulance Victoria membership or a registered health fund.5
Pensioners and concession cardholders
VIC residents holding either a Health Care Card or Victorian Pensioner Concession Card can receive free, clinically necessary ambulance services.2
If a cardholder is transported by ambulance from a private healthcare facility (like 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.
Ambulance cover in Queensland (QLD)
The QLD state government covers all ambulance costs for QLD residents, so you aren’t required to organise your own cover.6 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 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).
Pensioners and concession cardholders
QLD residents are automatically covered for emergency ambulance transport and treatment Australia-wide.2 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.6
You can also send documentation via email, and if eligible, the QAS may pay the invoice on your behalf.
Ambulance cover in South Australia (SA)
SA operates on a user-pays ambulance service where residents are charged based on the type of services required.7 Residents can purchase ambulance cover through their state ambulance service or a private health insurance policy.8
Pensioners and concession cardholders
Pensioners are eligible for discounted membership with the SA Ambulance Service; otherwise, ambulance cover can be purchased through private health insurance.8
Ambulance cover in Western Australia (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 state ambulance service (St John WA).9
Pensioners and concession cardholders
WA residents aged 65 years and over who receive a government pension concession are entitled to free emergency ambulance services and non-urgent ambulance services that are deemed medically necessary.2
WA residents aged 65 years and over who don’t receive a pension may still receive a 50% discount on the cost of ambulance services (excluding the transfer between hospitals where one or both are a private hospital).
Ambulance cover in Tasmania (TAS)
The TAS state government provides free ambulance services to Tasmanian residents within the state and its islands.10 The only exceptions 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.
If you need to claim treatment in another state or territory, you can do so by forwarding any invoices you receive, as well as proof of TAS residency, to Ambulance Tasmania.
Pensioners and concession cardholders
The state government covers ambulance services for all TAS residents within the state and its islands who require treatment and transport by ambulance.10 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.
Exceptions may apply in motor vehicle or workplace accidents where the insurance policies of the agreed parties would cover the cost.
Ambulance cover in the Northern Territory (NT)
Ambulance charges in the NT are based on a call-out fee plus a charge per kilometre. Ambulance services can be covered by a membership with St John Ambulance or private health insurance. St John Ambulance also provides cover for its Territorian members Australia-wide.11
Pensioners and concession cardholders
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.2
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.12 These specified, exempt groups i.e. Health Car Concession Card or Pensioner Concession Card holders 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. Unlike most other states and territories, ACT does not have a state subscription.
Fortunately, emergency ambulance cover is included in policies widely available in the ACT.
Pensioners and concession cardholders
Most Health Care Concession Card and Pensioner Concession Cardholders are entitled to free emergency ambulance services within the ACT.2 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.12
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.12 Alternatively, you can contact Shared Services Ambulance Finance.
More information
What if you don’t have ambulance cover?
If you don’t have ambulance cover, these are some of the potential costs you could pay for transport in the event of an emergency:
| State/Territory | Call out fee ($) | Per kilometre charges ($) |
|---|---|---|
|
ACT11 |
$1,032 | $14 for every km outside the ACT |
|
NSW2 |
$415 | $3.74 |
|
NT13 |
$815 (first 10km) | $5.25 (per km greater than 10km) |
|
QLD |
Free | N/A |
|
SA6 |
$1,085 | $6.20 |
|
TAS |
Free | N/A |
|
VIC3 |
$1,306 (Metropolitan) $1,927 (Regional) | N/A |
|
WA14 |
$1,072 (Perth) | N/A |
|
Note: All fees are current as of February 2023. 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 non-emergency. Both cover types vary depending on your policy and provider. Some contribute towards all ambulance transportation (such as helicopters), while others may only contribute towards road travel.
Is it worth having ambulance cover?
Absolutely! Unless you live in certain states where ambulance services are covered by the government or otherwise exempt, the alternative could be a very steep bill following a traumatic incident. Given the relatively low cost for cover, purchasing ambulance insurance can be a wise 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.
Meet our health insurance expert, Steven Spicer
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.
Want to know more about ambulance cover?
1 Australian Government: Productivity Commission – Report on Government Services 2022: part E, Section 11, Ambulance services. Published February 2022.
2 PrivateHealth.gov.au – Ambulance. Accessed February 2023.
3 NSW Government: NSW Ambulance – Accounts & Fees. Accessed February 2023.
4 Victoria State Government: Department of Health – Ambulance fees. Accessed February 2023.
5 Victoria State Government: Department of Health – Ambulance cover. Accessed February 2023.
6 Queensland Government – Interstate ambulance treatment and transport information for Queensland residents. Accessed February 2023.
7 SA Ambulance Service – Ambulance fees. Accessed February 2023.
8 SA Ambulance Service – Ambulance cover. Accessed February 2023.
9 St John WA, Metro and Country ambulance service. Accessed February 2023.
10 Tasmania Government: Department of Health – Ambulance Tasmania: Fees and Accounts. Accessed February 2023.
11 Northern Territory Government – Ambulance services. Accessed February 2023.
12 ACT Government: ACT Emergency Services Agency – Fees and charges. Accessed February 2023.
13 St John Ambulance Australia (NT) Inc. (St John NT) – Ambulance cover: Transport charges. Accessed February 2023.
14 St John WA – Metro Ambulance Fees. Accessed February 2023.
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