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Health Insurance Ambulance Cover

Name: Health Insurance Ambulance Cover
Creator: Savvy
Published: 2023-03-27T16:21:38+10:30

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Written by , updated on July 6th, 2023

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The cost of transport to hospital via ambulance isn’t covered by Medicare, so if you have an unexpected need for urgent hospital treatment, the ambulance ride can end up costing thousands of dollars. However, the cost and cover you have access to will depend on which state you live in, as it works differently across different parts of Australia. This is where private health insurance can help with the cost of your ambulance transport.

You can compare your options for ambulance cover here through Savvy. You’ll be able to consider online ambulance cover quotes side-by-side here through Savvy today. Start the process with us today to find out what cover you may need to help you be prepared for any unexpected ambulance trips.

What is ambulance cover and how does it work?

Most ambulance cover is a form of health insurance that can help pay for the cost of transport to hospital by ambulance. It’s available as a separate form of insurance on its own with some insurers, known as ambulance-only cover, or it can be provided in a package along with hospital cover, extras cover or a combined hospital and extras policy. Options to take out ambulance cover include:

Private health ambulance cover

Private health insurance policies often include ambulance cover with either hospital cover or extras cover. Be sure to check the exact details of what your policy covers, as some ambulance policies just cover transport to the nearest accident and emergency department, whilst others also include inter-hospital transfers, in case you need to travel from one hospital to another to receive your medical treatment.

Ambulance subscriptions

In some areas, the state or territory-based ambulance service offers direct subscriptions to the public, which cover you for ambulance transport not only in your home state but also nationwide. For instance, St John Ambulance NT is one example of such a region-based service.

State-funded ambulance cover

Some states in Australia provide ambulance cover for all their residents free of charge, both within the state and sometimes nationwide. Other states may offer free transport for pensioners and Centrelink recipients.

Federal funding for veterans’ ambulance transport

All Department of Veterans Affairs Health Card holders are entitled to free ambulance transport, both for emergency transport to hospital and also in many cases to attend non-urgent medical appointments.

What is and isn’t included under ambulance cover?

Ambulance cover can vary in the cover that it offers, so it’s important to compare policies carefully and make sure you understand what the limitations are.

Some insurers provide cover for all ambulance travel
Others only provide cover for ground transport (and exclude air evacuations, such as by the Royal Flying Doctor Service, Air Ambulance Australia or CareFlight Air Ambulance)
Some health funds do provide cover for non-urgent transport and transfers to other medical facilities, while others don’t
Call-out fees (where a patient calls an ambulance, but receives treatment on-site and is not transported to hospital) may be covered by some funds, but not others
Co-payments may or may not be covered (where a patient is billed for a co-payment for non-urgent transport)

Because the range of cover provided by health funds varies so much, it’s important to compare private health insurance ambulance cover so you understand exactly what coverage you’ve got. You can compare ambulance cover policies side-by-side right here through Savvy.

What are the different rules for ambulance cover around Australia?

The need for ambulance cover varies across the country as each state and territory in Australia has different rules regarding ambulance transport. The rules for each state are as follows:

ACT

Ambulance cover is provided free for:

Pensioners who hold a Health Care Card
Concession Health Care Card holders

All other ACT residents need private ambulance health insurance

NSW

Ambulance cover is provided free of charge for:

Health Care Card holders
Pensioner Concession Card holders
Commonwealth Seniors Health Care card holders

All other NSW residents need private ambulance health insurance

Free ambulance transport is provided for the following:

Centrelink Pensioner Concession Card holders
Health Care Card holders

All other NT residents need private ambulance health insurance. Subscriptions to the NT St John Ambulance Service are also available.

QLD

All emergency ambulance treatment and transport costs are covered by the state government, so no private ambulance cover is required by Queensland residents. This extends to transport required for Queensland residents in another state or territory.

Subscriptions to the state’s SA Ambulance Service are available, or else private ambulance health insurance is required. There are no concessions for pensioners available.

TAS

The Tasmanian state government provides free ambulance transport within the state for all Tasmanian residents, so no private ambulance cover is required on the island state. However, the state only has reciprocal agreements with the ACT, NT, Victoria and WA.

VIC

Free ambulance transport is provided to the following (in limited circumstances):

Pensioner Concession Card holders
Health Care Card holders

However, if the holder of one of these cards is transported from a private hospital or healthcare facility, the cost of that ambulance transport is passed onto the private health provider, who may choose to bill the patient. All other VIC residents need private ambulance health insurance. Subscriptions are available to the state ambulance service, Ambulance Victoria.

Ambulance services are provided to the following free of charge for medically necessary, emergency and urgent ambulance transport:

Residents who are over 65 years of age and receive an Australian Government pension

All other WA residents need private ambulance health insurance. Subscriptions are available to the state ambulance service, St John WA.

Types of health insurance

Hospital cover

This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.

Extras cover

This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).

Cover for singles

This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.

Cover for families

A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.

Cover for seniors

A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.

OVHC

Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.

Ambulance cover

Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).

Basic hospital cover

The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.

Bronze hospital cover

Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.

Silver hospital cover

Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.

Gold hospital cover

The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.

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Frequently asked questions about ambulance cover

What will happen if I don’t have private health insurance which includes ambulance cover?

If you don’t have private health insurance, such as ambulance-only cover, through a subscription that covers the cost of your ambulance transport, you could be left having to pay the full cost. This can amount to hundreds or even thousands of dollars. For example, in Victoria, the call-out fee for rural emergency road transport by ambulance is $1,927 (correct as of March 2023). Standalone ambulance cover can be bought for just a few dollars a week and is even provided as part of many hospital cover or family hospital and extras policies.

Does ambulance cover provide protection when you’re on holiday in another state?

Rules about the cover provided to customers when they are interstate vary between health funds, and there is no national standard which applies in all states and territories. As such, it’s important to check with your insurer to determine what you can and can’t be covered for.

Is there a waiting period before you can claim for ambulance cover on your hospital policy?

Waiting periods exist to ensure that private health insurance costs are kept down for all Australians. There isn’t usually a waiting period for emergency ambulance services. However, there may be a waiting period for non-urgent transport, such as if you require ambulance transport home after back or hip replacement surgery. Where waiting periods are present, they may range from just one day to one to two months.

Will I get a choice about which hospital the ambulance takes me to?

This will depend on the nature of your health emergency. If you are seriously injured, for example in a car crash, you will be taken to the nearest accident and emergency department which is appropriate for the care you require. This may not be the nearest hospital to the site of the accident, but the hospital which can provide the most appropriate treatment. If you wish to be treated as a private patient, you may be able to choose to be transferred to the private hospital of your choice once your condition has been stabilised and you’re no longer in danger. This may apply if you receive urgent surgery and then require a longer hospital stay during your recovery period, for instance.

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