Thousands of people in Australia every year require ambulance services, but these services are not covered by Medicare. Unless you live in Queensland or Tasmania (where the state government covers the costs), you'll need to organise your own ambulance cover or pay for it out-of-pocket.
You can purchase ambulance cover through an ambulance subscription with a state service or through your health fund.
Health funds offer ambulance cover as part of their hospital or extras coverage, or you can often purchase ambulance cover as a standalone product. The level of ambulance cover is usually either:
Emergencies are classified as:
Usually, the paramedic or doctor will determine whether the case is/was an emergency, and if so, your health fund will cover the cost.
For your convenience, we've listed all of moneytime's participating health funds and the way in which they provide ambulance cover:
Australian Unity
Emergency ambulance is included as part of all hospital covers except for Basic Hospital Cover.
GMHBA
In all states except NSW & ACT, GMHBA usually covers ambulance transportation by refunding ambulance subscription purchases that members make for themselves. If the member requires ambulance service and has not purchased an ambulance subscription, GMHBA may pay some of the benefit towards the cost, depending on the member's level of cover.
In NSW and the ACT, where ambulance subscriptions can only be purchased through a health fund, GMHBA policies cover emergency ambulance only within NSW.
HCF
All HCF Hospital policies cover comprehensive ambulance statewide, including road and air ambulance. A 1-day waiting period applies in emergencies, 12 months for pre-existing conditions and 2 months for non-emergency treatment.
NIB
Emergency ambulance cover is included on all nib policies, and ambulance only cover is also available for purchase.
Ambulance services operate independently in each state and territory.
Queensland and Tasmania
Ambulance services are funded by the State Government as a free service to all residents. As such, health funds have no need to cover ambulance for the residents in this state.
New South Wales & Australian Capital Territory
In NSW and ACT, ambulance cover can only be purchased through a health fund. An ambulance levy is included as part of basic hospital coverage, and may also be included in some extras coverage. “Ambulance only” covers also exist from some health funds.
Pensioners and residents who hold a Health Care concession card are entitled to free ambulance services, so you may be able to receive a reduction in the cost of your health insurance premium.
Victoria
In Victoria you may elect to be covered for ambulance services by either purchasing a subscription from Ambulance Victoria, or you can join a health fund that will pay a benefit towards ambulance costs. Some health funds, rather than paying a benefit toward the cost of an ambulance, may instead refund the cost of ambulance subscription to you.
When an Ambulance subscription is purchased, members are entitled to free ambulance transport and treatment throughout Victoria and Australia. This also includes air ambulance.
Holders for Health Care cards and Pensioner Concession cards are entitled to free ambulance services Australia wide, so you may be able to receive a reduction in the cost of your health insurance premium.
South Australia
In South Australia you may elect to be covered for ambulance services either by purchasing a subscription from SA Ambulance Service (SAAS), or you can join a health fund that will pay a benefit towards ambulance costs. Some health funds, rather than paying a benefit toward the cost of an ambulance, may instead refund the cost of ambulance subscription to you.
When an ambulance subscription is purchased with SAAS, members are entitled to free ambulance transport costs, whether it is an emergency or not, across Australia. In these cases where your health fund covers emergency ambulance only, you pay purchase Ambulance Cover Extras (ACE) from SAAS to supplement the aspects of ambulance cover which health insurance will not pay a benefit towards (ie. comprehensive cover).
Subscription costs are discounted for pensioners, so you may be able to receive a reduction in the cost of your health insurance premium.
Western Australia
In Western Australia, you may elect to be covered for ambulance services by a subscription to Metropolitan Ambulance Cover or Country Ambulance Cover; or by joining a health fund that pays a benefit towards ambulance costs. Some health funds, rather than paying a benefit toward the cost of an ambulance, may instead refund the cost of the ambulance subscription to you.
Metropolitan Ambulance Cover is administered by the Health Benefit Fund (HBF), and coverage relates only to urgent or emergency requirements. If you use an ambulance and are not admitted to a hospital emergency department a $50 co-payment applies.
Country Ambulance Cover is administered by St John Sub Centres. Residents with a St John Country Ambulance Cover can receive emergency and necessary non-emergency transport.
Aged pensioners are entitled to free ambulance services, so you may be able to receive a reduction in the cost of your health insurance premium.
Northern Territory
In the Northern Territory, you may elect to be covered for ambulance services by a subscription to St John Ambulance or by joining a health fund that pays a benefit towards ambulance costs. Some health funds, rather than paying a benefit toward the cost of an ambulance, may instead refund the cost of ambulance subscription to you.
If your health insurance policy covers emergency ambulance only, but you wish to have comprehensive ambulance cover, then it would be worthwhile taking out an ambulance subscription with your state service. Speak with your health fund to see if they will reduce your premium to account for your ambulance subscription, as some will.
A benefit to a state service subscription is that most have reciprocal agreements with ambulance services in other States and Territories. This enables people who have ambulance coverage to receive ambulance services when they are interstate, although it should be noted that often only emergencies are covered interstate. You should verify these details with your State Ambulance Service.
Please note: This is guide only, provided for your benefit. You are are advised to contact the ambulance service in the state you reside in, as well as your health fund, to determine the coverage you are entitled to receive.
