Ambulance Cover & Insurance - What’s covered and how can it benefit you

In the event of an accident or unexpected illness, the last thing you want to worry about is the cost of receiving urgent medical assistance. Ambulance cover helps you avoid the costly expense of emergency and non-emergency ambulance fees should you require treatment.

In 2015/16, ambulance personnel were called out to assist 3.2 million people around Australia. Unfortunately, not all of these people would have had ambulance cover or the right type, making their treatment very costly. Emergency air transport for example, can exceed $5000 should you require it!

Ambulance cover can get complicated depending on where you live and the concessions you’re entitled to. The Members Own team want to make understanding ambulance cover a whole lot easier, so we’ve put together this simple guide. This will help you navigate ambulance health cover and make sure you’re protected in the event you need to utilise this crucial service.

Once you know the basics, you’ll be able to compare ambulance cover from different funds with confidence!

Understanding the different types of cover

Ambulance insurance is often bundled into other health policies to provide individuals with a more comprehensive cover. Depending on where you live, neglecting to take out even basic ambulance cover could put you at risk of receiving an expensive bill in the mail after accepting urgent medical care.

While you might be tempted to opt for the cheapest ambulance cover, be sure to check what you’re exactly covered for under the policy. Being ill or in an accident is stressful enough without finding out from your insurer you’ll have to pay the entire ambulance bill out of your own pocket.

There are two types of ambulance cover for you to consider:

1. Emergency Ambulance

As the name suggests, emergency ambulance only provides cover for treatment and transport in an emergency situation where your life is at risk. This could be a major vehicle accident or a sudden collapse due to severe chest pains.

  • Typically, unlimited cover is provided for emergency incidents including:
  • Major accidents
  • Sudden onset of pain or collapse
  • Severe chest pain indicating heart attack
  • Broken bones
  • Severe blood loss
  • There are several events not covered under emergency ambulance such as:
  • Non-emergency medical treatment or transportation.If you require transportation from the hospital to your home, this is considered non-emergency medical transport. Likewise, if you are transported to the hospital for a non-critical illness or injury and the ambulance doesn’t require the use of lights or sirens during the journey, you won’t be covered under this policy.
  • Other reasons including:
  • If you hold a state or territory ambulance subscription
  • If the treatment or transport isn’t recognised by your private health fund
  • If you require specialised transported for routine treatment due to an ongoing health condition such as severe mobility.

2. Comprehensive Ambulance

Comprehensive ambulance cover offers you financial protection should you need ambulance treatment or transport on ground, at sea or in the air. This includes in both emergency and non-emergency situations.

  • Typically, with comprehensive ambulance you’ll be covered for:
  • Emergency treatment and transport road, air or sea
  • Ambulance treatment on-the-spot at any time, nation-wide.
  • Transportation via ambulance between hospitals when deemed medically necessary.
  • There are several situations not covered under comprehensive ambulance such as:
  • If you hold a state or territory ambulance subscription
  • If you receive transport from an air or road service that is not government operated or recognised by your health fund
  • If you receive non-emergency ambulance transportation while you’re serving your policy waiting period.

Choosing the right ambulance cover will depend on your what’s most important to you, where you live and who you wish to cover. Once you know the type of cover you’re wanting, you can easily compare policies with our online comparison tool.

Simply select ambulance only cover or mix and match it with a hospital or extras package to increase your benefits. Remember to consider the type of ambulance cover you’re requiring – emergency or comprehensive.

The Members Own Health funds are not-for-profit or mutual funds that exist to put its members first. Unlike for-profit funds, we don’t have shareholders or investors to please so by becoming a member, you’ll be enjoying more benefits and better coverage. Don’t believe us? Ask around. Over one million Australians are already are enjoying the benefits of being with one of the Members Own not-for-profit or mutual funds.

Does everyone need Ambulance Cover?

Ambulance cover isn’t just for those who enjoy extreme activities like skydiving or rock climbing. You never know when you might be in a car accident on the way to work or struck with extreme and debilitating pain.

While we might not like to think about these things, being protected means you and your family will have peace of mind so you won’t have to incur the costs of unexpected ambulance personnel treatment and transportation.

However, not all people need to take out ambulance insurance from their health fund. Depending on where you live and your eligibility for concessions, you may not need cover at all. For example, residents of Queensland and Tasmania are provided with free ambulance cover by their state government.

Here’s a breakdown the state Ambulance Cover arrangements:

STATE
AMBULANCE COVER ARRANGEMENTS
Australian Capital Territory
Those with a Pensioner Concession Card or a Health Care Concession Care are entitled to free emergency ambulance service.
New South Wales
Those with a Pensioner Concession Card, Health Care Concession Care or Commonwealth Seniors Health Card are entitled to free emergency Ambulance Cover NSW.
Northern Territory
Those with a Pensioner Concession Card or a Health Care Concession Care are entitled to free emergency ambulance service.
Northern Territory residents have the option to purchase a subscription through a state ambulance service or opt for cover through a registered health fund.
Queensland
The Queensland state government provides all residents with free Ambulance Cover.
South Australia
South Australian residents have the option to purchase a subscription through a state ambulance service or opt for cover through a registered health fund.
Tasmania
The Tasmanian state government provides all residents with free Ambulance Cover.
Victoria
Those with a Pensioner Concession Card or a Health Care Concession Care are entitled to free emergency Ambulance Cover Vic.
Victorian residents have the option to purchase a subscription through a state ambulance service or opt for cover through a registered health fund.
Western Australia
Those with a Pensioner Concession Card or a Health Care Concession Care may be entitled to free emergency ambulance service.
Western Australian residents have the option to purchase a subscription through a state ambulance service or opt for cover through a registered health fund.
Australia wide
Those with a Department of Veterans Affairs Gold Card are covered for state ambulance service Australia wide.

It’s important to note, this applies while you’re in your state of residence. It may not apply if you’re interstate, so if you travel it’s important to check with your state ambulance authority.

Does Medicare cover ambulance costs?

It’s a common misconception that Medicare covers the cost of ambulance treatment and transport like many medical expenses. If you’ve found out the hard way, you’ll know that you cannot claim these expenses with Medicare.

Taking out Ambulance Cover only through a health fund

If you’ve identified that you need ambulance cover, you have a range of options to become protected.

You can take out a standalone ambulance policy of either emergency or comprehensive cover. The main advantage of choosing ambulance cover only is that it’s typically more affordable than combining it with a hospital or extras insurance policy. This is because the benefits are limited to ambulance only. Choosing an emergency ambulance cover may also reduce the costs further while giving you basic cover. That’s great for those on a tight budget who don’t qualify for concessions like students.

You could also choose to take out a hospital plan that includes ambulance cover providing you with a more comprehensive insurance policy. Alternatively, you may choose an extras policy that includes the cover of ambulance treatment and transportation. While consolidating the covers will cost more than a standalone ambulance policy, it will include a greater variety of benefits. It’s just up to you to decide how much cover you require and whether it’s worth the additional expense.

If you do choose the option of combining your ambulance cover with an existing or new hospital or extras package, remember to consider the level of cover. The level of ambulance cover will vary from fund to fund.

Taking out Ambulance Cover through a subscription

If you’re a resident of the Northern Territory, Western Australia, South Australia or Victoria, you’re entitled to take out your ambulance cover through a subscription with your state ambulance authority. Some health funds may reimburse you or pay in part or full, the cost of your annual subscription.

Alternatively, you have the option to take out the ambulance cover through a registered health fund.

What are the costs of not having Ambulance Cover?

Thinking of of going without ambulance cover? That’s up to you, but be sure you’re aware of potential ambulance costs before you decide.

The costs of ambulance services vary between different states and territories. Here are just some of the costs you may be up for if you require emergency ambulance assistance:

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Who needs cover?

STATE
EMERGENCY CALL-OUT FEE
CHARGES PER KM
Australian Capital Territory
$936.00
including treatment and transport
$12
per km travelled outside the ACT
New South Wales
$372.00
$3.35
Northern Territory
$745.00
$4.80
South Australia
$955.00
$5.50
Victoria
$1,174.00
n/a
Western Australia
$949.00
for life threatening/ urgent situations
n/a

Remember, in the event of an accident or injury, you may not have any say in whether or not to call an ambulance. If someone calls the ambulance on your behalf, you’ll be responsible for paying the bill.

Questions to ask about your Ambulance Cover

Ready to compare ambulance cover policies? Before you search for the right cover for you and your family, we want to provide you with all the questions to ask your potential provider.

Does the policy cover non-emergency transportation and treatment?

As we’ve shared above, there are two types of ambulance cover with some limited to emergency events only.
It’s worth checking to see what type of cover the policy offers and how they define emergency situations.

Is there a waiting period?


Some funds with stipulate a waiting period before you’re entitled to receive benefits of your ambulance cover. While you can’t plan an emergency, it’s wise to know when you’re actually covered before you attempt that life or death stunt!

Will I be covered Australia-wide?

Some ambulance insurance policies will only cover you if you’re requiring the service in your state of residence. It’s particularly important if you travel interstate, you check if you’ll be covered outside of your home state.

Will the call-out fee be covered?

In the event you require an ambulance for treatment, but don’t need transportation to a hospital, you’ll be charged a call-out fee. Some policies will cover this, but others may not.

Will I need to make co-payments?

Depending on your policy, you may need to make a co-payment to contribute to the cost of the ambulance fee.

What types of transport are not covered?

The cost of emergency air transportation is excessive, so check what type of ambulance transport your policy covers. Does it include road, sea and air?

Will my children be covered?

Most funds and ambulance subscription services will offer singles, couples or family ambulance cover. If you have dependents, check that your children will be covered under the policy or membership.

Compare & Join

Now that you know everything about ambulance cover and what to look out for, you’re ready to compare policies to find the right one for you and your family.

If you’d like to ask any of the above questions or have queries about a particular ambulance cover, give the friendly team at Members Own a call on 13 10 66. They’ll be able to direct you to the right cover that ticks all the boxes.

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