What is ambulance cover and how much does it cost?

Ambulance trips are not covered by Medicare and while it is free in some states, other Australians can be left with hefty invoices.

The decision to get ambulance cover depends on your situation and where you live. Picture: iStock

Ambulance trips are not covered by Medicare in Australia, and the way ambulance fees are charged and paid varies from state to state.

Ambulance services typically charge a flat rate plus a per-kilometre fee, which is capped. For example, the maximum fee chargeable by NSW Ambulance for an emergency call is $6,571.

But that doesn’t necessarily mean patients are out-of-pocket.

In some states, patients are automatically covered in and out of state. Other states give residents the option of purchasing either an annual ambulance subscription or cover through private health insurance.

“There’s no legislative requirement to get ambulance cover,” a spokesperson for Private Healthcare Australia told news.com.au.

But in states like New South Wales, where the government subsidises only a portion of the ambulance cost, ambulance cover can be a prudent choice that mitigates the risk of paying a hefty invoice.

Ambulance costs are not covered by Medicare in Australia. Picture: iStock

WHO NEEDS AMBULANCE COVER?

The decision to get ambulance cover depends on your situation and where you live.

In Queensland and Tasmania, there’s no need to purchase ambulance cover.

In-state ambulance services are paid for by the state governments, which means residents are automatically covered for emergency transport.

For out-of-state emergencies, Tasmania has reciprocal agreements with all states except South Australia and Queensland. Queensland residents are covered for ambulance services whether they are in or out of their home state.

HOW MUCH DOES AMBULANCE COVER COST AND HOW TO GET IT?

In Victoria, South Australia, Northern Territory and rural Western Australia, patients have the choice of purchasing an annual subscription or purchasing private health care. The fees for ambulance-only cover or ambulance subscriptions are comparable and reasonable: around $50 to $100 per year for a single person, and around $100 to $130 per year for a family depending on the state or insurer.

Residents of NSW, ACT and metropolitan Perth need private ambulance cover or they run the risk of paying expensive ambulance bills themselves.

In states that require ambulance cover or ambulance subscriptions, patients with concession cards will usually receive free ambulance care.

HOW DOES AMBULANCE COVER WORK AND WHAT DOES IT INCLUDE?

When someone calls triple-0 for an ambulance, they will be treated and transported to hospital regardless of their ability to pay their ambulance bill.

Assuming they’re appropriately covered in their state, most people will never see their ambulance bill. Either the state government, subscription service or private health fund will often take care of the bill directly or reimburse people who have paid their own invoices.

In the case of those with ambulance-only cover, Private Healthcare Australia says to carefully consider the extent of your plan’s coverage. For example, some plans only cover a limited number of ambulance trips per year.

“Make sure you’re covered for an emergency ambulance for both on-the-spot treatment or hospital treatment, and ensure there are no limitations to the number of emergency trips each year.”

WHAT IS AMBULANCE-ONLY INSURANCE?

Opting for ambulance-only cover can affect you at tax time

Most health funds offer ambulance-only cover as an affordable, stand-alone product that can be purchased instead of hospital cover. But there can be financial implications for opting out of hospital cover.

The Medicare Levy is a 2 per cent levy payable by individuals who earn more than $90,000 and couples who earn more than $180,000. For those who don’t have private health insurance for a full financial year, there is a surcharge added to the levy, ranging from 1 per cent to 1.5 per cent depending on your salary.

“You could be up for $900 or more in tax if you don’t have the right level of hospital cover,” NIB’s website reads.

The government offers a rebate on premiums to people with private hospital cover.

The rebate is means tested and paid monthly or as a lump sum at tax time. For individuals earning $90,000 or less a year, the rebate is 25 per cent. The rebate reduces incrementally depending on salary, and those earning above $140,001 receive no rebate.

Private Healthcare Australia cautions that opting out of hospital cover could be problematic if the public hospital system is stretched.

“Ambulance-only cover is OK if you go to a public hospital that has beds available,” the spokesperson says.

“But ambulance and hospital cover should go hand-in-hand. If you have hospital cover then you would be able to go to a private emergency department.”

WHAT IF I CAN’T PAY?

Although having either a subscription or ambulance cover through private health is ideal, no one who calls an ambulance in an emergency will ever be refused help in Australia.

“NSW Ambulance responds to calls and treats and transports patients regardless of their ability to pay the resulting fee,” a spokesperson for NSW Ambulance says.

“While Medicare does not cover ambulance fees, the NSW government may waive fees for a range of people, including those who hold pension or health care benefits cards.”

This article is created in partnership with iSelect.

Originally published as What is ambulance cover and how much does it cost?