Living in Australia, you are entitled to Medicare and can also explore private insurance options if they’re affordable to you. However, there are a lot of questions about additional coverage, especially when it comes to ambulance coverage, as that policy can vary by each state. It can also differ between public and private health coverage. If you’re exploring this additional cover, here are some tips to keep in mind and some information to have in your back pocket before signing on for that insurance policy.
What Is Ambulance Coverage?
Exploring the health insurance marketplace can be confusing for patients at any age or with any medical conditions, and ambulance cover is no exception. Ambulance coverage comes into play when you call 000, helping cover some of the medical expenses related to hospital transport and treatment by paramedics. Emergency services have your back, and this form of extra insurance coverage helps reduce the stress of the ordeal and the cost of ambulance services.
A private health insurance policy treats this cover differently depending on the insurance company. Some funds provide cover for all ambulance travel, while others only pick up the bill for emergency transport to the nearest hospital. This can lead to obstacles in covering the out-of-pocket cost if other issues arise. For example, a policy could cover your ambulance ride to the hospital but not the ride to transfer to another hospital after you’re diagnosed with certain injuries that are better addressed elsewhere. Limitations may also be in place based on “call-out” fees or “on-the-spot” treatment.
Cost and Coverage
Ambulance coverage differs by the insurance provider, but there are some common clauses and conditions across these policies. Interstate travel is one item brought under consideration if you need transport to a hospital outside of the current state you’re in. Nonemergency coverage can also come into effect in a private health insurance policy. Different health funds have different definitions of emergencies. You’ll want to be certain you have clarity beyond your Medicare coverage.
Call-out fees or getting an ambulance on-site and even potentially being treated by paramedics without transportation to a hospital may not come under health coverage. Waiting periods may also fall under ambulance coverage, as well as any additional co-payments toward an ambulance fee. Some policies may cover air ambulance, which is transportation by flight to a hospital for further care. The cost of this coverage varies by carrier, but in Queensland and Tasmania, emergency transport is free of charge. In states like New South Wales and the Northern Territory, the charge of transport is based on the number of kilometers traveled.
Eligibility and Interstate Regulations
Each state offers different ambulance coverage concessions. For instance, pensioner concession cardholders are often given this policy free of charge. Additionally, residents in Queensland and Tasmania have state-funded coverage. In some states like the Australian Capital Territory, if you’re not eligible for a concession, you can purchase this coverage from a private health fund or through the state ambulance service. If you’re a Department of Veterans Affairs Gold Card holder, then you’re covered for emergency and some nonemergency state ambulance services in every state.
However, ambulance insurance coverage is not covered nationwide in certain states. These policies through state governments may not qualify for emergency transport or medical treatment if you need to receive medical care from a hospital across state lines. This coverage only applies while you’re in your home state and may not apply if you’re interstate. You’ll need to review the individual aspects of your policy to better understand how your cover is affected by interstate travel. Remember, be sure to explore all terms and conditions of your health care coverage to give yourself some peace of mind.