Not having the right ambulance cover can be costly
It’s good to know that with most Australian Unity hospital or combination cover, you’re covered for emergency ambulance transportation*.
But depending on where you live, ambulance cover can get quite complicated.
This guide’s been put together to help explain what you are covered for, and what else you might have to do to get fully covered. After all, if you ever need an ambulance, the last thing you want to be worried about is how much money it might cost you.
*Excludes Basic Hospital (B1) or Budget Overseas Visitors Cover.
You are covered for all emergency transport
When emergency ambulance transportation is used, the trip to hospital must be coded as an emergency for Australian Unity to cover you for it (up to your yearly benefit limit.) Members on Budget Hospital, Smart Start, Care ‘n Repair and Healthy Travel have a $1,000 limit per person each year for emergency ambulance.
What is emergency transportation?
Emergency Ambulance transportation is defined as when you are in a life threatening situation and in need of urgent assessment, resuscitation and/or treatment. For example, a cardiac arrest is usually coded as an emergency.
What might be non-emergency transportation (and therefore not covered)?
- Non-time critical cases. For instance, if an ambulance is not required to use its lights and sirens, this may be considered a non-emergency. An example of this might be a broken leg.
- Non-urgent routine cases. For instance, when you have an ongoing illness or a disability and require specialised transport to hospital. An example of this might be severe immobility.
What is an Ambulance paramedic attendance?
This is where attendance by a paramedic is required, but no transport is necessary. For instance, if an ambulance paramedic is dispatched to assist after a minor accident, provides you with first aid, but you don't need to be taken to hospital. Our brand new range of hospital covers provide up to two ambulance attendances per year*.
*Applies to Basic Hospital (YB2) , Mid Hospital, Mid Hospital with Pregnancy, Gold Hospital and Platinum Hospital covers.
Not all health cover has the same level of ambulance cover.
There are some restrictions on ambulance coverage on certain health covers, so it’s important to review the exact level of ambulance cover you’re entitled to.
Restrictions to coverage.
- Extras Only, Basic Hospital (B1) and Budget Overseas Visitors Cover members are not entitled to emergency ambulance cover.
- Members on Budget Hospital, Smart Start, Care ‘n Repair and Healthy Travel are covered for emergency ambulance transportation up to $1,000 per person per calendar year.
- If you have any concerns about your level of ambulance cover, call us on 13 29 39 to discuss your needs. We may be able to suggest an alternative health cover that will provide a greater level of ambulance coverage.
- In NSW, QLD, ACT & TAS ambulance services are subsidised by either the relevant state government or a levy on your hospital cover, this means that if you are a resident in one of these states the restrictions above may not apply to you.
Be aware! Different States have different cover.
As ambulance services are State based, your coverage needs could be affected depending on which State you live in.
Understanding your State ambulance coverage is vital if you want to avoid unexpected out-of-pocket costs.
- Eligible Australian Unity members from VIC are covered for emergency ambulance transportation services only, where it is not claimable through another source (e.g. Transport Accident Commission or Department of Veterans Affairs).
- Victorian residents have the option to purchase an Ambulance Victoria (AV) membership from ambulance.vic.gov.au
- Purchasing an Ambulance Victoria membership will ensure members are also covered for medically authorised, non-emergency transport:
- between hospitals and other medical facilities
- between your home or other medical facilities
- when you are discharged from the hospital to transport you home
- Victorian Pension and Concession card holders are provided with free transportation and on-the-spot treatment.
New South Wales and Australian Capital Territory
- To be fully covered for all ambulance services, NSW and ACT residents should take out hospital cover, or ambulance only cover from a private health fund that offers this type of cover (Australian Unity does not offer ambulance only cover).
- This means that as part of their private hospital cover, eligible Australian Unity members from NSW & ACT are covered for all medically required ambulance services across most of Australia.
- Exclusions: Overseas Visitors Cover members cannot receive comprehensive ambulance cover in NSW or the ACT through Australian Unity.
- NSW and ACT Pensioners get free ambulance services for all medically necessary trips within NSW or ACT, and for emergency transport in QLD and SA.
- Queensland has a Community Ambulance Cover scheme, which provides all QLD residents with free authorised ambulance services throughout Australia.
- A person will only be covered under the Community Ambulance Cover if they can demonstrate their principal place of residence is in QLD. Where a person cannot demonstrate residency in QLD, no cover will be offered under the Community Ambulance Cover.
- Overseas residents with a valid work visa who live in QLD will be fully covered under the Community Ambulance Cover, provided they can show evidence of living in QLD, such as:
- A letter from their employer;
- A copy of a rent receipt; or
- A statutory declaration.
- For Australian Unity members on an Overseas Visitors Cover (except for those on Budget Overseas Visitors Cover) who do not qualify to use the QLD Community Ambulance Cover scheme (as per above), we will pay a benefit for ambulance transportation that is coded as an emergency by the ambulance service.
- Eligible Australian Unity members from SA are covered for emergency ambulance transportation services only.
- South Australian Residents have the option to purchase a South Australian Ambulance Service (SAAS) membership from saambulance.com.au
- South Australian Ambulance Service membership provides coverage for emergency and non-emergency ambulance services Australia-wide.
- Ambulance Tasmania is subsidised by the Tasmanian State Government. Therefore, residents of Tasmania are provided with emergency ambulance care and non-emergency patient transport for free.
- Eligible Australian Unity members from WA are covered for emergency ambulance transportation services only.
- To be fully covered for all ambulance services, WA residents should take out stand-alone ambulance cover with a private health fund that offers this type of cover (Australian Unity do not offer ambulance only cover).
- Aged pensioners that are WA residents receive free ambulance transport that is deemed an emergency or non-urgent but medically necessary. Senior citizens aged over 65 receive a 50% subsidy on the cost of service. Veterans are covered by Department of Veterans’ Affairs.
- In country WA, St John Country Ambulance Cover is administered by the local St John Sub Centres. Country Ambulance Cover is only available for country residents who live in the following postcode zones: 6041-6044, 6084, 6207-6208, 6211-6799.
- Comprehensive Country Ambulance Cover covers the cost of an ambulance trip for as many emergency or necessary non-emergency transport trips as required.
- Eligible Australian Unity members from NT are covered for emergency ambulance services only.
- NT residents need to purchase a subscription to St John Ambulance NT to ensure full ambulance coverage. Subscriptions can be purchased using the application form from stjohnnt.org.au
If you have any questions or concerns about the level of ambulance cover provided by your health cover, please contact us on 13 29 39 to discuss your cover needs.