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Member Insider - Understanding Ambulance Cover

06 September, 2017
Ambulance cover

Calling an ambulance can be expensive!

Many Australians believe that just like so many other medical expenses, the cost of ambulance transport will be automatically covered by Medicare. Unfortunately, this is simply not the case. Depending on where you live, ambulance cover can get quite financially complicated. If you ever need an ambulance, the last thing you want to be worried about is how much money it might cost you.

Remember if you are in an emergency, please call 000.

How do I get ambulance cover with CBHS?

You are covered by CBHS for ambulance services, in accordance with your states rules, if you:

  • Hold any level of Hospital cover
  • Hold a stand-alone Ambulance cover
  • Have added ambulance cover to your Extras cover

What is the quickest way to claim?

The majority of accounts from Ambulance providers have clear instructions on what to do if you have private health insurance on the reverse of the account. Please follow these instructions as in some instance the Ambulance Service may log the claim for you. 

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.

  • Major accidents
  • Severe blood loss
  • Sudden onset of pain
  • Broken bones
  • Heart attacks, and more

What is non-emergency transportation?

  • Non-emergency medical transport or treatment. This may include if you have a non-critical ongoing illness/injury and the ambulance is not required to use lights or sirens when transporting you.
  • Routine treatment for ongoing illnesses and require specialised transport. An example of this may be severe ongoing immobility.
  • Transportation between hospitals

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.

Who determines what is an emergency for the purposes of transportation?

The providers of the ambulance service will determine if it is an emergency. Given the fact that when an ambulance is called, you will not always know if there is going to be any transport involved, CBHS will cover 100% of emergency call-out costs.

But all States have different arrangements?

Yes, as all ambulance services are State based, your coverage needs could be affected depending on which State you live in.

Does CBHS pay for any state-based Ambulance subscriptions?

No, CBHS does not reimburse any Ambulance Subscriptions.

What if I hold a Gold DVA Card?

All Department of Veterans Affairs Gold Card holders are covered for state ambulance services in every state by the Department.

Understanding your State ambulance coverage is vital if you want to avoid unexpected out-of-pocket costs.

Victoria

CBHS members with ambulance cover, 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 & Australian Capital Territory.

CBHS members with ambulance cover as part of their hospital cover are fully covered for emergency and non-emergency ambulance services provided by the NSW or ACT Ambulance Service, that are medically required.

CBHS Members in NSW or ACT with extras and Ambulance or Stand-alone Ambulance cover are covered for emergency ambulance transportation services only.  They are not covered for non-emergency transport.

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.  

Norfolk Island

CBHS members with ambulance cover, from Norfolk Island will receive benefits as if they resided in NSW. CBHS will not be liable for any ambulance transfers from Norfolk Island to Australia (Mainland).

Queensland

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.

South Australia

CBHS members with ambulance cover, 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.

Tasmania

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.

Western Australia

CBHS members with ambulance cover, 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.

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 required.

Northern Territory

CBHS members with ambulance cover, 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.

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