How Ambulance Cover Works in Each State

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While health insurance is provided to all Australians through the public Medicare system, people are encouraged to purchase private coverage through an insurer to expand their safety net. However, this can differ not just by the insurance company but also by the state you live in.

You can explore these health plans, but note that policies and costs may differ depending on your locale.

Getting Private Health Insurance

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While Medicare covers basics, private health insurance provides cover for treatment as a private patient in a public or private hospital. This, in turn, allows a patient to choose their doctor and hospital. Private medical insurance also offers health services not covered by Medicare, such as physiotherapy, optical, and dental care. Australians are eligible to receive the same base price for the same policy through a health insurance company rather than being rated on individual health concerns.

The two main types of private health insurance plans are hospital cover and extras cover. Hospital cover does just what it says, covering you when you go to the hospital for treatment. It starts with a basic policy covering rehabilitation, psychiatric services, and palliative care, with more comprehensive plans to follow. Extras cover provides benefits for services not generally covered by Medicare. Some insurance companies may also suggest ambulance cover for additional protection.

Ambulance Cover

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If you have to call 000 in an emergency and require transportation to the hospital, you could be on the hook for a significant bill just for that ambulance. This is why some insurance companies recommend purchasing ambulance cover as part of your individual health insurance plans. Ambulance cover takes care of expenses like transport or being treated by paramedics that are not covered under the public health insurance system.

Ambulance costs vary from state to state, and private health coverage insurers each treat ambulance cover differently with differing additional premiums or inclusion within your current insurance policy. Some funds provide cover for all ambulance travel, while others may only cover emergency transport costs to the nearest hospital, ground travel, or may have specific limitations. For example, if an ambulance takes you to the closest hospital, you may want to transfer elsewhere. However, some policies would not include this under ambulance cover, and your health insurance coverage may not take care of this relocation.

Some fees may apply.

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The costs for ambulance cover are different for Australians across the map, with some states actually incurring emergency services expenses. In states like Queensland and Tasmania, the local government covers an ambulance, leaving no out-of-pocket cost to the patient. Most states actually provide these services free to senior citizens, pensioners, or through Veterans Affairs services.

Some states like Victoria rely on a membership fee for ambulance cover, with a higher cost for regional parts of the states than metropolitan Victoria. In Western Australia, fees are only tacked on for serious medical emergencies, while New South Wales and the Northern Territory have additional expenses per kilometer traveled.

One consideration of an ambulance cover in a health insurance policy is whether there is coverage for traveling interstate. Another part of an ambulance cover to understand is if an insurance company only provides coverage in emergencies. It is important to look into how each insurer defines an emergency and whether your insurance plan covers certain “non-emergencies.” Australians should also be wary of call-out fees, whether or not a health insurance policy accounts for calling an ambulance to the scene of a medical emergency.

In the end, research matters. Evaluate your options to choose the insurance company and plan that best suits your needs.

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