If you live in NSW, you’ll generally need private health insurance to be covered for ambulance services, although the NSW Government says it does cover part of the cost. But how do you work out what kind of cover is most suitable, and what happens for non-NSW residents who are there for a visit? Let’s take a look.
This article covers:
What is ambulance cover?
Ambulance cover is a form of health insurance that’s designed to help cover the costs of being provided with ambulance services if you need them. Ambulance services are not covered by Medicare, but in some states and territories in Australia, ambulance services are funded by the government there, meaning there’s no cost to the user. In other parts of the country – New South Wales, for example – users are required to contribute to the cost of the services and may want to consider a level of ambulance cover to protect themselves financially if they need to use the ambulance service.
Health insurance cover for ambulance services can take a few different forms. Some health insurers offer a standalone ambulance cover product, whereas most simply cover ambulance costs under their hospital or extras products.
Even if you’re covered for the costs of ambulance assistance, once the ambulance gets you to the hospital, you may need cover for any further medical assistance you’re given, depending on factors like the hospital you go to and the types of treatment you receive. This means you may want to consider having a broader level of health insurance, just in case.
How do I get ambulance cover for NSW?
There are a number of ways you can get covered for the cost of ambulance services in NSW, including a private health insurance policy, a school/group contributions scheme or workers compensation/third party insurance.
Private health insurance ambulance-only cover
Eligible private health ambulance only policies provide cover for the cost of ambulance services in NSW. Depending on the policy, it may cover emergency ambulance services only (transport and any paramedic care provided) or both emergency and non-emergency services. Policies may also apply within the state of NSW only or Australia wide. Ambulance cover typically only applies to ambulance services by the recognised state-based provider (i.e. NSW Ambulance).
Some of considerations to watch out for when taking out an ambulance policy include:
- Does the policy cover ambulance services over air and sea or just road?
- Are there any limits on how much you can claim within a set period?
- What waiting periods apply between the time you take out the policy and when you can make a claim, bearing in mind that the waiting periods may be different for emergency and non-emergency cover?
It’s important to keep in mind that ambulance cover only applies to the cost of services provided by the ambulance service and generally does not cover care you receive at the hospital.
Private health insurance hospital or extras policy with ambulance cover
If you would like to be covered for ambulance services in NSW as part of a broader health insurance policy, you could consider a hospital and/or extras policy that includes a level of ambulance cover. If you already have health insurance in place, consider checking whether ambulance cover is included and to what level (e.g. does it cover emergency and non-emergency ambulance services, and just in NSW or nationally?).
School/Group Contributions Scheme
School groups in NSW can get ambulance services coverage directly from NSW Ambulance. According to NSW Ambulance, this provides cover for ambulance services provided to children who are injured or become ill while engaged in an approved school activity, subject to some conditions. The scheme also provides coverage to children attending Groups such as Child Care Centres, Long Day Care Centres (LDCC), Out of School Hours (OOSH), Vacation Care, Pre-school, Family Day Care (FDC) and Pony Clubs.
Workers compensation/third party insurance
In certain circumstances, compulsory third party (CTP) or workers compensation insurance may cover eligible ambulance services, NSW Ambulance says. It may be worth checking with your insurance company or your employer about any coverage you may have.
Compare Health Insurance Hospital and Extras
The table below displays some of our referral partners’ hospital and extras policies for a 39-year-old single female seeking cover in NSW without pregnancy cover. The table is sorted by Star Rating (highest to lowest) followed by provider name (alphabetical). Use Canstar’s health insurance comparison selector to view a wider range of policies. Canstar may earn a fee for referrals
How do ambulance services work for New South Wales residents?
Ambulance services in New South Wales are provided by NSW Ambulance. The cost of providing the services is subsidised by 49% for NSW residents by the government. This means that even if you do not qualify for any exemption or concessions on ambulance costs you’ve incurred, or you’re not covered by private health insurance that includes ambulance cover, you’ll still only have to pay 51% of the total costs out of pocket if you’re a NSW resident.
What are the fees for NSW Ambulance services?
At the time of writing, NSW Ambulance says the base fee charged to residents for emergency callouts is $401, plus a variable per kilometre charge of $3.62 based on the total (round trip) number of kilometres travelled by the ambulance. These charges apply to callouts via road, fixed wing aircraft or helicopter (or a combination of these) from the scene of an accident, illness or injury to a public hospital or other destination nominated by NSW Ambulance, such as a health facility. For non-emergencies (road only), the callout fee is $316, plus $1.95 per kilometre travelled. NSW Ambulance advises that the maximum amount they charge in any situation is $6,571.
The non-emergency fees are the same for non-NSW residents, but higher charges apply for emergencies: A callout fee of $786, plus $7.09 per kilometre.
Who is exempt from paying for ambulance services in NSW?
According to NSW Ambulance, you will be exempt from paying for ambulance services as a NSW resident if:
- you hold a concession card such as a Health Care Card, Pensioner Concession Card, Commonwealth Seniors Health Care Card, or a Repatriation Health Card
- you are a child or young person in the care of the State under relevant legislation
- you are a victim of sexual assault, domestic violence or child abuse
- you are a patient being taken involuntarily to a declared mental health facility under relevant legislation
- you have an appropriate level of private health insurance
- the ambulance service is covered by a workers compensation, motor accident or third party insurance claim
- you are a student covered by a school or group contribution
- you were in a motor vehicle accident involving a NSW registered vehicle and the incident occurred on a public road within NSW
- your expenses are being paid by the Lifetime Care and Support Authority
How do I get ambulance assistance or transport outside NSW?
If you’re a NSW resident travelling outside of your home state, in order to be covered for the costs of ambulance services, you’ll generally need to hold private health insurance which provides interstate cover for ambulance assistance and transport. Some policies may only cover you for ambulance assistance in your home state, so it could be a good idea to check with your health fund to see if you’re covered interstate.
Some NSW residents, such as pensioners or health care cardholders, may have their ambulance services paid for them by NSW Ambulance, depending on the state or territory you’re in when they receive the service.
What happens if I don’t pay for NSW Ambulance services?
NSW Ambulance says that if you aren’t eligible for free cover, and do not pay an ambulance bill, that it will be “referred to Revenue NSW for fee recovery action”. This might include:
- a garnishee order in relation to wages or salary
- a property seizure order
- a charge on land owned by the debtor
If the debt is referred to the State Debt Recovery Office to take fee recovery action, you will also be charged $65 and Sheriff’s costs.
Keep in mind that unpaid debt, and debt collection action, might negatively impact your credit score. Your credit score can impact your borrowing capacity for products such as home loans and personal loans, as well as ‘buy now pay later’ services and credit cards, plus interest rate ranges that apply.
Are visitors to NSW covered for ambulance services?
According to NSW Ambulance, the fees charged to non-NSW residents who use ambulance services in NSW are:
- Emergency callout fee of $786, plus $7.09 per kilometre travelled
- Non-emergency callout fee of $316, plus $1.95 per kilometre travelled
There is no maximum charge applicable for non-NSW residents who require ambulance services in New South Wales, although state residents’ costs are capped at $6,571.
The state or territory in which your main residence is located and the level of health insurance you have can impact how much, if any, of the costs you need to cover yourself. For example, Queensland residents are covered for the cost of ambulance services anywhere in Australia, but residents of Western Australia, Tasmania, Victoria, Northern Territory and the ACT are covered under reciprocal agreements and charged full rates.
Residents of other states may be charged the full rates, according to Ambulance NSW, unless they are eligible for an exemption, are a member of their or state or territory’s ambulance service or have an appropriate level of private health insurance.Expats and other international visitors who do not live in Australia are liable to pay the full charge for using ambulance services in NSW. NSW Ambulance says it encourages overseas visitors to purchase travel insurance or private health fund cover for the duration of their stay in Australia.
Original author: James Hurwood. Main image source: Papuchalka – kaelaimages (shutterstock.com)
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This content was reviewed by Sub Editor Jacqueline Belesky as part of our fact-checking process.
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