Ambulance Insurance - Are You Covered If Things Go South In New South Wales?

As a New South Wales (NSW) resident, are you adequately covered for the costs of ambulance transport and services in case of emergency? We’ve put together some information on how ambulance cover works both within NSW and interstate.

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’s the deal for non-NSW residents visiting the First State? Let’s take a look.

If you’re comparing health insurance policies, the table below displays some of the hospital and extras policies currently available on Canstar’s database for a single female born in 1985 seeking cover in NSW without pregnancy cover. Please note the table is sorted by Star Rating (highest to lowest), followed by provider name (alphabetical) and features links direct to the providers’ websites. Use Canstar’s health insurance comparison selector to view a wide range of policies.

What is ambulance cover?

While ambulance services are a fundamental component of the hospital system, they’re not covered by Medicare – which means that in some Australian states and territories, including NSW, ambulance services are not free.

This in turn means that, as with any other medical service not covered by Medicare, you could be paying out of pocket if you don’t have an appropriate level of insurance in place, and you live in a state – like NSW – where ambulance services aren’t fully covered by the government.

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 health insurance policy in place, just in case.

Access to ambulance services for New South Wales residents – how it works

Receiving ambulance assistance or transport within NSW

Ambulance services in New South Wales are provided by NSW Ambulance. The cost of providing the services are subsidised by 49% for NSW residents by the government there.

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, you’ll still only have to pay 51% of the total costs out of pocket if you’re a NSW resident.

At the time of writing, NSW Ambulance says its base callout fee for emergencies is $382, and it advises that the maximum amount they can charge in any situation is $6,258.

In order to be exempt from paying for ambulance services as a NSW resident, you need to either:

  • Hold private hospital cover – health fund members in NSW pay an ambulance levy as part of their premiums, which means they’re automatically covered for ambulance services – alternatively taking out ambulance-only cover could also be an option
  • Hold a concession card such as a health care card, pensioner concession card, Commonwealth Seniors Health Care Card, or a Repatriation Health Card

According to the Ambulance Service of NSW, you will also be exempt if you are/have been:

  • “a child in the care of the State under the Children and Young Person’s (Care and Protection) Act 1998”
  • “a victim of sexual assault, domestic violence or child abuse”
  • “a patient being taken involuntarily to a declared mental health facility under the Mental Health Act 2007 or the Mental Health (Forensic Provisions) Act 1990”

Some factors to consider when taking out ambulance cover in NSW

There may be other variable factors to think about when selecting ambulance cover. These can include:

  • Does your cover apply to non-emergency situations?
  • Are you covered for both the callout fee and the travel costs?
  • Does your ambulance cover come with a waiting period?
  • Does your policy cover you for potential air evacuation?

Receiving 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 need to hold private health insurance which provides interstate cover for ambulance assistance and transport. Your policy may cover you for ambulance assistance in your home state, but it may be prudent to check with your health fund to see if you’re covered interstate.

Are visitors to NSW covered for ambulance services?

ACT residents who are covered for interstate ambulance services through their private health insurer will be able to forward an invoice for ambulance services provided in NSW to their health fund. If they do not have private health insurance which provides interstate cover for ambulance cover, they may be liable to pay any ambulance costs incurred out of pocket.

Northern Territory residents may be eligible to have any ambulance services received in NSW paid for if they:

  • Are a St John Ambulance Service subscription scheme member, or
  • Are covered for interstate ambulance services through a private health insurer

Queensland residents are eligible for free ambulance services anywhere in Australia. They will receive an invoice for the services received in NSW, which they can then forward to the Queensland Ambulance Service for payment.

South Australian residents may be eligible to have the costs of any ambulance services received in NSW paid for if they:

  • Are a South Australia Ambulance Service member with interstate ambulance cover, or
  • Are covered for interstate ambulance services through a private health insurer

Tasmanian residents may be eligible to have any ambulance services they receive in NSW paid for if they are covered for interstate ambulance services through a private health insurer.

Victorian residents may be eligible to have any ambulance services received in NSW paid for if they:

  • Hold a pensioner or health care concession card, or
  • Are an Ambulance Victoria member, or
  • Are covered for interstate ambulance services through a private health insurer

Western Australian residents may be eligible to have any ambulance services received in NSW paid for if they:

  • Are over 65 and in receipt of an Australian Government pension
  • Are covered for interstate ambulance services through a private health insurer

Additionally, any individual who holds a Gold Card issued by the Department of Veterans’ Affairs (DVA) is also covered for the costs of any emergency ambulance services received in New South Wales.

Consider checking with your state government for any other specific exclusions or considerations that may be relevant to you.

Expats and other international visitors who do not live in Australia are encouraged by the New South Wales Government to get in touch with a travel agent to discuss potential options for ambulance cover while spending time in the state.

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