AMBULANCE COVER - TRAVELLING INTERSTATE

A first point of interest is that Medicare does not cover the provision of ambulance services and whether you may have to pay for ambulance service depends in which state you reside.  Also, depending on the ambulance policy of your state or territory, residents may need to take out cover with their health fund or ambulance provider for services within their resident state.  If you hold a Pensioner’s Concession Card check if you are exempt from payment of the ambulance levy or if there is a discount available. Another point to be mindful of is the definition of or the distinction between ‘emergency’ and ‘non-emergency’ ambulance transport.  When travelling interstate ‘non-emergency transport’ refers to pre-booked services such as transfer of the patient from one hospital to another.  Some private health funds may levy a co-payment for things such as ‘non-emergency’ transport. It may be that the ambulance cover will cover you for transport to the nearest hospital where the required treatment is available, but not back to your state of residence unless a doctor certifies this is necessary.  In such cases, travel insurance may be required if you want to cover all possible eventualities. See article on Travel Insurance Am I covered for ambulance service when I travel interstate ? It can all be confusing, as your private health fund may cover you for ‘emergency’ transport within your state but not in another state.  Also, ‘non-emergency’ transport may not be covered when you travel interstate. Prior to travelling interstate it is best to check that the state or territory you are to travel to has reciprocal arrangements for ambulance cover with your home state or territory.   It may be necessary to take out ambulance cover through a private health fund.  Make sure you get written confirmation of the cover. International visitors should take out travel insurance.  Where overseas visitors current travel insurance does not have adequate medical cover there are some approved health funds in Australia, such as MBF who provide Overseas Visitors’ Cover which includes emergency ambulance cover, if the visit to Australia is less than 12 months. The following is a  ‘snapshot’ of information obtained from ambulance service websites as at 2/8/08. Disclaimer:  As terms and conditions may change in the states or territories, you should make your own enquiry with your ambulance provider or private health fund to satisfy yourself that you and your family are covered whilst travelling nationwide. Check also whether you are covered for air (aeromedical) ambulance in the case of an ‘emergency’ and even for  ‘non-emergency’ as there may be a difference between being covered for ambulance transport by road or by air. Queensland The Queensland Government – Queensland Treasury website (last updated 2/7/08) states  - ‘Since 1 July 2003, all Queensland residents have been automatically covered for the cost of emergency ambulance services, anywhere, anytime across Australia. The Community Ambulance Cover levy helps fund the Queensland Ambulance Service’. The Queensland Ambulance Service website has an excelled frequently asked questions’ page that will answer most both resident and non-resident queries you may have. For example:- Question:  My principal place of residence is not in Queensland.  If I use an ambulance in Queensland, do I have to pay for this? Yes.  However, the following exceptions may apply: If you hold a Department of Veteran Affairs gold card. If you are an ambulance subscriber in Victoria, ACT, NT, and SA. If you are a pensioner in Victoria, ACT and WA. If you are transferred from one Queensland Health hospital to another Queensland Health hospital. If you live near a border with Queensland, and a cross-border arrangement applies. If QAS services were provided in respect of a work place accident or injury. If you are part of the Alpurrurulam community in NT. Additionally if you have health insurance, you may be covered for QAS costs.  Your health insurance provider should be able to provide advice in this regard.  Please note: if you are not a Queensland resident you will be issued a Tax Invoice for services rendered by the Queensland Ambulance Service.  This Tax Invoice is the responsibility of the individual and it is up to you for follow payment up with your nominated Health Fund or your State/Territory Ambulance Service. Queenslanders pay a levy on their electricity account and are covered nationwide for ambulance transport.  If you cease to be a resident of Queensland you will not be covered.  If you are a ‘resident’ of Queensland and receive an ambulance transport bill from another state you will need to contact the following to arrange payment.  A driver’s licence or some other identification showing your residential address may be required to confirm that you are a ‘resident’ of Queensland:- Director Community Service Unit Queensland Ambulance Service GPO Box 1425 Brisbane Qld 4001 Ph. 1300 369 003 New South Wales In NSW private health care fund members pay an ‘ambulance levy’ as part of their basic hospital cover.  The Ambulance Service of New South Wales website states:- 'Bulletin 5/3/08 Interstate ambulance charges are a complex issue and the Ambulance Service provides the following information for concession card holders. Pensioner Concession Card Holders (PCC), Health Care Concession Card Holders (HCCC), Commonwealth Seniors Health Card Holders (CSHC) Provision of Interstate Ambulance Services South Australia and Queensland – NSW resident concession holders receiving emergency ambulance services in South Australia or Queensland will have their accounts paid by the NSW Government.  NSW resident concession card holders receiving non emergency ambulance services in these states are liable for the cost of these services. NSW resident concession card holders who receive an ambulance account from the Queensland or South Australian ambulance Services for emergency ambulance services after July 1, 2006, are advised that they can have their invoice paid by sending the original invoice and a photocopy of both sides of the concession card to the Revenue Accountant, Ambulance Service of NSW at the below address. All Other Australian States and Territories NSW resident concession card holders are entitled to receive free emergency ambulance services in all other Australian States and Territories however the following restrictions apply; Western Australia do not recognise Health Care Concession cards, and Victoria do not recognise Commonwealth Seniors Health Cards. In the event that an account is received for the provision of emergency ambulance services this should be forwarded, under a covering letter containing the concession card number, to: Revenue Accountant, Ambulance Service of NSW, Locked bag 14, Rozelle, NSW 2039, and the matter will be attended to on your behalf. NSW resident concession card holders receiving non emergency ambulance services in these states are liable for the cost of these services. Repatriation to NSW If a NSW resident concession card holder is receiving treatment in another Australian state or territory public hospital and requests to be returned to a location within NSW (other than a public hospital) to be closer to family and friends, then the cost of this transport is the responsibility of the concession card holder. If the transport is from a public hospital in another Australian state or territory to a NSW public hospital then the cost of the transport is the responsibility of the receiving NSW public hospital All other types of transports to a NSW location are the responsibility of the concession card holder. Interstate Transport from NSW If a NSW resident concession card holder is transferred to another Australian state or territory health facility at their own request the cost of this transport is the responsibility of the concession card holder. If the transport is from a public hospital in NSW to another Australian state or territory public hospital the cost of the transport is the responsibility of the referring NSW public hospital. All other types of transports to an interstate location are the responsibility of the concession card holder. Department of Veterans Affairs (DVA) Card Holders DVA gold card holders are covered under an agreement with the Commonwealth for the provision of ambulance services. White card holders are only covered for treatment recognised by DVA as being the result of war service. DVA PCC and HCCC card holders are entitled to receive the same ambulance service concessions as other PCC and HCCC card holders. All other DVA issued cards do not entitle the holder to free ambulance services. Repatriation to home state is the responsibility of the DVA concession card holder. Australian Capital Territory (ACT) In the ACT, if you have private health cover which includes hospital cover with a registered health fund then you are automatically covered for ambulance service within the ACT by the ambulance levy on your insurance.  There is an additional charge for every kilometre travelled outside the ACT for emergency ambulance service. The website states – ‘ACT Pensioner Concession and Health Care Cardholders (valid at the time of service delivery) are entitled to free emergency and non-emergency ambulance services within the ACT. When interstate, ACT Pensioner Concession and Health Care Cardholders are entitled to free emergency ambulance services from an approved ambulance provider only if that state participates in reciprocal arrangements with the ACT.  It is strongly recommended that you check your entitlements prior to travelling interstate. ACT Residents are covered for emergency ambulance services within the ACT through the road rescue fee levied on vehicle registration’. What if I received an account but I am entitled to free ambulance services? Sometimes, despite our best efforts, you will be sent an ambulance account when you are entitled to free ambulance services. Perhaps you were too ill for the relevant details to be collected by our intensive care paramedics, or your details were incomplete or illegible when the account was processed.  If you are an ACT Pensioner Concession or Health Care Cardholder, please photocopy your pension or health care card and return a copy with your ambulance account to the address provided’.   As information was limited, the best thing to do in the ACT is check with your private health fund that you are covered Australia wide before departing on your journey. Victoria The Victorian Metropolitan Ambulance Service website states :- ‘No matter where you are in Victoria you will receive prompt, high quality emergency medical care and transport from the State's ambulance services. Our Membership Scheme provides inexpensive cover against ambulance costs anywhere in Australia with the proceeds of your membership directly supporting the operation of ambulance services in Victoria’. ‘Ambulance Victoria Membership provides 100% cover for all ambulance treatment and transport Australia-wide. It’s simple and affordable and helps support the life saving activities of paramedics across the state.’ Membership Cover states:- ‘You’re covered 100% for all*: All emergency Ambulance transport All MICA (Mobile Intensive Care Ambulance) attendance and/or treatment All emergency air Ambulance transport All Ambulance treatment where transport is not required   All medically authorised non-emergency patient transport including: From private hospital to treatment facilities and return From home to treatment facilities and return** From home to hospital for admission and on discharge from hospital to home Inter hospital transport between private hospitals. All Ambulance transport and treatment services provided by interstate services*** A 60-Day qualifying period exists on pre-existing medical conditions and non-emergency transport for new members ** Excluding transport to public hospital outpatient clinics *** Ambulance transport back to Victoria must be medically required and approved by Metropolitan Ambulance or Rural Ambulance Victoria’. There are some exclusions so please refer to their website and make your own enquires. Tasmania Ambulance cover is provided under the state scheme to residents of Tasmania. ‘The Tasmanian Ambulance Service provides a free service to Tasmanian residents. The only chargeable cases are those related to motor vehicle or workplace accidents where insurance arrangements cover costs. In addition the Department of Veterans Affairs meet the cost of ambulance transport for veterans.’ If you are a resident of Tasmania and intend to travel on the mainland please make further enquires. NB:  The Tasmanian Government budget 2008/2009 indicates it is considering introducing an ambulance levy. South Australia Ambulance cover is available to SA residents.  The website indicates that some private health funds only cover you for ‘emergency’ attendance or transportation.  If you have private health cover you may care to check that it also covers you for ‘non-emergency’ ambulance transport.  This would cover you for transport for say other tests or ongoing treatment. Ambulance cover is available via subscription through the South Australia Ambulance Service and Ambulance Cover Extras (ACE) is also available.  Their website states:-  ‘Ambulance Cover from SAAS provides pre-paid medical emergency care, Australia-wide, 24 hours a day, seven days a week. It covers all your ambulance transport costs, whether it's an emergency or not. So it makes good sense to join Ambulance Cover today.’  ‘If you are a member of Ambulance Cover with SA Ambulance Service and require ambulance transport whilst visiting interstate, you will be fully covered for all emergency and medically justified non-emergency transport, except where a third party is responsible’.   Western Australia If you are a Western Australia resident you can choose either to take out ambulance stand-alone cover with St John’s Ambulance or an approved private health insurance fund which would cover you for ambulance transport Australia wide.  If you need an ambulance and you have no ambulance cover you will be responsible for payment of the account. Ambulance transport is free to an aged pensioner living in Western Australia.  If you are aged 65 years and over there is a 50% subsidy on the cost of an ambulance.  'St John Country Ambulance Cover will protect you for St John Ambulance transport, 24 hours a day, 365 days a year, in Western Australia. If you are travelling in the Eastern States, your cover will also extend to intra state road transport with other principle providers of emergency road transport.’ Check with your private health fund as some insurers charge further for ‘emergency transport’ and the cost can vary between metropolitan and regional areas.  You will need to check the insurance covers Australia wide ambulance transport if you are not a resident of WA. Northern Territory The St John’s Ambulance provides ambulance services in urban areas and the Territory Health Service provides the same service in remote areas.  There is a fee for the service you can subscribe to the St John’s Ambulance and cover is obtainable through private health care funds. Further information will be provided when available.  Meantime, ensure you make your own enquiry. Where can I get ambulance cover? You can obtain ambulance cover direct from some state ambulance services, where available, or from private health funds. Four such funds are:- Australian Health Management (ahm) website states they offer hospital as well as Australia wide ambulance cover only for residents of NSW and the ACT.  If you reside in SA, Vic, WA or the NT they can offer you ambulance cover as part of your hospital cover at no extra cost. NIB Health Fund (NIB) website states their ambulance only cover will provide cover for air, land and sea ambulance (service must be provided by a State Ambulance Service) within 24 hours of joining.  It states you are not covered for transport which is not considered a medical necessity by a doctor or for transport for outpatient services. HCF – if you don’t want hospital and extras cover, they can provide ambulance only cover Australia wide.  HCF provide a stand-alone (unlimited) Urgent Ambulance Cover which covers circumstances classified by St John’s Ambulance as requiring urgent attention (does not cover elective ambulance such as pre-booked, non-urgent ambulance care). MBF - With MBF Emergency Ambulance cover, you're covered for 100% of recognised casualty or medical emergency transportation costs, up to $5,000 per person, per year in total, anywhere in Australia. That includes the cost of emergency air ambulance services, excluding helicopter services. MBF also state what you are not covered for – ‘Please note: Benefits are only available for emergency or casualty transportation where, in the opinion of a medical officer, a member requires immediate treatment in circumstances where there is serious threat to the member's life or health. Benefits are not payable for transportation from a hospital to your home, nursing home or other hospital, or for transportation for ongoing medical treatment’. Information above extracted 2/8/08.  Please contact the funds direct to confirm details and their membership fees. Royal Flying Doctor Service (RFDS) The RFDS is a not-for-profit service that provides aeromedical and health care services to people who travel, live and work in remote and regional Australia. Their website provides excellent information on trip preparation, snake bites and what to do in an emergency.  They recommend that travellers and 4WD tourists to remote areas investigate obtaining and using a HF Radio. See article on HF Radios.  Contact numbers and radio frequencies are available on their website.  Donations are welcomed. Other Tips Make sure your take an adequate First Aid kit Complete a first aid and/or CPR course Obtain and maintain a fire extinguisher Keep a list of emergency numbers Make sure you have a device such as a PLB, HF radio, mobile telephone or satellite telephone to be able to make contact in an emergency. 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