Does my hospital cover include ambulance cover?
Ambulance services are subject to the state-based terms below.
Emergency ambulance
Emergency ambulance is covered when it results from an event that is unplanned, non-routine, and requires immediate medical attention (up to the annual limit). In this event you are transported directly to a hospital or treated at the scene.
You are not covered for transportation to hospital for the routine management of an ongoing medical condition or inter-hospital transfers (other than emergency transfers).
Non-Emergency ambulance
Non-emergency ambulance is covered for
- a call out or attendance by an ambulance where no transport occurs
- admission to a hospital from home where transport is deemed medically necessary
- discharge from hospital to home where transport is deemed medically necessary, and does not include inter-hospital transfers
All medically necessary ambulance transport must be supported by a letter from the treating doctor explaining the medical requirement for ambulance transport. Medically necessary ambulance transport is classified as:
- a patient requiring stretcher transport, is not able to travel in a normal seated position or has impaired cognitive function, or
- a patient requiring active management or monitoring while in transit
All Queensland residents are covered by Queensland Ambulance Service (QAS) arrangements, including interstate travel. Any claims are to be submitted directly to QAS.
If you live in ACT or NSW, an ambulance levy to cover transportation or attendance by NSW ambulance is included in your hospital cover. If you receive a NSW Ambulance account, send it to us.
If you require ambulance assistance in another state, you will be covered if you have combined hospital and extras cover.
When a dependant resides in NSW or the ACT, but the main member’s residential address is in another state, ambulance cover is only covered on combined hospital and extras covers.
All Tasmanian residents are covered by Ambulance Tasmania. If a Tasmanian resident requires services in QLD or SA, they’re not covered by the state scheme and can only claim if they are on combined hospital and extras cover.
You are entitled to cover for emergency ambulance transportation or attendance if you have both hospital and extras cover. A waiting period of 1 day will apply for ambulance benefits. If you receive an ambulance account, send it to us for payment.
Benefits for air ambulance services are payable up to the annual limit and are only payable for state-owned air ambulance services.
Ambulance subscription
Members residing in South Australia, Northern Territory, Victoria or regional Western Australia who have an eligible stand-alone general/extras treatment cover may purchase an ambulance subscription with their ambulance service provider and claim the cost of that subscription from us under the Health Management benefit category (refer to your Product Guide for details of eligibility and annual limits).
Any subsequent ambulance transportation fees must then be reconciled with the ambulance service provider under the terms of your subscription.