Who pays when the unexpected happens?


There are a multitude of reasons why Australia’s ambulance services is under the pump. What is not so easy to comprehend is why some of us are charged for the service and others are not.

Some attribute the increase in utilisation to population growth, growing community health awareness or Australia’s ageing society, others argue reduced access to primary care services has prompted more people to call the service.

According to a recent report on government services, there were 3.5 million incidents reported to ambulance service organisations (145.1 incidents per 1000 people) nationally in 2016/17. In total, there were 4.4 million responses, where an ambulance was sent to an incident (179.2 responses per 1000 people), including responses to incidents that do not have people requiring treatment and/or transport.

In total, state governments spent $3.2 billion on ambulance services during this period. While different jurisdictions have different funding models, it’s a fact of life that those who use the service are usually the ones expected to pay for it.

And it doesn’t come cheap, with call out fees ranging from around $370 up to $1776, and additional kilometre charges starting at $3.35 per kilometre but extending to $5.50 per kilometre in some states.

Depending on where you live, your home state will determine how much you pay for ambulance cover. For the most part, however, Australia’s active seniors are able to receive free ambulance cover if they’re a valid concession card holder.

All permanent residents in Queensland, regardless of age, are entitled to have their ambulance costs covered by the state government, the Queensland Ambulance Service says. In the event you are issued with an invoice this needs to be sent through to the Queensland Ambulance Service and your bill will be paid for by them, with no out of pocket fees.

The case is similar in Victoria where all eligible Centrelink Health Care Card or Pensioner Concession Card holders are entitled to free clinically necessary ambulance coverage around Australia. This covers the cost of transport to the nearest and most appropriate medical facility.

St Johns Western Australia says active seniors in receipt of an Australian Government pension are entitled to free ambulance transport whenever it is medically necessary in Western Australia - except when being transferred between hospitals and one or both is a private hospital. Inter-hospital transfers between two public hospitals will be arranged and paid for by the sending hospital.

The Australian Capital Territory Emergency Services Agency says most full aged pension and health care concession card holders will also be entitled to free of charge ambulances services within the ACT.

Reciprocal arrangements exist for interstate services with the exception of services provided in Queensland, South Australia and Western Australia and if active seniors from this state intend travelling to any one of the three states mentioned above, the service recommends taking out some form of ambulance cover.

The Ambulance Service of New South Wales says a range of pensioner card and concession card holders are entitled to free ambulance services in NSW, including those who hold a Pensioner Concession Card, a Commonwealth Seniors Health Care Card or a Department of Veterans Affairs Repatriation Health Card, also known as a Gold Card (excluding non-emergency ambulance services).

It is a similar scenario in the Northern Territory where all holders of a Pensioner Concession Card or a Commonwealth Seniors Health Card are entitled to free ambulance transport services.

According to the South Australia Ambulance Service, there are pension rates available for holders of a SA Pension concession card. The rate starts at $49 for a single pensioner. The service says it encourages all South Australians to take out third-party ambulance cover. Coverage is usually provided to active seniors aged 65-plus at a discount.

“Ambulance costs are not covered by Medicare and even if you have private health insurance, your policy may not cover the cost of an ambulance. Many private health insurance schemes only cover you and your family for emergency ambulance services. Many illnesses or injuries require additional patient transportation which are classified as ‘non-emergency’ (e.g. for tests, ongoing treatment or transfer to another hospital),” the service says.

Ambulance Tasmania says it provides a free service to Tasmanian residents within the state and its islands. The only exemptions from free ambulance cover are those related to motor vehicle or some workplace accidents where insurance provisions cover costs, including cases involving veterans where the Department of Veterans’ Affairs (DVA) meets the cost of ambulance transport.

All the services warn that despite their best efforts, sometimes those who use the service are still sent an ambulance account when you are entitled to free ambulance services.

This may be because the patient was too ill for the relevant details to be collected by the paramedics, or the patient’s details were incomplete or illegible when the account was processed.

This can be rectified by photocopying the front and back of the patient’s pensioner health care card and returning a copy with the ambulance account to the relevant authorities.


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