How to claim for Ambulance services

An ambulance is road vehicle, boat or aircraft operated by a service approved by Medibank and equipped for the transport and/or paramedical treatment of a person requiring medical attention.

We don’t pay benefits:

• Towards any ambulance costs that are fully covered by a third-party arrangement such as an ambulance subscription scheme or a State/Territory ambulance transportation scheme. However, we may pay benefits for any ambulance costs not fully covered by these schemes if the service meets our assessment criteria.
• When you are transferred by ambulance between public hospital facilities while you are an admitted patient.
• For ambulance transfers once you have been discharged from hospital, including transport from hospital to home.
• When you’re aged 65 or over and live in WA, since you are eligible for free or subsidised ambulance services. However, if you’re eligible for subsidised services, you may be able to claim the remaining cost from Medibank.
• When you live in NSW or the ACT, since you pay an ambulance levy as part of your hospital cover premium and are entitled to cover under your state scheme. If you have a Commonwealth concession card you might be exempt from paying the ambulance levy.
• When you live in QLD or TAS, since you’re entitled to cover for ambulance transport under the State Government scheme. 

Where the State scheme allows, here are some other situations you can claim for:

• You’re an admitted patient in hospital, and the hospital requires you to be transferred from one hospital to another. (Note that this doesn’t include transfers between public hospitals.)
• The air ambulance provider has received pre-approval from Medibank to provide transport by air ambulance.
• A member is transported by ambulance to a hospital or other approved facility immediately following their death.

Any ambulance called via 000 or by the hospital or other approved facility is an approved ambulance provider.

An “other approved facility” must be capable of providing immediate professional medical attention, like a medical centre or clinics. It doesn’t need to be closer than the nearest hospital or in a rural area.

We don’t keep a list of these facilities and assess whether one is an “other approved facility” on a case-by-case basis.

Health insurers are required to pay a "health insurance levy" or "ambulance levy" to certain State governments for all residential policies which include hospital treatment for permanent residents of those states.

It will depend on the service that attends to you.

For an injury in a ski resort there may be a ski patrol that would administer first aid and take you off the mountain to safety. In most cases, the ski patrol is employed by the ski resort and their services are usually provided free of charge. However, the ski patrol is not an approved ambulance provider, so if there is a charge no benefits will be payable.

If an ambulance is dispatched to you via a 000 call, this will automatically be an approved ambulance provider. This means that benefits would generally be paid because the ambulance was called to attend to provide you with immediate professional attention.

The benefits we pay for ambulance services do not cover search and rescue operations.