Does my membership cover Air Ambulance?

Air ambulance is included in your membership cover, however, there are conditions.

In all cases:

  • Transport must be to the nearest medical facility that can help the patient; and
  • The transport needs to be Clinically Necessary and Medically authorised
  • The AV Membership Scheme Business Rules are used to determine an outcome
  • Non-emergency air services are required to have pre-approval by AV before booking the service (if you want membership to consider covering the costs)

If you are claiming membership to cover costs, AV will review the case and require further information such as below:

  • What happened
  • Why the transport was required
  • Where the transport occurred (from and to)
  • Who performed the transport

Please note:

  • Clinically Necessary means the patient/member requires active clinical monitoring/care or clinical supervision during transport that is provided by a paramedic, health professional or qualified patient transport officer or attendant.
  • Authorisation must be provided by a Health Professional who can make an informed decision about whether there is a genuine clinical need for a patient to be transported by ambulance instead of any other way.
  • Your doctor/health professional can book transport, however you may be liable for the invoice should it not be approved by AV. This means you may have to pay out of your own pocket.
  • If the member is not able to be covered under their membership, they can contact that State’s Air Ambulance team for further advice about getting a quote to return to Victoria.  

Members are generally covered for emergency ambulance services Australia Wide however, there are some restrictions. Restrictions or exclusions can include:

  • Privately booked transports, where the member or their representative booked with the transport directly with a provider.
  • Repatriation to Victoria. In most cases the patient can be treated in the State where they are currently receiving treatment, and transport back to Victoria would not generally be covered.  
  • Transport home upon discharge from hospital. If the member has been discharged, they are generally well enough to go home by other means and do not need paramedic assistance.
  • If they still require paramedic assistance to get home, they can obtain a quote to pay. If they are not well enough to get home at this stage, they will have to look at accommodation where they are until they are well enough.
  • Search and Rescue services are not generally covered, such as evacuation from remote locations. (Unless this is specifically performed as part of an emergency service by a state’s registered ambulance service).

Scenario 1:
My mother needed brain surgery and the only doctor that would do it is in Sydney, so we flew up for treatment.  We want to bring her back to Victoria to recover at Cabrini Private.  Can membership pay for this?

No. Your mother would have to recover in Sydney at the nearest most appropriate facility that can treat her condition.  AV does not repatriate members so they can be treated at a preferred hospital or to be closer to home.

Scenario 2:
I was on holiday and had an accident.  I am in hospital in Corowa NSW and need to go to the Hospital in Mornington VIC for specialist treatment?

Possibly. Your AV membership covers Clinically Necessary, transport to the nearest and most appropriate medical facility that can treat that condition (provided no waiting periods are in place).  If the nearest hospital that can treat that condition is in Victoria, then AV membership may cover the costs.

Whilst it is unlikely that the nearest facility that can treat you is interstate from your location, some specialist hospitals located in Victoria may be the most appropriate medical facility that can treat your condition.

Written authorisation must be provided by the doctor stating that there is a genuine clinical need for a patient to be transported by ambulance instead of any other way and, that the nearest medical facility that can treat the patient is in Victoria.   

Approval from Head Office is required before AV will cover the costs.  AV may seek a second medical opinion.

Scenario 3: 
I have cancer and went on holiday to Queensland.  I’m now in hospital and want to come back to Monash in Melbourne as my oncologist says he can treat me. Can my Membership pay for this?

No. Whilst this is an unfortunate situation, AV membership does not cover repatriation from interstate for social or convenience reasons, such as being treated at your preferred hospital or by your preferred doctor.

A quote can be obtained for the member to bear the costs if they still wish to return to Victoria.

Scenario 4: 
I was on holiday in the NT, and I broke my leg.  I am in Darwin base hospital, but I want to come back to Melbourne.  Can my AV Membership pay for the ambulance flight back to Victoria?

No. You must recover in Darwin until you are able to travel by commercial means to return to Victoria.  If the hospital that you are in cannot treat your condition you may be transported to the nearest hospital that can treat your condition (provided the transport is Clinically Necessary).

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