For non-emergency ambulance transport to be covered under your membership, it must be assessed as ‘Clinically Necessary’ by a qualified medical clinician.

The term ‘Clinically Necessary’ means that there is a genuine clinical need;
• To move the patient (i.e. the current hospital cannot treat the patient)
• For the patient to use an ambulance
• For clinical monitoring during transport

Membership does not cover:

• Ambulance services if your benefits have not started and you are within your qualifying period
• Cases where the transport is for social or convenience reasons (such as choosing your own location of treatment)
• When a third party is responsible for payment (such as the sending hospital in the public system)

Click here for a full list of exclusions.

Please note:

• Patients cannot book their own transport. It must be booked by your doctor via Triple Zero Victoria on 1300 366 313.
• We cannot guarantee that a particular transport will be covered under membership however, if your clinician has booked the transport in line with the Department of Health and Human Services (DHHS) Ambulance Payment Guidelines and the Membership Scheme Business Rules then it will likely be covered.
• If the booking is found to not be in line within the DHHS guidelines, membership will not cover it.

For more information please refer to the following links:

• Membership Cover and Non-Emergency Transport
• Ambulance Payment Guidelines 
• Membership Scheme Business Rules