A:

In NSW or ACT, you are covered in full for ambulance transportation with hospital or extras cover. In all other states, ambulance is covered only under general treatment products.

If you go to an emergency department of a private hospital, you will be classed as an ‘out-patient’ and as such ACA Health is not legally permitted to pay benefits on these services or any blood tests or x-rays that may be taken at this time. These fees are instead reimbursed by Medicare, as services provided to “not admitted patients”, at 85% of the Medicare Schedule Fee.

Many private hospitals also charge a ‘facility fee’ for attendance at their emergency department to help off-set their running costs. ACA Health does pay a benefit towards this fee.

If, after emergency treatment, you require admission to the hospital, you will then be covered by your Hospital cover with ACA Health (provided all waiting periods are served and the treatment is covered by your hospital cover).