Free ambulance service needed for older South Australians
Facing bill shock on a tight and fixed budget and experiencing a medical episode that needs urgent care are two of the most significant and constant worries for many older South Australians.
For one SA pensioner, a medical episode that required urgent ambulance care was closely followed by bill shock in the form of an invoice from SA Ambulance Service of almost $1200 for transporting her to hospital.
It should be noted that this pensioner is incredibly grateful for the medical treatment she received from SA Ambulance Service paramedics and praises the care.
It’s just that she was not prepared for the bill.
This pensioner thought long and hard before making the emergency call for an ambulance.
“I had a temperature over 40 and I was a bit in and out of being aware,” she says.
“I had thought I need to go to the hospital but the kids are all interstate, overseas. I kept thinking ‘I’ll just ride it out, I’m not that sick, I’ll be alright’.”
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This is the quandary for many South Australian age pensioners: do they call an ambulance if they are in need or can they “ride it out” and avoid a significant bill.
In our state, SA Ambulance Service is a user pays service, with emergency transportation costing $1171, plus a per kilometre fee of $6.70. SA Ambulance Service (SAAS) says that pensioners may be eligible to request a concession on the fees.
COTA SA has for a number of years advocated for free ambulances for full age pensioners in our state to bring us into line with all other jurisdictions.
South Australia is now the last remaining jurisdiction in the nation not to provide free ambulances to those on a full age pension.
No other state or territory across the nation charges full age pensioners for emergency ambulance services, and Queensland and Tasmania do not make their residents of any age pay at all for this critical service.
It is argued that older South Australians can take out insurance in case they need ambulance treatment – but we know that for many private health insurance is already out of reach, let alone the additional cost of ambulance cover.
A recent national survey indicated 45% of full age pensioners responding did not have private health insurance and 53% of respondents with cover indicated they would need to cut costs to maintain it.
We know after much consultation with older South Australians, cost of living is the issue most impacting them currently followed closely by health services.
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With rising energy costs over the last decade and the latest cost of living burden, escalating insurance premiums for home and car, household budgets are being squeezed tighter than ever.
Older South Australians are making hard decisions about whether they heat or cool their home, put food on their table or fuel in their car. Many live on low and fixed incomes with little room for unexpected bills.
The cost of an emergency ambulance service is more than the fortnightly rate for a single full Age Pension. This means that a number of older South Australians will make the difficult decision to “ride it out” and not call an ambulance when they are in need of emergency medical help.
In our 2025/26 State Budget submission, COTA SA is calling on the State Government to provide a fair and compassionate approach to ambulance costs for our state’s most vulnerable. We ask the Government to provide free emergency ambulance transportation for South Australians on a full Age Pension in line with all other Australian jurisdictions.
It has been suggested free ambulances for full age pensioners will lead to escalating demand for the service – and compound ramping across public hospitals.
Let’s keep in mind that every other state and territory provides free ambulance for full age pensioners – and there is no evidence that this has made ramping worse in those jurisdictions.
Research in both Queensland and Victoria did not find a sustained spike in call outs linked to free ambulances for older people.
The experience of other jurisdictions should be reassuring for the State Government.
Meanwhile, the State Government has invested in SA Ambulance Service to develop a new Electronic Patient Care Record system which will be crucial for first responders and streamline patient relationship management and billing creating a more efficient system. Savings from these efficiencies can be used to offset foregone revenue from emergency transport of age pensioners.
Currently SA Ambulance Service is forced to spend money chasing down people who don’t pay their bill and it writes off many millions of dollars of debt every year due to unpaid ambulance fees. Many of these bills will be in the name of older South Australians who just can’t afford to pay. Again there are potential savings to be made for SA Ambulance Service.
It’s time South Australia caught up with the rest of the country and ensured that no full age pensioner has to “ride it out”, choosing financial stability over their health.
We urge the State Government to implement free emergency ambulance services for full age pensioners.
Miranda Starke is the Chief Executive of COTA SA.
