2. Membership Types, Fees, Benefits And Exclusions
2.1 Membership Types
2.1.1 AV has two Membership options available: Single Membership or Family Membership.
2.1.2 Single Membership – Covers one Member only. The named Member is the only individual authorised to make changes to or obtain information on the Membership. A third party can obtain information or make changes as required provided a legal authority to do so is received in writing or where the named Member has nominated a third party to act as an authorised representative on their behalf – either verbally or in writing.
2.1.3 Family Membership – Covers the primary Member and any eligible Dependants listed. A Dependant spouse will have the same level of access to Membership information as the primary Member and can access information and make changes to the Membership as required excluding resigning the Membership or removing the primary Member. All other third party requests for information are as per Clause 2.1.2.
2.1.4 All individuals must adhere to a three point identification check in order to make changes or access information on a Membership.
2.2 Membership Fees
Membership Fees are set by the Victorian Government Department of Health and may be amended from time to time. Any change in Membership Fee comes into effect upon the next Membership Renewal date following a Membership Fee change unless otherwise notified.
2.3 Member Benefits
2.3.1 Member benefits commence at 5pm (1700 hours) AEST the day after the Membership Fee is received by AV and cease at the end of the Membership Period. Refer to Section 3.0 – Membership Commencement and Qualifying Period.
2.3.2 Members and their eligible Dependants (if applicable) receive Member Benefits for all Emergency Cases and Clinically Necessary Non-Emergency Cases at no additional cost to the Member. In all cases transport is provided to the nearest, most appropriate medical facility. In Victoria, AV Services must be provided by AV or those resources contracted to AV to be included as a Member Benefit.
Before authorising a patient for any ambulance transport interstate, the referring health professional must contact AV and provide detailed evidence as to why the patient must attend interstate health services. AV may seek a second opinion.
2.3.3 Members are covered for the same benefits Australia wide as they would have received had they been in Victoria. All the conditions relating to AV Services in Victoria will apply to the same services received interstate. Inter-state Member Benefits only apply for services provided by that State’s official State or Territory Ambulance Services. Refer to Clause 4.1 – Residential Requirements.
2.3.4 No invoice will be sent to the Member when a Member uses AV’s services if AV can match the transport information with the Membership details. If a Member receives a transport invoice which they believe should be covered by their Membership, the Member should make sure their membership record is up to date and then complete the relevant section on the reverse of the invoice and return to the AV Accounts Receivable Department for action.
A Member may be presented with an account for transport by an interstate Ambulance Service. If this occurs, the account and Membership details should be sent to the AV Accounts Receivable Department for action:
Call: (03) 9840 3544 or 1800 990 029
Email: accountsreceivable@ambulance.vic.gov.au(opens in a new window)
Write: Locked Bag 9000, Ballarat, VIC 3354
2.3.5 Members who renew their Membership within thirty (30) days of the Renewal date may be offered Continuity of Benefits at the discretion of AV.
2.3.6 Cover Notes can be issued on request for a period of twenty one (21) days and all Member benefits will apply providing the Membership is paid prior to the expiry of the Cover Note. Once paid, Member Benefits will commence from 5:00pm (1700hours) AEST on the day after the Cover Note was requested by the Member. Only one Cover Note per person per annum will be issued.
2.4 Exclusions
Membership benefits do not cover:
2.4.1 Ambulance Services that are not deemed Clinically Necessary.
2.4.2 AV Services where a patient requests to be moved between medical facilities for reasons that are not Clinically Necessary. For example social or convenience reasons such as:
- The patient chooses to move to another hospital to be closer to their home and/or family Members (this includes returning back to Victoria from another State or Territory
where they might have been receiving treatment); - The patient chooses to move to another hospital in order to be treated by a preferred physician or in a preferred hospital.
2.4.3 Transport from one private home to another.
2.4.4 Relocation from one accommodation facility to another or from hospital to home and return to hospital for weekend or holiday relief.
2.4.5 Royal Flying Doctor Services, where services are not the result of an Emergency Case or pre-approval has not been provided by AV in advance.
2.4.6 Repatriation if the transport is not Clinically Necessary and approved by AV in advance. Note: If prior approval is not given by AV the Membership will not cover any costs incurred.
2.4.7 Transport fees where responsibility for payment is ultimately the responsibility of a third party, as per the Department of Health Patient Transport Charging Guidelines for Victoria. These are available at www.health.vic.gov.au/patient-care/ambulance-fees(opens in a new window)
2.4.8 Non-Emergency Cases requiring AV Services during the Qualifying Period.
2.4.9 Emergency Cases during the Qualifying Period where the service is required as a result of a Pre-Existing Ailment.
2.4.10 Services used prior to 5pm (1700 hours) AEST the day after the Membership Fee is received by AV. Refer to Section 3.1 Membership Commencement.
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