Who pays when you get evacuated from a hike?


For a number of years the discussion over medical evacuation from the bush was something that I hadn’t paid much attention to, at least from a domestic perspective. I was very much aware that if I needed to set of a Personal Locator Beacon that someone would come to rescue me or the effected party and always having had medical insurance I just assumed that this process would be covered under my private health insurance.

Late last year while I was walking the Tasmanian South Coast Track a medical situation arose and while not life threatening the hiker concerned looked unlikely to be able to walk themselves out. This situation was managed by the leader of another group that was on trail at the same time and with one of the issues raised with the individual concerned was how an evacuation was going to be paid for.

Over the past few months this article has been on my ‘to do list’ and while I initially planned on doing a detailed article covering all bases I quickly learned that the various Australian States and Territories all do things differently. Some states will cover residents even if they are travelling interstate. Other states will do full cost recovery and the prices vary from state to state.

If that’s not bad enough every state and territory seems to have a two tier system were locals pay one price ranging from being fully covered at best or at worst paying a lower rate than interstate travellers. To make matters worse there are a slew of exemptions that apply and with so many variations is makes it hard to work out what’s what without doing some very detailed research based on your own specific set of circumstances.

Then theres travelling overseas for hiking which is a whole different ballgame and if that’s what you plan to do then with very rare exceptions to need to have travel insurance (which is a good idea even if you are just being a tourist) otherwise you may wind up with a very, very, large bill particularly when travelling in the USA.

So what does this mean for us as hikers? Find out below.

Australia-things to know

  • Medicare doesn’t cover you for ambulance services. This includes road based ambulances, air ambulances, and helicopters.
  • Some states may cover for ambulance cover both inside your home state as well as interstate. But remember to read the fine print.
  • If you have private health cover / Ambulance cover then you will typically need to read to fine print to see what is covered.
    • I was surprised to learn that my private health insurer does cover air ambulances but there is a caveat that states that “only if the air ambulance provider seeks approval from my insurer first”.
      • What happened if I’m unconscious and no-one knows who that is?
  • Medical evacuation whether it be by road or air isn’t cheap. I work colleague of mine had a rock climbing accident in the blue mountains in NSW that required helicopter evacuation and it cost them $1,900. That’s cheap as far as helicopter evacuation is concerned with the dearest fee that I could find being approximately $13,500 for a  trip that is up to 1 hour in duration.
  • Concession card holders/Pensioners will often attract a discount anywhere up to 100% of the costs but this can be aged based and does vary

Options in Australia

While hiking in Australia is generally a safe activity it’s not without risks. While you may never have a life threatening injury there may be instance where you are unable to continue your hike and may not be able to walk out which means that an emergency evacuation is required.

Its worth checking with your state and territory of residence as well as the state you plan on travelling to about what the potential costs are. In all honesty its not worth the risk to not have insurance so what are the options?

  1. Include ambulance cover as part of your private health insurance.
    • Check with your provider what’s provided with this cover and ensure that it covers air ambulances.
  2. If you don’t want full private health cover then look at just ambulance cover.
    • You can usually get ambulance cover for under $100/year. That’s pretty cheap.
  3. Arrange domestic travel insurance
    • One thing to note is that a number of credit card companies provide travel insurance as part of their package but again read the fine print.


Travelling overseas to undertake a hike means that your coverage in Australia no longer applies. Every country is different in what they charge with some treating you without costs while other countries such as the USA charging full cost recovery. You will often find when purchasing overseas travel/medical insurance that company’s will often quote a worldwide price both with and without the USA/Canada.  When you start researching overseas travel insurance, particularly in the USA you may be surprised at the size of the policies required for evacuations and medical treatment.

If you are travelling overseas you first need to identify what activities that you will be undertaking. Are you just wandering the streets as a tourist or are you undertaking adventure activities (hiking). To make matters worse the altitude that you go to is a major consideration of insurance companies mainly because altitude sickness can be an issue.  Over the years I have done treks in South America and Bhutan where we reached over 5,00metres in altitude and some insurance policies won’t cover you or else require you to upgrade your policy.

One thing to note with many overseas travel policies is that you may be required to call a hotline to seek approval for treatment prior to it occurring. Again read the fine print.

Final thoughts

Undertaking an Outoor adventure activity such as hiking in Australia is relatively safe as far as adventure sports go but break and ankle or leg in a remote area and end up in a situation where you can’t walk out then you may need to be evacuated by medical professionals. If you are hiking in remote or rugged terrain this may require a helicopter and if you aren’t covered by some form of insurance the bill you receive may be a bit of a shock. Travel overseas, particularly in the USA, without travel insurance, and the medical expenses can be exponentially larger and isn’t worth the risk.

What it comes down to is know what coverage you need, know what coverage that you have based on the state/territory that  you live in and the state/territory/country  that you plan on travelling to for your outdoor adventure and make a conscious decision about the level of risk that you are willing to take. If you are happy to pay for a medical evacuation out of your own pocket thats fine but if you aren’t then at the very least get ambulance coverage that will also includes evacuation by air, its a small price to pay.

The following links provide an overview of what medical evacuation cost in each Australian State and Territory. The costs vary between each jurisdiction and there are a range of exemptions that apply that will impact on the financial responsibility that individuals are likely to have to cover. As such there is not one ‘cost’ that applies

Overseas medical insurance

I have travelled extensively overseas including on various adventure holidays and will always have travel insurance. Hiking is considered an adventure sport by many insurers and for the sake of  what ends up being a relatively small amount when compared to the cost of medical treatment its well worth having even if its for piece of mind.

The following are just some of the insurance options to cover your outdoor adventure. Read the policies very carefully and make sure that what you are planning on doing is covered by the policy you are looking at. Some policies will only cover you to a certain altitude, others will only cover you if you are part of a professional organised group:

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