14 months after rolling her ankle, Canberran Kayla was billed $45,000 (2024)

Kayla Dempsey loves the outdoors and adventure.

So, it's little wonder Australia's premier alpine walk, the Overland Track in Tasmania, was on her bucket list.

And in January 2023, Ms Dempsey and her partner thought they'd be ticking the walk off.

But about 17 kilometres in, Ms Dempsey rolled her ankle.

"We'd summitted Cradle Mountain and about a kilometre away from the first hut I rolled my ankle with a 20-kilogram pack on my back, so it was a pretty bad roll," she said.

She managed to get to the second hut, with the help of fellow walkers, and despite staying an extra night in an attempt to recover, the situation deteriorated.

"The swelling just got out of control and I wasn't able to weight bear very well," she said.

"The pain was getting worse and I had a few chats to the rangers and they were suggesting that we get emergency airlifted out."

Unable to walk out, the couple decided their only option was to activate their personal locator beacon — a device used by those who do not have mobile phone reception in remote areas — and call for assistance.

"It was pretty upsetting, we really didn't want to but we knew that we didn't have any other option," Ms Dempsey said.

Within 30 minutes, a helicopter carrying paramedics arrived to evacuate the pair from the remote location, and Ms Dempsey was flown to the Royal Hobart Hospital.

It wasn't until 14 months later in March this year, long after returning to her home in Canberra, that Ms Dempsey received an unexpected invoice from the Tasmanian government.

It was a bill for $45,450.36.

'Totally shocked'

Ms Dempsey said receiving the bill was "a big shock".

"There was no mention of any cost or anything like that when we were on the chopper," she said.

"I didn't know if it was real or not and I couldn't think straight.

"[It's] very confronting to see such a large sum as a bill, I have never owed that much money so to get something like that was very stressful."

Ms Dempsey was given a month to pay the money, and in a final notice posted to her, the Tasmanian government said the matter could be referred to a debt collection agency if the bill wasn't paid.

She had contacted her private health insurer immediately after receiving the invoice, and after months of back and forth, the insurance company covered the entire bill.

"It definitely makes me wary to look into my insurance and what it covers to make sure I am fully covered for the things I want to do," she said.

What are the rules?

Ambulance services are not covered by Medicare and fees vary around Australia, depending on which state or territory you live in.

While that's fairly straight forward, it gets much more complicated when you travel interstate and require an ambulance.

Some jurisdictions have what's called a "reciprocal arrangement" — but these agreements vary significantly.

In Ms Dempsey's case, if she was a Tasmanian resident, she would not have been charged for the helicopter flight as Tasmanians do not pay for ambulance services.

In the case of the ACT, where Ms Dempsey lives, residents are charged for ambulances and there are no formal reciprocal arrangements in place between the ACT Ambulance Service and other states and territories in Australia.

"If an ACT resident requires the use of an interstate ambulance service, the service cost would be determined by that state's ambulance service," the ACT Emergency Services Agency said.

However, for example, if a Tasmanian travelled to the ACT and required an emergency road ambulance, the Tasmanian government has in place an agreement that would see the bill waived.

Would travel insurance help?

The Tasmanian government's website states it's "important to think about travel insurance if you are planning to visit Tasmania from another state in Australia".

"Whether visiting Tasmania or for Tasmanians travelling interstate, it is advisable to know what arrangements are in place," Ambulance Tasmania acting chief executive Michelle Baxter said in a statement.

"Check what health funds will cover and consider what additional cover may be needed," she said.

But domestic travel insurance would have been unlikely to help in Ms Dempsey's case, according to adjunct fellow in management and tourism Dr David Beirman from the University of Technology Sydney.

Dr Beirman said domestic travel insurance did not have the same coverage as international travel insurance.

"The reason that a domestic travel insurance policy is very cheap is because it doesn't actually cover all that much," he said.

"The reason that it doesn't generally cover medical events is because the assumption that most insurance providers will have is that people have either medical cover through Medicare or through private health insurance."

He said 90 per cent of Australians who travel overseas take out travel insurance, as against only 10 to 20 per cent of domestic travellers.