Pregnancy and Birth Health Insurance

If you plan is to avoid the 2 ½ to 3 hours wait each appointment at a public hospital to see a different midwife or resident every time or sharing a crowded ward with other mothers and babies and noisy visitors then having your baby in a private hospital with the obstetrician of your choice would be a very costly experience without proper private health insurance.

Planning and joining a private health fund well in advance of your pregnancy in mandatory as most funds have a 9-12 month qualifying period for obstetric cover. Now while everything will probably go smoothly there are a few things to be aware of so making sure you are fully covered earlier than the planned event is vital. Apart from your regular visits to your obstetrician, some common examples of early hospitalisation include:

·         Problems that require bed rest and or monitoring of your baby prior to delivery

·         Premature delivery

·         Miscarriage

·         Termination

Add to this list blood tests, ultra sounds etc and if not adequately covered insurance benefits may not be payable or may be paid at a reduced rate leaving you out of pocket.

It is wise to speak to one of the consultants at your health fund as there are quite a few things that may or may not be covered and there are some rather large gaps that you may still have to pay for. There have been cases where people have paid into private funds merely for the right to see the same obstetrician all the way through and have had quite a sizeable hospital bill pay and should  there be a longer than anticipated stay or extra procedures involved the cost could skyrocket. Most anaesthetists bills will see you paying a big gap and in some cases, so should you require a C section you could be out of pocket over $500.other costs such as pathology costs alone can severely dent your wallet. 

Should your baby arrive early or need any specialist treatment it is wise to know in advance that you and your baby are well insured. Always check with your obstetrician and paediatrician about bulk billing and ask them about the gap you are going to have to pay. Check with the hospital about any extras that may be required, be they hospital luxuries like TV”s etc or medical items and procedures.

There are funds and there are funds each offering a different level of cover so it is wise to check and if necessary shop around for the best coverage you can afford. All in all it can be very daunting especially since you are planning for something so far in advance and if this is your first pregnancy it is hard to know what to ask.