For many people, pregnancy or planning a family is the time when private health insurance (PHI) is organised and bought for the first time. Unfortunately, some people organise their PHI without really knowing exactly which pregnancy services they are covered for. They might find this out too late, when the baby is on its way, or after the little one has arrived! Don’t be caught out and plan early. There is often a waiting period of 12 months for pregnancy cover, so getting insurance after you know you are pregnant will mean you will have lot’s of out of pocket expenses.
Obviously, Medicare covers heaps of services when it comes to pregnancy. If it didn’t, women would not be able to have their baby in a hospital at all. But, Medicare only covers certain things. The other thing we forget with pregnancy is that it’s not just the birth itself that requires usually requires medical attention. Ante-natal checks (before birth) and post-natal services (after child-birth) all require medical help. In most cases, this means 9 months or so of hospital and Dr’s visits. It’s a good idea to see exactly what the costs of pregnancy are, so let’s take a look.
If you are pregnant and do not have private health insurance, Medicare will cover you for the following things:
- Some of the cost of check-up’s with your GP
- Some of the cost of specialists appointments with an Obstetrician (you will have several of these). You cannot choose your Obstetrician under Medicare.
- Some of the cost of blood tests and ultrasounds (you will have several of these)
- Some of the cost of specialised tests (if your need them)
- Ante-natal classes are NOT covered by Medicare
- With Medicare only, you cannot choose your Obstetrician or Paediatrician
- You will be a public patient in a public hospital
Once at hospital, Medicare will cover:
- Some of the cost of baby delivery fees
- Some of the anaesthetics fees
- Some of the cost of your baby’s first heath-check with a Paediatrician
- A portion of health check-up’s fees after your baby is born (like a visit from a mid-wife)
As you can see, Medicare covers some, but not all of the costs of pregnancy.
It’s also important to know that PHI covers some aspects of pregnancy, but not others, so lets have a look at what your PHI will cover:
- A portion of your Obstetricians delivery fee
- Private hospital charges
- A portion of anaesthetics fees
- You can have the Obstetrician of your choice and see the same Obstetrician throughout your entire pregnancy
- You can have the Paediatrician of your choice for your baby
- You can choose to be a private patient in a private hospital
- You can choose to be a private patient in a public hospital
- You can choose PHI that will cover your baby too (family insurance)
PHI does not cover you for Ante-natal classes, GP visits, blood tests, appointments with Obstetricians, Ultrasounds and other more specialised tests you might need (these are already partially covered by Medicare). Having PHI on top of Medicare is the best option to reduce your out pocket expenses and to give you the choices and peace of mind when it comes to choosing a Dr and a hospital you feel most comfortable with, whether that be public, or private.