Is it worth having private health insurance for pregnancy?
Our recommendations are dedicated to helping you find the right product at the right price. We may receive revenue from affiliate and advertising partnerships for sharing this content and when you make a purchase. Learn more  Theres a lot to consider when planning a baby. Like, Am I ready for this life change? and Can we even afford to have a child? and Should we go through the public healthcare system or take advantage of private health insurance?  Here we look into your options for pregnancy and birth care in Australia by answering eight important questions. 1. Australia has a world-class public healthcare system but it does come with some limitations. While you can expect excellent service and care using Medicare during your pregnancy and birthing experience, your choice of health practitioners, appointment times and accommodation may be limited (depending on resources in your local area). On the other hand, private health insurance cover provides members with more options and access to additional resources that arent accessible through Medicare, such as consistency of care under your chosen health practitioner and a private room and facilities in a public or private hospital during birth. Find the right pregnancy cover  2. Depending on the insurer and the policy you choose, private health insurance pregnancy cover may provide hospital accommodation (sometimes of your choice), theatre and labour ward fees, hospital-administered pharmaceuticals, access to the special care nursery (if youre on a family or single parent policy), Medicare Benefit Schedule fees and intensive care services (during and after birth). RELATED: Mums pregnancy surprise reveals insurance mistake  3. What youre not covered for depends entirely on your private health insurance policy. In general, the level of health cover will sometimes (but not always) depend on the cost of the policy  so if you go for a budget option, you can expect fewer benefits. You may have to pay excess costs  or a gap  on some services, where healthcare providers charge more than the insurer pays out. These may include specialist consultations and check-ups with an obstetrician, paediatric appointments and some hospital fees (although a portion of these costs could potentially be claimed on Medicare). 4. While parents using Medicare will have very few, if any, out-of-pocket expenses, parents with private health insurance can certainly expect to pay more. These expenses will vary, depending on your requirements, health insurance policy and insurer, but in general, you can expect to pay the agreed excess for hospital admission as well as costs for care and procedures not covered by your policy. For example, out-of-hospital care is not always covered in your policy or may be part of extras cover. Other expenses might include specialist and outpatient consultations, the gap on medical services incurred at the hospital, appointments made when not an inpatient, some IVF treatments and hospital prerelease check-ups. Find the right pregnancy cover  5. Theres an enormous array of health insurance policies on offer covering pregnancy and birth to choose from, all varying in price and cover. And because everyone has different needs, the best policy for one person may not meet the requirements of another. To help you decide which health insurance policy is best for you, consider your budget and how much you can afford to pay towards your policy each month. Also be realistic about the excess payment youll need to pay on hospital admission  while excesses can vary, the less you opt for on sign up, the more youll potentially pay in premiums. 6. Insurers consider pregnancy a pre-existing health condition, so to be eligible for private health cover, youll need to have had pregnancy cover in place for a minimum of 12 months to access these benefits. This means that if you want your pregnancies and birth to be covered by private health insurance, youll need to think ahead and get your health insurance sorted well in advance of falling pregnant to ensure eligibility. 7. Youll need to upgrade to a new policy if you dont already have cover for pregnancy and childbirth. Then you must comply with the 12-month wait time to be covered for pre-existing conditions  such as pregnancy. While youre planning ahead, its also an ideal time to review your health insurance. If not, consider upgrading to family cover along with pregnancy and birth cover, which provides the right level of care throughout pregnancy and childbirth and also ensures your cute new family member will be covered on their arrival. Find the right pregnancy cover  8. A proportion of the costs of some pregnancy-related outpatient services can be claimed on Medicare, such as specialist consultations and check-ups with obstetricians and paediatric appointments. (Please check with your service provider.) But youll be required to advise your hospital when you book yourself in for the birth on whether you intend to be a public or private patient. This will determine whether you obtain access to your choice of heath practitioner or if one will be assigned to you; if you share a room with other patients or are put up in a private one; and if youll be charged certain out-of-pocket expenses that are waved for public patients. RELATED: Everything you need to know about extras insurance