Health fund - Too Late

[7316tracey]

Hi All,

I just found out I am Pregnant and due around the 9th March 2008. We joined up with a health fund on the 4th April this year... see my dilemma?? My health fund of course won’t cover any costs of the pregnancy or birth.

Has anyone been in this situation? What did you do?

And does anyone know the costs of going private as an uninsured patient (I'm in Perth)? I have 1 child, he is nearly 8 now, but everything seems to work differently then!!

Kind Regards,
Tracey

[Wazza]

I had this dilemma too and went public for my first bubs. Haven't looked back since as it all went so well- so well that i am having bubs #2 at the same public hospital because they were great!!!!
I know it doesn't answer the question but others haven't had cover from their health fund and I had a healthy little boy!!!!

[TwoBoysOnly]

Why do you need to go private???? Are you high risk??? What about an independent midwife and a homebirth???? What about a birth centre????

[Mamaduke]

This happened to us with our first and I went public.
To self insure would be expensive.
I think it may have the costs for my hospital in my pre-admission literature...be right back.

[TwoBoysOnly]

I know at the hospital I work at accommodation for private is approx 450 a night....then if you want to be fully private you would pay for obs visits which are usually areound 50 a visit and then you get some back from medicare....delivery can be negotiated with the ob.....usually around 3000....and then anaethetist has their own fees if you have an epidural....and if you have a c/s you would have anaethetist fees, operating theatre fees and a longer stay in hospital.....

Just go public...I am biased though as I work in the public sector.... or as I said early I can recommend an IM and have a homebirth :thumbsup:


Midwives - the safer birth option

[Mamaduke]

I just checked and my hospital charges $675 per night (not including food!)

[OneBabyBoy]

I had this problem too, so I was forced to go public. It was the most horrendous experience of my life. I unfortunately had to stay in hospital for weeks and it was so traumatic that I throw up even now when I think about that hospital.
In hindsight I obviously would have just paid for private. And now even though I have almost no money it is still a priority of mine to have full cover for everything so that neither myself or my son have to stay in a public hospital again.

[TwoBoysOnly]

In defence of the public hospital system....they aren't all horendeous and the majority of the time do the best they can despite severe staff shortages, severe lack of resources, severe bed shortages and an extremely high intake of patients.....

If you go to a public hospital based on recommendation you will do just fine....

[7316tracey]

Firstly thank you for all your replies!!

I guess I don't need to go private, my first son was born at Woodside Hospital in East Fremantle they were great and I would have been happy to go there again but they have since closed down. I guess it just daunting, I have heard mixed (but mostly bad) comments about Armadale Hospital. Kaleeya (East Fremantle) I haven't heard anything about.

I shouldn't be high risk... I'm going to see my doctor on Monday for my first appointment. My son's birth 8 years ago was a text book birth.

What about an independent midwife and a homebirth???? What about a birth centre????... What would the costs be for this? I also worry about what if something goes wrong. Though it would be nice to be at home with my family. Hospital stays are so boring!!

Onebabyboy - can I ask why your experience was so traumatic?

Tracey

[shed]

I'd just go public. There are more good stories than bad. I hate hospitals and I am having a homebirth next time, but I hate all hospitals not just public ones.

You're only having a baby, its not like you are sick or anything.

[TwoBoysOnly]

You're only having a baby, its not like you are sick or anything.

Hmmm if only more people saw it that way - birth is a 'normal' physiological event in a woman's life.

Tracey - homebirth with an independent midwife would roughly be 3000 (although don't quote me as I don't know what they charge over in perth but I do know of a midwife over there that I can ask for you if you would like)

If you had a textbook first birth then you are a perfect candidate for homebirth..... give it consideration....it is a true option that could be very rewarding for you.... I don't know if any of the hospitals in perth have a birth centre but that is also worth looking into. Continuity of care with a known midwife has great outcomes on your birth and your birth experience..... Just some food for thought :thumbsup:

[7316tracey]

Hmmm if only more people saw it that way - birth is a 'normal' physiological event in a woman's life.

Tracey - homebirth with an independent midwife would roughly be 3000 (although don't quote me as I don't know what they charge over in perth but I do know of a midwife over there that I can ask for you if you would like)

If you had a textbook first birth then you are a perfect candidate for homebirth..... give it consideration....it is a true option that could be very rewarding for you.... I don't know if any of the hospitals in perth have a birth centre but that is also worth looking into. Continuity of care with a known midwife has great outcomes on your birth and your birth experience..... Just some food for thought :thumbsup:


I've just sent an email to a midwife company, so I'll see what they say, they will put me in touch with a local midwife.

Then again maybe I'm just being paranoid.

[7316tracey]

The main thing I guess that is bothering me is, I had a GP/OB (of my choice) all the way through my first pregnancy but I've been told it's not like that now and if you go public you have to go to the clinics and you get whoever is on that day!!

Is this right?

[Bron]

You can do shared care with your GP and a public hossy, where your GP takes you through your pregnancy and whoever is on roster at the hossy delivers.

Or you could find a GP Obstetrician. There aren't many around, but they deliver at public hospitals.

[TwoBoysOnly]

GP share care is the most common antenatal care at the moment GP does all your antenatal care and then you usually go to the hospital for about 3 appointments and then a midwife should help you birth as long as everything is uncomplicated and 'normal'....otherwise you will just have the doctor or ob that is on call for that day attend to any complications.

[shed]

Yeah, you do get whoever is on and they are probably different midwives at your antenatal appointments than at your labour. I always thought that was a bit creepy (and still do), so I had a doula. She became my friend during my pregnancy and then she was there when I gave birth, so she was my continuity of care. I can hardly remember the hospital midwives because I was focussed on my doula and my DP.

I should have said in my last post that I wouldn't have a baby in a hospital without a doula. I highly recommend one.

That's if you don't choose a homebirth, although of course you can still have a doula at a homebirth :yes:

oh - and I had GP shared care too. Just went to the hospy in the last couple of weeks, a couple of times (can't remember exactly how many, maybe two?)

[korahblue]

Ring your public hospital and ask to talk to the admissions information coordinator or whatever label they might have. They can usually work out some deal for you as a sweetener to get you to go private

I was in the same predicament as you, due on the 25/12/06 and my ob cover didnt start until a week or so later. I managed to get a private OB who only charged me the medicare fee for all my visits. My scans and tests where all covered by medicare as it was a public hospital. I also wrote to my health care fund [mutual] explaining the situation and they agreed to waive the last two weeks of my OB waiting period so the birth was covered.

Most hospitals will also let you pay off your bed fees in installments

But then again, there are lots of other options. I had my first bubs as a public patient with no probs

[OneBabyBoy]

The hospital I went to is one of the (if not the) biggest in Sydney. Recommendations were useless.

Not all GP’s do shared care. If you do go public I recommend that you find a GP that does shared care because if you go through the midwives clinic at the hospital you will get a different one every time. And they all say different things. It’s the lack of communication between midwives (at that particular hospital) that is the reason for my bad outcome and the bad outcome my baby had. If you have to go this way I recommend (and I tell everyone this) to take some kind of notebook EVERY time you see them, write down the date, time, name of dr/ob/midwife and exactly what they told you. Because they treat you like an idiot if you say something that one of them told you and you can’t remember who it was.

I don’t want to offend all midwives, just the ones at that hospital, and they know how I feel, there was a formal complaint lodged by myself and my family which is still being dealt with. Already one of them has received disciplinary action. There were a few midwives in the antenatal ward who were amazing and they know how I feel about them too. However they were unfortunately the exception there.
The whole time I longed for someone familiar, to have someone see me regularily and know me. Not 500 people all saying different things. I wished so much that I had my own ob.:gloomy:
If you have an easy smooth pregnancy and labour then it probably would be fine, but the problem is that you just can't predict that. Things happen/develop and it's best to have the best medical care and conditions that you can.



You're only having a baby, its not like you are sick or anything.


Unfortunately that is not always the case. Some women and/or unborn babies do get very very sick.

Tracey - I don't want you to unneccessarily scare you, and I'm sure your pregnancy will be smooth and have an awesome delivery. I was just telling you of my experience - Just take note of everything said to you. All the best :hugs:

[shed]

Unfortunately that is not always the case. Some women and/or unborn babies do get very very sick.


I wasn't saying they didn't, please don't take what I say out of context. The process of having a baby is not an illness in itself.

I'm sorry you had a bad experience. I also had a different midwife every visit and then different ones again at the labour. That's the worst part of the system and it needs to be fixed.

[kirstenriley]

Have you actually checked with your health fund? The reason i ask is we originally went with a cheaper "option" which meant i had to wait 2 yrs instead of the 12 months. I did get pregnant before the 2 yrs and when i rang they pretty much said that it would be ok as long as its not "get health fund one day and have baby the next" IYKWIM.

[TickledPink]

I would ring your health fund, I would have been two months short of my 12 month waiting period, however they were very understanding and all they made me do was pay the 2 months worth of fees and then they covered me no problems.

I know a friend tried the same thing but with about a 7 month gap and they wouldnt do it, but surely you shouldnt have any problems.

[TwoBoysOnly]

At the hospital I work at we also run team midwifery through the hospital....so the idea is that you get continuity of care. There is a team of 8 midwives and you should see most of them during your antenatal visits then one of them will look after during your birth and then you should be looked after by more on the ward postnatally.

Most large public hospitals should have this team midwifery happening by now. Just check with your local hospital. The risk you run with having an ob for a perfectly healthy pregnancy is INTERVENTION....that is what they are trained for. A lot of them don't see pregnancy and birth as 'normal' they seek out the abnormal and respond to it - even if there is no abnormal to be sought. IMHO..

[OneBabyBoy]

That definitely sounds like a much better way of running things TBO.
In my personal opinion the risk you run of having an OB that is intervention happy is much less of a problem than actually having complications with a pregnancy and not recieving the level of care, conditions and consistancy that you should. It can be achieved in the public sector through much more funding for staff, upgrades of hospitals and better equipment and general conditions. IMO, from what I've seen private hospitals are ahead in those areas because they do have more money. You get what you pay for basically.
If you have a complication free pregnancy and birth then it doesn't matter at all. Like I've said before the problem is that unfortunately you don't know in advance what is going to happen.

[TwoBoysOnly]

But can I just add.....when the private hospitals can't cope with the preterm or high risk pregnancies they end up sending the woman to the public tertiary hospital anyway....well that is what happens here in QLD...so why not be at that tertiary hospital to start off with .....they have the biggest ICN/SCN and the most well equipped to deal with the sick little bubbas if need be????

[7316tracey]

Have you actually checked with your health fund? The reason i ask is we originally went with a cheaper "option" which meant i had to wait 2 yrs instead of the 12 months. I did get pregnant before the 2 yrs and when i rang they pretty much said that it would be ok as long as its not "get health fund one day and have baby the next" IYKWIM.

Yes I did... I'm with GMHBA and they will not cover a cent even though it's only 3 1/2 weeks out. They said it wouldn't be fair on their other members. I hate health funds!!!

[pickles]

I have top private health insurance yet made the informed choice of having both my babies at a public birth centre.
The common misconception is that private doctor + fancy room = better care. If anything the escalating c/section rates in private hospitals has means that midwives spend most of their time doing observations and surgical care as oppossed to spending time with new parents and helping with breastfeeding.
As a non-insured patient you will be up for around
$2100 for three nights accomidation.
$650 for labour ward ( even if you are only there for a couple of hours)
$ 700 per night for level 2 nursery ( or you transfer baby out to the public system )
plus the epidural ( $650 - $800 ) if you have one.

so around$2750 plus doctors fees.

Go to KEMH birth Centre or Community midwifery program ( government funded home birth in WA ) = free

care for my daughter cost $13 ( parking )
my son $40 ( hire glucose monitor and parking )

1 night at the birth centre with both and then midwife came to see me everyday for another 5 days at home.

Also had free acsess to the breastfeeding clinic for 12 weeks after the baby born .

good luck
Pickles

[TwoBoysOnly]

Man WA has a cool system by the sounds of it....:yelclap:

[Rachael]

Yes I did... I'm with GMHBA and they will not cover a cent even though it's only 3 1/2 weeks out. They said it wouldn't be fair on their other members. I hate health funds!!!


3.5 weeks and they won't cover you!! That is really harsh.

Try again and speak to someone in the customer relations department or at least a supervisor. Offer to pay that extra month that your short.

Lol if it was me I would say I will pay the extra month and I want you to cover me. If your not going to cover me then I may as well switch funds...

or something along those lines.

I would never go public but that is me.

Goodluck hope it works out for you

[7316tracey]

Thanks...

I complained again, offering to pay to the end of the 12 months or even 1-2 years in advance if I have to and she still said NO!!... after the 3rd email the Customer Service Advisor said if I'd like to take it further I have to write to their Member Service Committee explaining my situation and they will vote on it... So I've written my letter and it's in the post today.[/font]
FINGERS CROSSED

Failing that... I'll call other health funds and see what they can do for me.

[Rachael]

Goodluck :)

Try Medibank they are great.

[jorey]

Goodluck :)

Try Medibank they are great.

I agree!:yes: Medibank is really great! Worth every cent.:thumbsup:

[7316tracey]

While I'm waiting for a reply from GMHBA, I have been researching other health funds... I found a health fund called "Latrobe" and they only have a 9 month waith period for obstetics!! Has anyone heard of this fund and what has been your experience with them?

Thank you everyone who have replied so far, you all have been a huge help!!

[Rachael]

Never heard of them as a health fund but there is a home loan lender called Latrobe.

I would try and stick with one of the big ones personally.

Medibank and MBF(I think this one) are best for pregnant related things.

[Sammilee]

Hiya Tracey,

I'm not too sure if you've sorted it all out by now but I thought that I would put my two cents worth in.

Have you looked into the Family Birth Centre at King Edward? I've not had any direct experience there myself (have to admit I'm going down the private path and will be going to SJOG Subi), but I know of someone who has used the centre and she was very happy with the whole experience.

You might want to check it out as it's all public and covered by Medicare (which means no big bills to pay!). Apparently you are 'assigned' two midwives right from the beginning who do all your antenatal visits, and when it comes to the delivery there should be at least one middie there that you know and who knows you. If all goes well you can go home within 24 hours after delivery, and then for the next few weeks you will be visited at home by a middie. Or if there are any probs during delivery KEMH is right next door so you will be transferred over there asap.

I hope that is of help. Check out KEMH's website for all the details.

Thanks,

Sam...

[kylesjb]

Go Public. Your ony there to have a baby and the public doctors and midwifes can do the same job as the private ones.....except you have to pay for the private use!
I went public and i am going public again, even though I have health insurance