Private Health Insurance for HomeBirths

[MilkOnTap]

I just thought I would create a PHI thread for those who are considering homebirth. So far in my travels there are only two PHI's who will cover home-based midwifery care. That's Australian Unity (AU) and Defence Health (DH).

AU will cover up to $3K of the cost. I'm not sure if this is per financial year - or per pregnancy. It's a case-by-case basis however, and you need to write them a letter requesting a benefit quote.

DH will cover $1K for confinement and delivery and $500 for pre-natal care. These are 'per financial year' based prices, so if your pregnant over two financial years, you can claim the $500 twice for a total claim of $2K. If your midwife is also a childbirth instructor you can claim up to $120 per financial year for physiotherapy/birth education.

1 April 08, a lot changed in the PHI world in regards to homebirth benefits. I'm not sure exactly what these changes were - but it meant that most funds either cut out their homebirth benefits altogether, or slashed the benefit to some silly amount like $200 benefit. AU and DH were the only insurers who kept their benefits and both funds actually increased the benefits by 100%-200%.

I'm sure there are other funds out there who must do SOMETHING... Perhaps we can collate what we know here in order to make it easier for homebirthers who are looking at PHI :)

[Thermolicious]

They don't do anything, I am with SGIO and they wont cover it at all as my home is not a medical facility (derr!) I can't believe I pay $260 a month for private insurance, I could go to a private hospital and have my baby for free (very high level of cover that they no longer offer to new clients) but they wont cover me to have my baby at home :dizzy:

:geek::geek::geek:

[MilkOnTap]

Yeah - its so wrong... Oh - and of course with AU and DH there are terms and conditions that if a doctor is required to intervene then all payments will be forfeited.

[bubs_and_us]

HBF cancelled their homebirth benefit in april this year, but i have been in contact with the policy manager... he assures me "they are working towards drafting a new policy in regards to homebirth in WA"

i still have to follow it up though.

[Bron]

HBF cancelled their homebirth benefit in april this year, but i have been in contact with the policy manager... he assures me "they are working towards drafting a new policy in regards to homebirth in WA"

i still have to follow it up though.

Of course, in WA, you can do it for free through the Community Midwifery Program, if you're eligible and you're lucky enough to book in early enough.

But yes, it is annoying that many private health funds got rid of it this year. I was under the impression it was due to some change in law? Maybe?

[MilkOnTap]

So far in my travels there are only two PHI's who will cover home-based midwifery care. That's Australian Unity (AU) and Defence Health (DH)

Oh - I forgot to mention. There are clauses involved in both benefits stating that if a doctor is required to intervene in the delivery then all benefits are forfeited. They wont pay out if you have to transfer.

Bron - Yes there was something that happened on 1st of April 08 but I have no idea exactly 'what' it was... I'm trying to work it out. IM's cant get insurance - so it could not have been changes in any insurance legislation. I'm really stumped...

[bubs_and_us]

a law changed which meant their definition of 'hospital services' had to be redefined. homebirth fell outside the paramaters of this new definition, so under hospital services, they are unable to pay for homebirth.... does that make any sense at all!?

and yes, i know we can get the CMP, BUT, HBF would've paid for other stuff as well, such as the birth pool, medical supplies, extra towels etc..... and only low risk women are usually accepted onto the CMP....

and anyway, i pay bloody good money for PHI, and neve make a claim! the 1 time i want to, and i cant.... i dont know what the issue is - i'm saving them thousands by birthing at home instead of a private hospital!!!

[Thermolicious]

a law changed which meant their definition of 'hospital services' had to be redefined. homebirth fell outside the paramaters of this new definition, so under hospital services, they are unable to pay for homebirth.... does that make any sense at all!?

and yes, i know we can get the CMP, BUT, HBF would've paid for other stuff as well, such as the birth pool, medical supplies, extra towels etc..... and only low risk women are usually accepted onto the CMP....

and anyway, i pay bloody good money for PHI, and neve make a claim! the 1 time i want to, and i cant.... i dont know what the issue is - i'm saving them thousands by birthing at home instead of a private hospital!!!

:iagree: $260 a month down the drain it feels like hey! :thumbsdown:

Do they really cover some equipment still, or did they used too :detective:?

[bubs_and_us]

they dont cover anything homebirth related anymore

[MamaLlama]

Well you are if nothing goes wrong. That's the point isn't it for them which is not surprising. They can assess the risk of a bad hospital experience, an unlucky event, a bad Dr even... but they can't assess the risk of someone's home unless they have some kind of inspection system like home offices for professionals (eg lawyers home office will be paid for by employer only if it complies with OHS standards). It would be very expensive to inspect every home prior to a homebirth.

I guess I don't know why you'd get extra towels covered. I ruined a ton of towels postpartum from absolutely horrendous bleeding...no private insurance would pay for that so why would anyone else get it? Just because of where they gave birth? I don't get it.

I'm not against homebirth. But it IS outside the medical system so it really isn't reasonable to expect it to be inside the medical insurance system.

[shed]

I'm not against homebirth. But it IS outside the medical system so it really isn't reasonable to expect it to be inside the medical insurance system.

Its only outside the medical system because they say it is.

It manages to be inside the medical system in other countries with good results.

GP's used to do housecalls back in the day and nobody questioned that.

[doulacara]

a law changed which meant their definition of 'hospital services' had to be redefined. homebirth fell outside the paramaters of this new definition, so under hospital services, they are unable to pay for homebirth.... does that make any sense at all!?

It's a load of codswallop - the PHI's have intepreted the law that way, but that is not what was intended. They could fund it if they wanted to, but they choose not to.


Well you are if nothing goes wrong. That's the point isn't it for them which is not surprising. They can assess the risk of a bad hospital experience, an unlucky event, a bad Dr even... but they can't assess the risk of someone's home.

I am not sure what you mean by this. If there is a bad outcome at a private hospital, it would be the Ob and hospital who would be liable. Not the insurer. Same goes for homebirth.

As for homebirth being outside the medical system. How is a university educated midwife, whose training includes practical experience working in hospital, further outside the medical system than a chiropractor? PHI covers visits to a chiropractor.

[MamaLlama]

I am not sure what you mean by this. If there is a bad outcome at a private hospital, it would be the Ob and hospital who would be liable. Not the insurer. Same goes for homebirth.

As for homebirth being outside the medical system. How is a university educated midwife, whose training includes practical experience working in hospital, further outside the medical system than a chiropractor? PHI covers visits to a chiropractor.

Fair point. But I think chiropractors are quacks who ARE outside the medical system and its a huge rort that they get insurance coverage, so I would consider in an insult to any midwife to be compared to that.

What I mean is it is not in a hospital or other equipped medical facility, so it makes total sense to me to not be covered. I would rather see all dentists covered, they are closer to medical than midwives. Sorry but nurses are just not doctors. When they are I will clamour for them to be covered.

I guess I don't see what's so expensive. You aren't paying for a hospital bed, or expensive equipment, or round the clock nursing, or emergency on call services or anaesthetists or OBs... you already own/rent your location you're just hiring a nurse to come and help. She just can't be that expensive imho. Compare her to the gap payments on all the other things for a hospital birth.

What costs do you want covered? Sorry I don't get why they should restock your laundry with towels. Sorry.
Best of luck!