Private Patient/Hospital - Will I have to pay for an Epi?

[Mia78]

I have private health insurance, and am having my bub at the Epworth Freemasons in Melbourne (Private Hospital)....There info sheet states that epidurals have an out of pocket cost....this is the first I have heard of this, as I thought the labour and everything that it entailed would be covered by my health insurance....is anyone able to shed some light on this for me??

[~Emmylou~]

As a general rule you will have an out of pocket payment for an epidural in a private hospital. This can be as low as a few hundred, or over a thousand. There doesn't seem to be much consistency in what is charged as fees are up to the anaesthesist who gives it.

Private hospital births are not covered in full by your health insurance. You will have out of pocket fees for the pediatrician even for a normal, drug free vaginal birth because a ped is involved in every private hospital birth whether they are actually required or not. At a minimum, they will check the baby at birth and then every day while you are in hospital and again on discharge. And every time they set foot in your room, you get billed.

If you have an epidural there will be fees for that. If you have an emergency c/s, you will have anaesthesist fees and possibly fees for an assistant surgeon as well.

If your OB doesn't do no-gap, you may also have fees for him, as well any excess for the hospital.

My private hospital birth (on top cover) cost me about $1000 out of pocket just for the birth - OB, pediatrician, hospital excess - that's not including what was shelled out before the birth that wasn't rebated through medicare or private health (OB consult fees, and some tests).

[Opinionated]

I had $850 worth of out of pocket expenses for my private birth, and that is with no pain relief! Also, I had to pay on discharge, worth knowing that in advance.

[ImNotJustAnymum]

my epidural cost $345- it dependent on the anaethatist oncall...that was my only unexpected out of pocket cost- think he charged more but sent that part diectly to medicare.

same goes if you need c section- you will get bill for anaethatist and paediatrician-

[MountainGirl]

Yep.

Thankfully I have never needed one,.. but at RNSprivate in Sydney, and epidural is $1500 and a c.section starts at $3,000,..ontop of Ob and Hospital fees.

[Izy]

you normally shouldn't have an out of pocket for the epidural as such, but you will most likely have out of pockets from the aneasthatist that administers it.

Drugs administered are usually covered as part of the contract between your fund and the hospital, the same as the labour ward, the accomodation costs etc. (Once you have paid any excess/co-contribution that is)

The Dr's are always seperate though. The funds can't dictate how much Dr's charge, and this is why you tend to have out of pockets for services. It's also why your fund can't tell you what your out of pocket is, because it depends on the dr's

Each dr can charge what they like on a patient by patient basis too, so makes estimation a very tricky business.

[Solarberry]

So would the only reason you would consider private is because you get to pick your own OB?

[garfield13]

Yes, its part of the cost of the anthesist. I didnt have an epi, but the out of pocket would have roughly been about $850 for it

DD need the paed to come and see her a few times while we where there were mild jaundice, his bill was a couple of hundred, but after health insurance & medicare rebate, we were out of pocket $60 odd.

If you were to have a c-sect, a paed has to be present so you'll be out of pocket partly for that too.
Someone I know who went to the same hospy as me, had an epi during labour, ended up needing an emergency c-sec. After all rebates she was out of pocket around $1500

Any obs i know of just charge standard fee, regardless of what labour you have - not sure if thats always the case though


So would the only reason you would consider private is because you get to pick your own OB?
For me no, not the only reason. Being able to choose my own ob, being able to choose my own hospital which had a good reputation & having better options for my birth and excellent care afterwards, and also for the longer stay & private room

[Pina Colada]

My out of pocket costs for each private hospital birth was around $850, that is for the epidural (c-section), paed and hosptial excess.

[pkbub]

My only out of pocket expense was for the ped. (about $400) and we could claim a portion of that back on medicare. The epi/anesthetist did not cost me a thing.

So, depends on your PHI and hospy as well as the Dr's there...so many variables - why do they have to make it so confusing for us:hair:

[kylie87]

i think i paid about 500 for my anathesiest to give me the epidural and i paid a couple hundred to have the paeditricin come visit for approx 30sec each day. :rolleyes:

[Hannahsmumma]

Both of my births I had a $250 excess to my health care provider.
DD1 I had an epi - no costs.
DD1 the pead - no costs.

DD2 - I didn't have an epi this time around but I got a nice little $550 bill for the pead which I was not expecting.

Same peads office but different guys each time. Apparantly they choose whether to just take the medicare amount refunded or charge you more. I had about a $330 out of pocket after medicare for the pead with DD2.

A straight forward list of costs would be lovely :rolleyes: