Which Fund to go with?

[notmummyyet]

Hi, this is my first post, and so I apologise if I am asking it in the wrong section...

I was reading a few of the other threads in relation to PHI, and was hoping someone out there could give me some feedback on their experiences, and what they would do in my situation..

Bit of background (will try to be quick)
DH and I have been married 1 year, about 2 months ago we decided we were ready to plan for a baby. I upgraded my PHI to include obstetrics, and was told I have a 12 month wait, which I thought was standard for most PHI companies.

Anyway, I started to get worried in case we conceive before the waiting period is over... and called my Current Provider today and they said that there was no way they could cover me if I get pregnant earlier than the waiting period.

So I read on some of the forums here that Latrobe Health Services Private Health Insurance only have a 9 month waiting period for Pregnancy, which means if I fall pregnant, I will be covered, unlike my current Health insurance provider....So it will be peace of mind if I do fall pregnant straight away...(my first pregnancy so I'm making sure I'm covered for what i choose to go with) It doesn't cover some hospital admissions before the due date, but then neither would my current one, but if I choose to go private for the birth, at least it would be covered...

So I decided to go with Latrobe, and was happy with that decision. So I signed up, gave them my credit card details, all good....

But now, I called My Other Provider to cancel my cover and they are happy to match the waiting period with Latrobe! Argggh - what to do, who to join, who to stay with????

Has anyone on here had any experiences with Latrobe? I am sort of tempted to stay with my other provider, if they can match the waiting period, but am worried that they might re-neg on the deal and then I will be left high and dry. At least with Latrobe I know I am covered for the birth (AND they will also cover early delivery if my doctor gives a letter to say that my due date was after the 9 month waiting period)

thanks for your help!

[Jellyblush]

Hi there - I have been with Latrobe, for the same ttc reason, and as soon as I realised I wasn't going to need the 9 month period (i.e., ttc four months) I switched to Medibank Private.

Reasons - Latrobe has a more limited selection of hospitals - much more - they don't have the same level of convenience i.e. shops everywhere, online claiming, and also, I have read on here that some people with Latrobe found they were out of pocket for things other funds covered (try google search for latrobe maternity or something like that).

I'm pregnant now and really happy I switched - MP have been brilliant, really accessible, and they cover what I expected.

But you don't say who your old fund was - I guess a lot depends on how good they were!

All the best whatever you choose

[garfield13]

i am with Latrobe - due to the 9mth waiting period - but same as you when i caled to cancel with ahm they said they would match. I'd already signed up to Latrobe so i just kept the change.
I was admitted at 31wks for some minor issues and it was fully covered. Once i had dd everything was covered for the birth etc, not out of pocket at all. They dont have branches etc, but i've only had to make one claim a few mths ago via mail and it was very quick.
For anything else it was all done hosptals straight to Latrobe ad i never saw anything or had to do claim forms and it was all fully covered.
A couple of mths ago I started looking around to see if any other providers would cover any of the pre birth obs fees etc and also to see if there was cheaper cover, but as i found out no funds cover those. Latrobe was the cheapest except for one type with medibank, but it didnt cover 100% of the hospital costs, but as Latrobe fully covers the hospy costs its better for us to stay with them



I have read on here that some people with Latrobe found they were out of pocket for things other funds covered (try google search for latrobe maternity or something like that).

I'm pregnant now and really happy I switched - MP have been brilliant, really accessible, and they cover what I expected.

But you don't say who your old fund was - I guess a lot depends on how good they were!

All the best whatever you choose

What have MP covered pre birth? I was hunting around to see if there was a fund that would cover some of the pg m'ment etc (trying to get prepared due to the medicare changes next year) but was told after some research that none do :confused:

[Jellyblush]

MP don't cover any obs management fees per se - if only!

What they do have is Gapcover, where some obs have arranged with MP to charge a reduced management fee because you're with MP. They have a list of them on the website. Bet other funds do this too, or something similar. Can't remember if Latrobe does.

[m3l154]

notmummyyet - hi, I am ttc and I am planning to join lathrobe as well.. and I was wondering what was the other PHI who offer you to match with Latrobe? was it HBF?

and does Latrobe covers pre-birth OB cost?

[garfield13]

and does Latrobe covers pre-birth OB cost?


:no: nope, no health funds do. We're with Latrobe and with the changes that are possibly coming in Jan 2010 to the medicare rebates I looked around a couple of mths ago to try and find a health fund that would cover any of the pre birth costs and discovered none do.
I think a smart insurer should start covering even some of them & I think the extra business they would get would be well worth it:)

[Izy]

I think a smart insurer should start covering even some of them & I think the extra business they would get would be well worth it:)

There's legislation in place that prevents registered health funds from covering it, even if they wanted too.

[garfield13]

interesting,, i wonder why:confused:
though obs would probably just charge more anyway so we'd still be out ot pocket the same

[Izy]

The legislation came in with medicare (not sure it was the first or the second time) but it was originally there to help prevent segregation in care between private and public. That everyone should be able to access dr's equally.

These days it would make more sense for them to introduce ceilings on charges to combat segregation of care, but instead that joyful old piece of legislation is still there.

It means funds can't pay on medical outpatient services. Recent legislation allows for some outpatient services to be covered when they're shown to prevent hospitalisation... it's all messy.

[m3l154]

@garfield13 so did u go to public/private hosp? how much was ur total cost? how much did latrobe cover?

I sent an email to Latrobe to find out a list of 100%-covered-by-Latrobe. they dont hv such thing, while HBF I know they do have this list. So how should I choose my OB?

[garfield13]

@garfield13 so did u go to public/private hosp? how much was ur total cost? how much did latrobe cover?

I sent an email to Latrobe to find out a list of 100%-covered-by-Latrobe. they dont hv such thing, while HBF I know they do have this list. So how should I choose my OB?

We went to a private hospital. Latrobe covered all my hospital costs 100% & as I was on the top cover we had no excess, so I paid nothing. We've since dropped our cover to their lowest that includes pg so next time we will be covered 100% except have to pay a $500 excess.
That said, I didn't have an epi, if I would have had one I would have been out of pocket around $400-500 for it.
No health funds cover any of the pre birth obs fees. So it just depends on what the obs charges as to how much youll be out of pocket.
My ob charged $3257 all up and I was out of pocket around $1700-1800 after medicare rebates.

[Izy]

M3- it's often easier to start at the hospital end. Pick a hospital that you'd like to birth at and get a list from them who will deliver there.

From there you can call the Ob's and ask them about their availability and charges :thumbsup:

[m3l154]

M3- it's often easier to start at the hospital end. Pick a hospital that you'd like to birth at and get a list from them who will deliver there.

From there you can call the Ob's and ask them about their availability and charges :thumbsup:

I have picked the hospital, and it's in Lathrobe's list. does that mean that if I choose any OB who's delivering in there Latrobe will cover me for 100%?

[garfield13]

yep - except for the obs pre birth fees that health funds dont cover

[Izy]

May be worthwhile just double checking the Dr's Just in case (ask the secretary), cause dr's operate as a seperate entity to the hospital itself.