Fee's from Ob's and Medicare/Private Health fund

[Vron]

Hi
I'm going to have my first OB appt next monday and I'm going to be paying about $1000 for the ob's services. Can I claim any of that money with medicare or with my private health fund (MBF)

[sugar n spice]

You should be able to claim a large amount or all of the ob back with your private health insurance. phone your local health insurance and tell them the name of your ob as some are fully covered and others have a gap, they can tell you what your likely to be covered for and recieve. mine you this is only if your health insurance covers maternity otherwise you wont get anything back. A word of advice if you go private and your child has to go into a special care nursery or something (mine went in for 1/2 day) you will have to pay for that as a new child is not covered until they are added to your insurance though someone told me afterwords that you can pay some amount to cover this if it does happen so discuss that aswell.
good luck:D

[pegasus]

All ob's I've come across, their outpatient services are medicare covered (with a payable gap), and only their inpatient fees are recoverable by private health. When I looked at getting private health - we looked at this in great depth and didn't find any fund which covers any outpatient (prior to admission) fees. There is also a lumpsum fee which is payable up front (somewhere round the 20week mark) which isn't covered by medicare or private health.

This has been the same for both my OB's (one in the NT and one in WA) and of OB's of friends I've talked to.

[Mumtobe25]

My OBs pregnancy mamgement fee (or whatever they call it) was about $1400 and I got back about $760 from medicare.

Bron

[zenifa]

My experience was that I had to pay for my OB fees, the monthly checkups $50 (til I got closer to EDD then they were fortnightly and then weekly), the 20 week ultrasound $200 and the management fee $900 and I could only claim through medicare, not my private health fund. I received back 50% of the monthly check up fees and ultrasound, so that once I reached my threshold with medicare (by paying that management fee), in the second half of my pregnancy I got back $45 from a $50 appt from medicare.

In terms of private health I had to pay an excess of $200 but everything else was covered by private health fund, as I had a caesar - anaesthetist, paediatrician etc. My fund told me that they would cover my baby instantly if there was a need for special care nursery etc, but only for the first six weeks, after that I had to pay to add DD for full cover.

After the birth I did see my OB and the paed for 6 weekly follow up appts and again I could claim these from medicare only.

[MotherOfPearl]

Hi Vron,

My ob sent out a schedule of her fees and when they need to be paid. We're paying about the same as you, with some claimable from Medicare. There is also the Medicare Safety Net which covers 80% of your out of pocket expenses in a calendar year over $1000 for most families but lower for some. This is including specialists fee gaps, ultrasound gaps, gp gaps etc. Apparently the new rule is 2/3 of preganacy care fee- paid to ob- is now claimable towards the safety net. As far as I'm aware your visits to your ob in their rooms are not covered by health funds, it's no different to visiting your gp really and they won't cover that.


You need to register for the safety net, this can be done through www.hic.gov.au and on the Medicare site. Hope this helps and doesn't confuse you even more! I've got all this info from my ob's info sheet which is rather nice to have things explained like this.

K