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  1. #1
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    Default Due date 1 day over PHI waiting period - will we still be covered??

    We are looking at going as private patients in a public hospital, and our calculated due date is 21 April 2013 and our PHI 12 month waiting period finishes 20 April 2013 (we joined 20 April 2012) .... are we still covered, even if the baby came early? Is it as long as your doctor has your due date in writing that you will be covered?

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  2. #2
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    Not sure, perhaps a call to insurer without saying who you are?

  3. #3
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    I am sure you would be. We were with HCF and my due date was 2 weeks before 12 months and they just made a note and said we would be covered. We were long standing customers though.

  4. #4
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    I can't be sure but I'm going to say no. I investigated this question myself. We are with medibank. When I rang and asked they said no. We upgraded our OB cover and it's waiting period is up in October. Our bub is due December. We were worried about getting pregnant too close to waiting period date too! But you could ring and check.

  5. #5
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    Yes, they give a 3 week period as full term is 37-42weeks.

    Sent from my LG-P500 using BubHub

  6. #6
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    Different health funds have different policies - u should ring and check, that's ur safest option.

  7. #7
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    Not with hbf. They wouldn't cover her and she was 2-3 days over. Just a suggestion, fiddle with your first day of your last period?! Whatever due date your hospital ends up with is what the insurer will go on. Good luck

  8. #8
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    It generally goes by your birth date, not due date (I'm in the industry). So it really depends on when your bub arrives.

    Having said that, if it is only a matter of days, 'most' PHI providers in good faith will cover you. But best to have the conversation first so you don't end up with an expensive shock.

  9. #9
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    I had a similar problem with my 2nd pregnancy in May this year. My due date was 7 days after the waiting period finished. When I first fell pregnant I called my PHI fund (medibank) and I was told as long as the due date is after the waiting period then they would cover me. They said even if the baby was very premature then they might just ask for a letter of 'proof' from my OB that the baby was due after the waiting period. So I booked into a private hospital, found an OB etc. Because im such a worrier i called then again before I paid for my OB and again was reassured they would pay. However, a few weeks before I was due the hospital called me to ask if I still wanted to go ahead with the booking as medibank had told them if the baby comes early, they won't cover me. I freaked out!! Made about 10 phone calls to medibank and finally got put through to a supervisor who was able to give me a straight answer. They said that if the baby arrived before the waiting period I would have to pay the hospital fees (something like $8000 ) and then put in a claim to them which would then be assessed by an 'independent party' and they would decide whether or not to pay me back the money. When I told him about the previous conversations id had all he said was that the information was incorrect and also that there was no record of the conversations. Thankfully my baby arrived after the waiting period but it was pretty stressful! 

    I don't know who youre with but I found medibank to be incredibly frustrating to deal with and the information from the call centre staff conflicting. If you go ahead with it maybe ask them to send you something in writing. Medibank refused to do this for me. Good luck!!

  10. #10
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    Lie. Tell your OB you got your LMP date wrong and it was a day later than you originally said.

    Or get your OB to lie and adjust your date. If it means they get money in their pockets I'm pretty sure they'll do it.


 

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