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  1. #11
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    Default PHI confusion!?

    Quote Originally Posted by Grebbeci View Post
    Sorry but a private room post birth or if you are admitted as an ante natal patient isn't guaranteed. If there is one available you will get it but most private hospitals do have some shared rooms and you may get one of them. If you read the standard information sheets from your health insurer it will state that it doesn't guarantee a private room.

    Sent from my GT-I9100 using BubHub
    Actually mine does guarantee a private room, so all policies are different. If they can't physically provide a private room, I get cash back.

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  3. #12
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    Quote Originally Posted by Pesca77 View Post
    Actually mine does guarantee a private room, so all policies are different. If they can't physically provide a private room, I get cash back.
    Yep I'm with MBP and my PDS says I get a private room, be that a shared one they don't share or a purpose built spare room. It really depends on the level of cover you have.

    We have top hospital, excluding what they call 'age related ailments', so no knee replacements due to degeneration etc, we will upgrade that later. Our extras is 85%, so we get 85% back of any extras claim we make.

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  5. #13
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    Default PHI confusion!?

    Quote Originally Posted by CottonCandy View Post
    Be aware also that if you go private you will still be out of pocket a substantial amount.
    We were about $5-6k out of pocket, as PHI doesn't cover anything except the hospital stay.
    Keep in mind expenses such as
    initial GP appts- two for blood tests
    OB appts -I had about 10 at $130 each
    scans -I had 4, dating, NT, 20wk and growth at 32, they were about $300 each
    OB management fee, $4k
    PHI excess- $500

    Then afterwards a Paediatric bill for a checkup for bub before discharge (standard practice at our hospy?) of $200, don't know if I can claim any of this yet.

    All the above can be claimed through Medicare (except excess), but it is minimal you get back. Once you hit the safety net it helps, but even then you don't get much of the management fee.
    !
    This just goes to show how different all OB's can be - I feel for your back pocket

    My OB charged a $4,500 mgt fee (about $460 back from Medicare), but the his appointments were only $50, of which I got $43 back from Medicare. My scans were $230 and I got $85 back from Medicare. I don't have an excess so was fine there.

    Oh also FYI - yes you can claim the Pead visit from Medicare too

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  7. #14
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    Just adding in that I have PHI and my ob doesn't charge any management fee, everything at hospital is covered (all ob fees, anaesthetist etc) and the babies will be added immediately to our cover and be covered if they need any extra care. All I pay is gap on scans (what medicare doesn't cover) and $72 per visit to my ob.

    Note: I live in a country area and there is only one ob in our district so perhaps that's why he doesn't bump up prices.

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  9. #15
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    I have my insurance through la trobe health. It covers maternity and is relatively cheep (sorry I cant tell you exact).I only have hospital cover and find that that's good enough at the moment. My ob charged $3500 management fee ($400 ish back from Medicare) that also covers her consultation fees after 23 weeks. Hospital excess is $500, epidural can be anything from $500-$1200 (claimable through Phi and Medicare, but not much). Ive heard of c sections costing $5000 though (unvarified)!

    Just make sure you have family cover or bubs wont be covered if s/he needs admitting.


    Lastly, please do not rely on ambulance cover through your Phi. It is unbeleivably inadequate and oftern doesn't cover pre existing conditions and non emergency transport (which you will want if bubs needs transporting to a closer hospital after recovering from an emergency). Also be aware that there is a three month waiting period for these two things through ambulance Victoria, so get in early and make sure you add babies name to your policy withing 30 days of birth or s/he will have to sit the waiting period.
    Last edited by mousky; 11-01-2013 at 10:43.

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  11. #16
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    Yep our OB costs are significantly different to PPs as well.

    Mngmt fee $1600 with $276 back from medicare
    OB visit $95 with $43 back from medicare
    Midwife visit $65 with $38 back from medicare
    Scans - Dating $65, NT $195, Morph $250 (can't remember the rebates)
    Sizing scan - no charge done in house at OB

    We have a once per year excess of $500 for hospital and bub is on cover from moment of birth so anything in the hospital is covered.

    ETA: of the 3 OBs we have that operate from the local private hospital, ours is the most expensive, but we live in NQ
    Last edited by PR2bMum; 11-01-2013 at 10:52.

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  13. #17
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    Thank you so much!

    Well I am getting pretty set on MBP top hospital and I may add an extras cover (i didn't look into them to much).

    I am going to select the one without excess. I think if I have the option to choose a good doctor in a hospital that only has single rooms I will. My fear of 'get it out get it out' has dissipated!

    I understand having a baby costs money. I am just trying to limit how much it costs if something goes wrong! I also understand an expect there to be a gap between whats covered and what it actually costs and if thats like 5-10k so be it. I have wanted children my entire life and can not imagine money better spent.

    I was told by a person on the phone at MBP that if I get pregnant before the 12months waiting period it would be considered a 'preexisting condition'. I might need to call again and really pressure them to tell me otherwise. If I can not worry about getting pregnant after my wedding (its not like a ttc straight away we are having a few months of newly wed fun before our honeymoon over Dec/Jan) and be covered then that would be a massive weight off my shoulders.

    Whoever else reads, please keep posting and giving stories, I may miss something and I need all the advice I can get and share.
    Last edited by sprinkelle; 11-01-2013 at 13:53.

  14. #18
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    Just wondering what sort of limitations etc. they place on you if it is a pre existing condition. I always just thought that you had to just wait the initial 12 months waiting period from start of policy. Is it different for obstetrics?

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  16. #19
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    Default PHI confusion!?

    Quote Originally Posted by mousky View Post
    I have my insurance through la trobe health. It covers maternity and is relatively cheep (sorry I cant tell you exact).I only have hospital cover and find that that's good enough at the moment. My ob charged $3500 management fee ($400 ish back from Medicare) that also covers her consultation fees after 23 weeks. Hospital excess is $500, epidural can be anything from $500-$1200 (claimable through Phi and Medicare, but not much). Ive heard of c sections costing $5000 though (unvarified)!

    Just make sure you have family cover or bubs wont be covered if s/he needs admitting.


    Lastly, please do not rely on ambulance cover through your Phi. It is unbeleivably inadequate and oftern doesn't cover pre existing conditions and non emergency transport (which you will want if bubs needs transporting to a closer hospital after recovering from an emergency). Also be aware that there is a three month waiting period for these two things through ambulance Victoria, so get in early and make sure you add babies name to your policy withing 30 days of birth or s/he will have to sit the waiting period.
    My epidural was only $250 which I got 80% back from Medicare and didn't pay any extra having a c-section. I also had singles cover through MBP (mid hospital) which covered obstetrics and bub if he needed special care, after he was born I had 60 days to put him onto my cover and we then changed over to a family after he was born.

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  18. #20
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    That's why I love QLD, you don't need ambulance cover in your pvt health, it's paid for in electricity bills and EVERYONE is AUTOMATICALLY covered.

  19. The Following 2 Users Say Thank You to PR2bMum For This Useful Post:

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