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  1. #1
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    Default Private insurance, hospitals and doctors

    A big hello to the group!!

    Just wondering if someone can help up with a few queries. We are really confused with conflicting advise from people about doctors.

    The background is that we currently have very good private insurance and I want to take advantage of it by going to a private hospital. But, a couple of hospitals we called said that they only do deliveries for patients who are using their "panel" of doctors. So we are forced to pick a doctor based on the hospital we chose.

    Fine so far, but those doctors have a very hefty "registration fee" upwards of 2500 dollars, which is not covered by medicare nor by my private insurance. I feel kinda cheated because, inspite of payinig top premiums, I will end up spending this money. I could goto a government hospital but we don't have one close by and its not going to be as convenient. The nearest one is 40 minutes away.

    so our question to people here is, do we have to bite the bullet and pay that fee if we want to use a private hospital? Is there any way around it, or am I stuck with this only option?

    Any suggestions/responses will be greatly appreciated.

  2. #2
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    In a nutshell: yes you have to pay the fee if you want to go private.

    It is a management and planning fee that is payable at 20 weeks, you'll usually find they're in the order of $2000. They are not covered by your private health insurer but you do get a small medicare from rebate, maybe around $400?

    The fee is set by the obstetrician, not the hospital.

    The reason there are a limited number of obs to choose from for each hospital is because hospitals can't open their doors to just any doctors, they have affiliated doctors that 'have rights' at their hospital. So if you are choosing your hospital first then you will be limited to your doctor, OR if you want to choose a particular ob, then you will be limited by the hospitals he/she has rights to deliver at.

  3. #3
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    yes as pp said you will still have to pay that fee if you go private. having private cover does not mean it's entirely free unfortunately. You may also pay extra for the anethetist should you need one.

  4. #4
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    As above yes its the OB that charges the preg management fee. I also recieved about $400 from medicare and then more at tax time.
    You could discuss a reduced fee with your Dr but not sure how many reduce.

    Sent from my GT-I9507 using The Bub Hub mobile app

  5. #5
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    It is normal for doctors to have admitting rights to certain hospitals. Therefore your choice would be to choose a hospital if that is your preference and then choose an ob who has admitting rights there, or choose an ob, and then enquire which hospitals they have admitting rights at, and choose the hospital from there.
    Private health is for hospital admission only, therefore the pregnancy and management fee is an outpatient fee from your ob. There is a rebate from Medicare. If you have reached the threshold then you will receive a larger amount back. (Make sure you and your DH are registered for the Medicare threshold). It runs on a calendar year, so your tally will currently be back to zero.
    You should also check that the hospital you plan to have your baby at, is a partner with your health fund.

  6. #6
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    Yep all normal. Your medical insurance pays for your stay in hospital, it does not cover your management fee (paying for your ob's services). On top of that you will also have appointments which are usable $70-100, scans, anaesthetist ($400-1000) and the Paed's fees. All things to take into account!

    You'll get a Medicare rebate for the management fee but I believe it's capped now? And once you reach the threshold you'll get more back so best to save all your appointment receipts until you pay the management fee. After hitting the threshold I got $64 back each $80 appointment.
    Last edited by callmedragon22; 08-01-2014 at 10:39.

  7. #7
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    I paid out of pocket about $5000 to go private which inc the fees for ob appointments. Paed wheb ds was born and epi dural.


 

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