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  1. #1
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    Default Out of Pocket Costs When Going Private

    My wife is pregnant and we are considering going private as we have HBF private health insurance. We are torn between Dr. Al Tamimi in Attadale and Dr. Linda Wong in St. John Of God, Subiaco.

    Other than the pregnancy management fees, which I would appreciate if anybody can share the fees of the above two Obs, what other out of pocket costs are we talking about? (Anesthetic, etc??)

    My wife had a C-section on the first delivery which was overseas so this will be a C-section as well.

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    I haven't got the specific breakdown but estimate our total out of pocket expenses at about 5k for each of our children who were born by c-section.

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    Both my children were born by csection and out of pocket was under $2000. The Obs will have a schedule of fees and then you can call Medicare with provider numbers.

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    You'll have to pay your hospital excess, plus you could have out of pocket expenses for ultrasounds, blood tests, anaesthetist, paediatrician, lactation consultants, post-natal physiotherapist, pharmaceuticals and so on. It really depends on the obstetrician you choose- see if you can get an idea from them.

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    My out of pocket in inner Melbourne were $5kish (includes all OB appointments, scans, blood test, anesthetist, and post birth stay).

    I've cancelled my PHI for pregnancy then and will go public for next bub

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    pirlo  (22-04-2014)

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    I'm in Perth also, different Dr, and my OB fees were $2300.. With HBF I pay my gap and my hospital stay is then covered, along with CS, anaesthetist etc. Out of pocket expenses have been ultrasounds, blood tests etc, though HBF did cover some physio I've been taking and I'm about to find out about rebate on CSC recovery shorts etc (night as well ask and see). I knew going private was going to be $$ but I prefer the personal contact with one Dr and I can't fault the one I'm seeing so far (though I'm 32 weeks so there's still time

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    pirlo  (22-04-2014)

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    All up private for us in perth was about 5k. This included ob appointments throughout the pregnancy.. so u wouldnt be forking out 5k in one bill its spread throughout. I think at 20 weeks I had to pay ob abiut 1200 and at end the delivery fee was a bit more than that.. so the 2 bigger lump sums

  10. #8
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    Thanks for all those who replied. For the blood tests, arent those covered by medicare? Blood tests are also done when using the public system so are they completely free when going public? Same as with ultrasounds?

    We called the insurance and they confirmed that if the Dr and the Anesthetic are preferred providers then we would not be paying anything other than the excess. Now the hospital can not inform us if the anesthetic is covered or not since they dont know which one will be on call at delivery time. This is the only uncertainty I guess but it shouldn't cost too much ?

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    @pirlo
    don't assume anything in term of OOP cost. I was told the same by my PHI and my anesthetist was over $1k OOP.

    You can go to a bulk bill place for scans where it won't cost you anything but I doubt your OB will advise this, they usually have their preferred place and it's pricier as the scan is done by doctors (as opposed to technicians).

    Same for blood test. free if you go public not if you go private.

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    Quote Originally Posted by pirlo View Post
    Thanks for all those who replied. For the blood tests, arent those covered by medicare? Blood tests are also done when using the public system so are they completely free when going public? Same as with ultrasounds?

    We called the insurance and they confirmed that if the Dr and the Anesthetic are preferred providers then we would not be paying anything other than the excess. Now the hospital can not inform us if the anesthetic is covered or not since they dont know which one will be on call at delivery time. This is the only uncertainty I guess but it shouldn't cost too much ?
    You're not gauranteed that anesthetist unfortunatly. I paid about $300 out of pocket for my first anesthetist but DD was an emergency CS and I was $1200 out of pocket, and I definitely wasn't expecting it!

    Blood tests can be covered, just make sure you don't go to a SJOG lab. They charge above the medicare fee, and by a lot in some cases. I was out of pocket into the thousands for blood tests my daughter had while in NICU. Which unfortunatly can't be avoided once you're actually in hospital! And the safety net rebate doesn't apply for inpatient services which is something to remember. I thought I'd get heaps back for all mine and DDs tests but I got next to nothing

    In all, having an emergency CS with a prem baby plus pregnancy care I was out of pocket close to $10k going private.


 

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