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  1. #1
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    Default Public vs Private

    Hi,
    We are a couple in late 30s, we had our reasons and circumstances that we decided not to have children till now, but we are thinking about trying for a baby this year.
    We have been doing a fair bit of research to determine whether we should sign up for a private health insurance or go public.
    We have, over the years, considered joining private insurance, especially when we were turning 30, but my husband has not been to hospital for over 10 years and I may have been once or twice a year tops, so we just stuck with Medicare. We've never had any problem not having private insurance.
    But now, with medicare levy, which we pay a bit over $2k, we are wondering if we should pay another $1000 to have a private insurance.
    My husband is leaning towards having private insurance, he thinks it's worth it in a long run, especially once we have kids and they need dental etc.
    But I have been reading quite a lot of reviews where people talk about all the extra "out of pocket" cost if you go with the private option, so the difference would be way way more than $1000 in the end.
    My other concern is that we don't particularly want to wait 3 months to make sure we'll be covered, so if we fall pregnant soon, there's a chance we won't be covered for the pregnancy/birth.
    I've come across a few posts about La Trobe health insurance has a 9 months waiting period instead of 12, but on their website, it says 12 months for pregnancy.
    Does anyone have insurance with them? Have they changed their policy?

    To me, apart from having "an insurance" in case of unforeseen accidents etc. we probably won't need general hospital or extras, so we'll be pretty much getting it to cover the pregnancy.
    If we could get some advice/experience/feedback on the overall cost if you had private health insurance or went public, if the private, which company etc. that would be great.

    We just haven't been able to figure out the rough cost if you go with;
    - public (just with medicare)
    - public hospital but bring own obstetrician
    - private - what would be the "out of pocket" cost


    If anyone has info for La Trobe, that would be great too. (we have sent an inquiry to them but have not heard from them yet)
    We live in Southern Down QLD, so we'll probably have it in Brisbane or Toowoomba.


    Thank you so much in advance!

  2. #2
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    If you go public with Medicare you pay nothing (apart from some hospitals where you need to pay for tv).

    Private you can end up paying extra for excesses, co-payments, and any gap payments on drs bills. Gap payments will vary depending on your dr and also what you have done (natural vs csection, no pain relief vs epidural). You may also has out of pocket costs for baby's paediatrician consults in hospital.

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    rar  (09-06-2014)

  4. #3
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    Hi Op!
    I went through this same dilemma but then found out I was pregnant. I already had private health but it didn't include Obstetrics. Also check it out but my understanding is that most private health funds have a 12 month wait for pregnancy and birth related services so don't bet on a 3 month wait!

    I'm going private - but private patient in a public hospital. I pay a contribution of $500 for the stay - no matter how long i'm in hospital and i'm not guaranteed a private room either. But what I do get is the ability to choose my obstetrician which was important to me. I also found out that any theatre fees, anaesthetic fees or epidural fees are covered in my private health so that's good.

    All up i'll pay about $2000 to have my baby as a private patient in a public hospital and will get a small amount of that back from medicare.

    Look around at what different private health funds offer you. Some public hospitals have very good reputations for birth and you might find you are very happy as a public patient.

    I did not enjoy the experience I had with the midwife who booked me into the hospital or the obstetrician I met at the hospital so went with my GP who is also an Ob and so laid back he's almost horizontal. That suited me as i've been a frantic mess! for visits to him, I just pay what I would normally pay to go to the Dr for a GP visit.

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    I went private with DD and am going private again with this bub (due in 6wks).

    For DD my out of pocket was about $2000 for the OB (after Medicare rebate of about $480), $500 excess for the hospital, a few hundred for the epidural and a consult fee for the paediatrician,

    Everyone is different, but for me it was 100% worth every cent. I had a great OB who knew me well, a private room which I really appreciated as a first time mum recovering from a long and difficult labour/delivery, my DH could stay with me every night as the room had a double bed and I just generally really enjoyed having the choices that private allows.

    Now that I'm having my second I am able to have the same OB, same paediatrician etc. I loved my private experience and am looking forward to doing it again

    For me, if there's anything worth spending money on it's things like health and having babies!

    We also did IVF for this baby so PHI helped with the day surgery fees for that too.

    My brother had a nasty sporting injury a while back that required surgery - without PHI he would have waited ages to get it fixed properly but instead was in surgery within days. These sorts of things freak me out now that I have kids so I would always want to be able to choose the best & quickest treatment option for them.

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    rar  (09-06-2014)

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    DS was preemie, so I had to give birth in a public hospital anyway. I was treated like a leper, and gotten ridden off as fast as they could. This is despite paying $2000 OB with a few hundred dollar medicare rebate. For DS to have a private paediatrician (they also couldn't transfer him fast enough), we were out of pocket for over $2000. We still had to pay for all the private consults with the sonographer which were $200 every time, plus blood work ect. Public with DD, everything was taken care of, no issues and we were left alone for the birth, much better and the nursing staff were way more considerate. Still, I would actually go with PHI, I just wouldn't use it for pregnancy.

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    rar  (09-06-2014)

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    You can get private health without obstetric cover.


    For pregnancy care if you have no medical problems, I would look into Toowoomba Birth Centre or My Midwives Toowoomba.


    The Birth Centre is part of Toowoomba Base and a continuity of care model with the hospital midwives - you see the same midwife for all of your pregnancy care and you call her when in labour and she comes in.


    My Midwives are a private midwifery group who bulk bill and work the same way - you see them for all of your antenatal care and they have practicing rights at Toowoomba so would come in and look after you as well.


    Basically the same as a private obstetrician, but midwifery care. Both would refer/consult with obstetric doctors if they any problems with pregnancy/birth developed.


    Also it's not the obstetrician who cares for you in labour, it's the hospital midwives. The doctor just might see you when you first come in, or even just wait until your pushing before they decide to come in.

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    rar  (09-06-2014)

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    Default Go private

    My first birth was in public because our cover did not kick in in time for obstetrics. My second was in private. There is an alarming difference in the level of care that you receive between the 2. Pregnant with no 3 and going private again. I would strongly suggest that if you can afford it, go private. The public system is fine if your young, healthy and having a totally uncomplicated birth. But if you develop any kind of complication or an age related risk factor you are far better private hands. My example: I'm 35, 2 previous non eventful births - this time I developed a short cervix at 20 weeks. I had stitches put in and am on bed rest for the remainder of the pregnancy. I am still in hospital to receive care and antibiotics. The nurse told me that had I have been public I would have had stitches in and home the next day with supply of antibiotics for 2 days... Scary given post op bleeding and the high risk

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    Just wanted to add, I think it depends a lot on your area - the midwifery practices mentioned above sound really good, so that could be a great option. In my area it's very hard to get into the midwife program at the local public hospital and I would not want to birth there outside of that program.

    In other areas there are some fantastic public facilities.

    Also, while I know the middies are the ones looking after me for the birth, I like to know who'll be making the decisions and performing any emergency procedures if things go wrong. I value that highly but understand that it's not as important for others.

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    rar  (09-06-2014)

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    Default thank you :)

    Thank you so much everyone! We really appreciate everyone's insights - very helpful and interesting.

    firstimemum34, sorry what I wrote may have been a little unclear about not wanting to wait for 3 month... I meant that those 12 months waiting period is usually depending on the due date, so if we fall pregnant at least 3 months after we've been with the cover, then we should be fine, but if it happens in this coming 3 months, then we won't be covered. But we don't necessarily want to wait 3 months before we start trying....is what I meant

    From reading all your advice, it sounds like those out of pocket cost are not as huge as I feared by reading those other posts, and we certainly don't see having a private insurance as waste of money, it was just we weren't sure what sort of cost those things were...so it really helps us to hear first-hand feedbacks.

    One thing that still concerns me is that we have also come across quite a bit of posts and articles that if something goes wrong at the private hospital, often times the patients are sent to public hospitals?

    But I am starting to understand (I think) that perhaps it is more to do with which hospital rather than public or private.
    My both sisters in law had all their babies in their hometown in NSW where they do get a private room, although public, and hubbies can stay and they pretty much get to know and have same people attending you throughout... but I also heard a friend of my friend who went public in Brisbane where she had to share with 6 people.

    I think we'll have to really narrow down what are most/more important factors for us and what we can or cannot budge on.
    All your advice and hearing experience are so helpful, so thanks again!

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    TheGooch  (08-06-2014)

  18. #10
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    Quote Originally Posted by rar View Post
    Thank you so much everyone! We really appreciate everyone's insights - very helpful and interesting.

    firstimemum34, sorry what I wrote may have been a little unclear about not wanting to wait for 3 month... I meant that those 12 months waiting period is usually depending on the due date, so if we fall pregnant at least 3 months after we've been with the cover, then we should be fine, but if it happens in this coming 3 months, then we won't be covered. But we don't necessarily want to wait 3 months before we start trying....is what I meant

    From reading all your advice, it sounds like those out of pocket cost are not as huge as I feared by reading those other posts, and we certainly don't see having a private insurance as waste of money, it was just we weren't sure what sort of cost those things were...so it really helps us to hear first-hand feedbacks.

    One thing that still concerns me is that we have also come across quite a bit of posts and articles that if something goes wrong at the private hospital, often times the patients are sent to public hospitals?

    But I am starting to understand (I think) that perhaps it is more to do with which hospital rather than public or private.
    My both sisters in law had all their babies in their hometown in NSW where they do get a private room, although public, and hubbies can stay and they pretty much get to know and have same people attending you throughout... but I also heard a friend of my friend who went public in Brisbane where she had to share with 6 people.

    I think we'll have to really narrow down what are most/more important factors for us and what we can or cannot budge on.
    All your advice and hearing experience are so helpful, so thanks again!

    Hahaha i wondered if I read that properly or not! I didn't want you to make the same mistake I did, get excited about 3 month waiting periods only to look harder and find out that wasn't to be.

    Ooh ooh ooh but... some of my friends had some luck with their health funds. They already had it, didn't have obstetrics, got pregnant before including obstetrics and went to their health funds and asked if they would waive the 12 months because they had been good customers. Their health fund said sure! I couldn't believe it! I always thought they were the equivalent of the devil!

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