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  1. #1
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    Default Private patient at public hospital

    Hi, ladies, someone has a similar post on this thread but I have few specific questions. I hope you ladies can help me out.

    I am currently pregnant (just under 12w) and under an OB care from day 1 of BFP due to previous history of early miscarriages. We like the OB and would have loved to stay with him but we really can't afford to go private in the end. IVF has used up our available fund (if it would have worked the first round, we could have gone priv without a problem).

    Despite with the highest coverage with medibank, my good friend spent ~$10k OOP for the entire pregnancy by going private. I know people spent less but you just never know what can go wrong. Like needing emergency c-section, bub needs to be hospitalized, outrageous aneathestist fee etc. Am i wrong about the cost? Is it really this expensive?

    My GP told me that the public hospital doesnt take me on until 20w. Since I am weaning off some drugs, OB is happy to continue the care until 20w. Will i be charged a management fee if i wait until then to leave?

    I do enjoy the OB care. If I go to public hospital as a private patient, can I see an OB? Do I have to pay the gap for delivery, anaesthetic etc? I know that if i go on public fully, everything will be covered.

    BTW, I am in WA. Thanks.

  2. #2
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    I can only tell you my experiences - It's probably going to vary on the hospitals and systems. Here, if you go public then you get who you are given - you would have every right to request the head obstetrician for every visit due to your immune issues. However, I only went public with our babies up until I developed immune issues. After that I found that I had to go private to get the extra scans, care, etc. I did however choose an ob that could deliver at public or private just in case bubs came early as our private only takes births from 34 weeks. The management fee was due at 20 weeks (you would have to ask your ob if/when you will be billed for management fee). Up until then it was just an appt fee. I started seeing the ob early to ensure changeover from my fs. Management fee was $2600 (I think about $400 was refundable from medicare) - once this was paid, we reached the threshold for medicare safety net thing and then only had to pay around $10-$15 per appt. Other cost was for the paed for the baby check when back on ward. Sometimes there can also be a gap fee for the anaethetist, but we were never billed by the one that we had. We've found out of 3 ops at the private hospital that we've only been billed for a gap by one anaethetist - so it really does depend on who you get. Do you have private health insurance? Your ob may also be able to do a payment plan - asking never hurts. If you have a great public hospital though with really good obstetricians, then that may also be an option, but they were quite slack in my care with all my babies.

  3. #3
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    What about seeing an obstetric gp? They're usually less expensive and you see the same dr and can deliver private or public depending where you live and where they deliver

  4. #4
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    My OB appt isn't really that expensive (~$40 OOP) as compared to the gap ($25) I pay for my GP visit each time. The plus is that i get to see bub each of my OB appt (worth the extra). None of the hospitals my OB affiliated with are close to home. His clinic is within walking distance to one of them. The only reason i went to see him is due to needing him to administer immune drugs. Otherwise, it is quite a long drive -- each visit took us 40 mins to drive through the traffic from work. From home, it would be 50 mins drive.

    What's GP OB? Is it a shared care?

    Can i choose the public hospital if i go private? I ask because one of my friends delivered at a public hospital that she isn't zoned in. I live in the same postcode as her. That public hospital is certainly closer than the one i am zoned in. and good. I don't want to ask her since we are not ready to let everyone knows about the pregnancy. However, my GP did mention about this public hospital despite me not in the zone.

    @littleTed: yes, I have priv insurance. However, if i have to pay $10k OOP in the end, I would rather not to use it. I have been using them to cover my hospital admission each time I need the infusion. So they are forking out more than I am paying them monthly atm. Overall, we are still a loser since we have been with them for over 4yrs now and they didn't pay out our first IVF when we didn't have medicare cover.
    Last edited by bbhope; 02-04-2015 at 23:46.

  5. #5
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    I'm fuzzy on some of the details and don't have the answer to all your questions, but from my experience, this is what I know.

    The management fee for OB is usually paid after the 20 week mark (at least it was for us). So if you leave at 20 weeks, you shouldn't have to pay the management fee. The management fee is supposed to compensate for the fact that they may need to be available for your delivery at any time (or so they say...). If you're switching to a public hospital care, then the OB will not be there for delivery so they shouldn't charge a management fee.

    In terms of the costs, $10K is really high! We had an expensive OB and we paid out of pocket about $4000. With our private health, everything from the time we were admitted to hospital was covered. That would have included anything that could have gone wrong with baby (I checked). It included the anaesthetics, drugs, tests for baby... basically we did not see a bill from the actual hospital or any care involved in the delivery and post natal care. With really serious cases, anyway, most private hospitals transfer you to whatever the specialised pre-natal hospital is in your area, which would be a public hospital.

    Every OB is different and charges differently. The fees were partially covered by Medicare, and we very quickly hit that threshold (whatever it's called) which meant that medicare then covered a higher percentage of the fees so basically after the management fee, the costs for each appointment reduced significantly. Our management fee was $2,800, so that was the biggest cost by far.

    I'm not exactly sure about being a private patient at a public hospital. You should speak to the hospital you're considering about that. You should also check with your OB about whether or not they deliver at public hospitals and if so, which one. For example, my OB delivered at 2 private and one public hospital, so if you wanted to be a private patient at that public hospital, you could be under her care. But you'd still have to pay all of her fees, which are not covered by insurance so really you'd be in the same position. In our case, our OB would recommend the public hospital for high risk patients (because it's the specialist pre-natal neonatal etc hospital in the area) or any patient that goes into premature labour.

    That's just how my OB operated. Others may do differently. I don't know.

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    My situation is different, I'm a repeat customer with my oby ( and at his old rate so I get it significantly cheaper) but all up including scans ( that I would have had to pay for even as public) we are spending less than 2k this pregnancy.
    -Scans will be $400
    -Bloods free
    -Pmf $1000 ( usually charges $2500 first time visitors) with Medicare rebate around $250 ( so only costs be $750)
    - hospital excess $250
    - then I'm budgeting $600 for incidental ie pead, if I need epi etc ( it wasn't that high last time but just want to be safe)

    To me part of the whole benefit of going private is obviously the care during pregnancy ( having someone on call 24/7, appointments when it suits you and on time) but the stay after.
    For $250 ( my hospital excess) I get a minimum of 4 nights in a luxury private room ( and my own bathroom) with around the clock support and delicious meals provided ( and a snack menu ) . Part of the appeal of private is the care, support and sanctuary after

  7. #7
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    Thanks ladies.
    @TeaM: so you appromixate OOP is $4000+$2800 = $6800?
    @maternidade: Is there a separated delivery fee? A friend of mine saying OB delivery fee is different than the management fee.

    Ya, if I still have to pay the gap (OOP) as a priv patient at a public hospital, I would just go in as a public patient. There is no saving here. So far, i have spent $2800 OOP since BFP. The most expensive cost is the immune treatment, which doesn't attract medicare rebate. You can see why I'm keen to go onto the public system once the "dangerous period" is over.

  8. #8
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    Default Private patient at public hospital

    Quote Originally Posted by bbhope View Post
    Thanks ladies.
    @TeaM: so you appromixate OOP is $4000+$2800 = $6800?
    @maternidade: Is there a separated delivery fee? A friend of mine saying OB delivery fee is different than the management fee.

    Ya, if I still have to pay the gap (OOP) as a priv patient at a public hospital, I would just go in as a public patient. There is no saving here. So far, i have spent $2800 OOP since BFP. The most expensive cost is the immune treatment, which doesn't attract medicare rebate. You can see why I'm keen to go onto the public system once the "dangerous period" is over.
    The OB delivery fee is separate to the management fee. Usually your PHI covers that as its in hospital. My OB charges $1.5K for a vb and $2.5k for a Cs if you don't have PHI. Then you need to add on anaesthesia paed etc. then your hospital costs.

    But with my PHI and Medicare I'm OOP 2200 (management fee -400$ from Medicare), $65 per appt (get most back from Medicare) and that's it. I don't pay for anything else other than paed after birth.
    Last edited by Rose&Aurelia&Hannah; 03-04-2015 at 12:22.

  9. #9
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    Quote Originally Posted by bbhope View Post
    Thanks ladies.
    @TeaM: so you appromixate OOP is $4000+$2800 = $6800?
    @maternidade: Is there a separated delivery fee? A friend of mine saying OB delivery fee is different than the management fee.

    Ya, if I still have to pay the gap (OOP) as a priv patient at a public hospital, I would just go in as a public patient. There is no saving here. So far, i have spent $2800 OOP since BFP. The most expensive cost is the immune treatment, which doesn't attract medicare rebate. You can see why I'm keen to go onto the public system once the "dangerous period" is over.
    Think it's $4000 all up with $2800 being management fee.

    $10k is really unusual and over the top.

  10. #10
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    I started out private but ended up delivering in a public hospital due to a high risk pregnancy and prem delivery. I had already paid my OB management fee so can't answer that part. However as a private pt for my C-Section it was all covered by my insurance, they tell you there are no gaps for any of the inpatient costs including for bubs (he was a private pt in the NICU) but you do have to send off bills to your insurance later and forward the cheques back to the hospital. I am in WA and all the public hospitals have this same policy.


 

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