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  1. #1
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    Default Private Insurance - Top Hospital Cover for Pregnancy - My findings and research

    Disclaimer; I don't work for any health insurance company, just completed a LOT of research which took lots of time and wanted to share my experience for your consideration, always read fund rules and check with your heath fund of choice!! ...notes eff. 8 AUG 15.

    Hey guys,

    My husband and I are planning to start conceiving in 4-5 months - our first child!
    (exciting times!)

    I have been researching all the Top Hospital Cover - Private Health Insurance (PHI) funds and happy to share my findings/tips and tricks for everyone, as I found it really time consuming to read all the fine print.

    1. Waiting Periods,

    Most are 12 months, except Teachers Health who offer 9 Months
    (TH are a closed members only fund, you need to be related to someone in the education industry to join or have affiliation).

    Must have Top Hosp. and it is recommended to have cover for 3-4 months before trying to conceive to be safe, incase bubs is born Premi etc. I wouldn't want to be caught out on this, if you can avoid it

    2. PHI Top Hospital - What this level of cover includes,
    This will ONLY cover your pregnancy in-hospital costs, when admitted as a patient. OB fees / Antenatal classes outside of this are not covered and it's worth looking at your extras for this cover for antenatal classes etc.

    3. Top Hospital - Single or Family Cover?
    As my husband is very fit and healthy, he has a basic level of hospital cover.
    We have decided to keep our covers separate and only I will get the upgrade.
    Also he earns more than I do, so Family Tax rates were less, I get more of a rebate on a single policy!!

    After ringing around all the health funds, going for a Single Policy was best, this was always the recommended way to keep costs down for healthy young couples, without children...

    I will get Single Top Hospital Cover & Basic Extras for myself
    (approx. $140 per month).

    Therefore, we're not paying inflated hospital rates for hubby, as he doesn't need Top Hosp. cover for pregnancy IVF etc.v

    4. Baby's cover from birth - Newborn policies; MAJOR WATCHPOINT!!!
    Make sure the fund you choose allows your newborn to be covered from Birth!!

    VERY IMPORTANT incase bubs needs hospital admission for complications, Intensive Care etc. All the funds have diff policies on this; so ask....I found;
    NIB, BUPA and Teachers Health all allow the baby to be covered from Birth on the Mother's policy, as long as you add the baby within 60 DAYS from birth and upgrade to Family/Single Parent cover.

    HCF - require the baby to be added onto the policy,
    for at least 3 months before Birth date on the policy!!

    5. Hospital Excess - Ask WHEN & how often do you have to pay this in a year - is it capped?
    This varies per health fund, this is especially important for those who may need IVF.
    This is generally payable for both Day Surgery and Overnight Surgery.

    Many IVF Treatments require some form of day surgery - if you need multiple of these - this excess could add up. I read in fund rules:

    NIB - You only pay 1 x excess for unlimited hospital admissions per calendar year
    BUPA - Excess is payable and capped like NIB,
    Payable once per calendar year - Day surgery and / or Overnight stays.

    HCF - don't charge an excess for day surgery/IVF procedures

    6. Check your choice of hospital is on their network hospital lists



    7. Level of Cover

    TOP Hospital is a Must for pregnancy cover.
    Some health funds offer a Mid-tier hospital cover, that will cover pregnancy birth in a private hospital, but NOT IVF. make sure you check depending on your requirement.

    I have chosen $500 excess as my work will pay $250 per annum towards this.

    Extras?

    I have decided to go with a Basic Extras Cover, as there was not a HUGE lot of coverage for pregnancy related items. Perhaps Physio and Antenatal Classes - but the jump in cost was not worth the 'extras' pay back amount when I did the research.

    I have decided on BUPA for now, although will probably switch to NIB closer to the New Year to take advantage of single excess payable per calendar year.

    OTHER NOTES:
    I researched the majors, HCF, NIB, BUPA, Teachers Health, Medibank
    TOTAL COST PER MONTH - $140

    Good luck everyone on your journey, I hope this helps,
    If anyone has thoughts on BUPA VS. NIB, would greatly appreciate this as I am looking to go from BUPA >> to > NIB...

    Thanksss!!!



    Disclaimer; I don't work for any health insurance company, just completed a LOT of research which took lots of time and wanted to share my experience for your consideration, always read fund rules and check with your heath fund of choice!! ...notes eff. 8 AUG 15.
    Last edited by maybeebaby; 09-08-2015 at 19:47. Reason: Correction in statement

  2. #2
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    Quote Originally Posted by maybeebaby View Post
    Disclaimer; I don't work for any health insurance company, just completed a LOT of research which took lots of time and wanted to share my experience for your consideration, always read fund rules and check with your heath fund of choice!! ...notes eff. 8 AUG 15.

    Hey guys,

    My husband and I are planning to start conceiving in 4-5 months - our first child!
    (exciting times!)

    I have been researching all the Top Hospital Cover - Private Health Insurance (PHI) funds and happy to share my findings/tips and tricks for everyone, as I found it really time consuming to read all the fine print.

    1. Waiting Periods,
    All 12 months, except Teachers Health who offer 9 Months
    (TH are a closed members only fund, you need to be related to someone in the education industry to join or have affiliation).

    Must have Top Hosp. cover 4 months before trying to conceive to be safe, incase bubs is born Premi.

    2. PHI Top Hospital - What this level of cover includes,
    This will ONLY cover your pregnancy in-hospital costs, when admitted as a patient. OB fees / Antenatal classes outside of this are not covered and it's worth looking at your extras for this cover for antenatal classes etc.

    3. Top Hospital - Single or Family Cover?
    As my husband is very fit and healthy, he has a basic level of hospital cover.
    We have decided to keep our covers separate and only I will get the upgrade.
    Also he earns more than I do, so Family Tax rates were less, I get more of a rebate on a single policy!!

    After ringing around all the health funds, going for a Single Policy was best, this was always the recommended way to keep costs down for healthy young couples, without children...

    I will get Single Top Hospital Cover & Basic Extras for myself
    (approx. $140 per month).

    Therefore, we're not paying inflated hospital rates for hubby, as he doesn't need Top Hosp. cover for pregnancy IVF etc.v

    4. Baby's cover from birth - Newborn policies; MAJOR WATCHPOINT!!!
    Make sure the fund you choose allows your newborn to be covered from Birth!!

    VERY IMPORTANT incase bubs needs hospital admission for complications, Intensive Care etc. All the funds have diff policies on this; so ask....I found;
    NIB, BUPA and Teachers Health all allow the baby to be covered from Birth on the Mother's policy, as long as you add the baby within 60 DAYS from birth and upgrade to Family/Single Parent cover.

    HCF - require the baby to be added onto the policy,
    for at least 3 months before Birth date on the policy!!

    5. Hospital Excess - Ask WHEN & how often do you have to pay this in a year - is it capped?
    This varies per health fund, this is especially important for those who may need IVF.
    This is generally payable for both Day Surgery and Overnight Surgery.

    Many IVF Treatments require some form of day surgery - if you need multiple of these - this excess could add up. I read in fund rules:

    NIB - You only pay 1 x excess for unlimited hospital admissions per calendar year
    BUPA - Excess is payable for every hospital admission, regardless day or overnight.
    6. Check your choice of hospital is on their network hospital lists



    7. Level of Cover

    TOP Hospital is a Must for pregnancy cover.
    Some health funds offer a Mid-tier hospital cover, that will cover pregnancy birth in a private hospital, but NOT IVF. make sure you check depending on your requirement.

    I have chosen $500 excess as my work will pay $250 per annum towards this.

    Extras?

    I have decided to go with a Basic Extras Cover, as there was not a HUGE lot of coverage for pregnancy related items. Perhaps Physio and Antenatal Classes - but the jump in cost was not worth the 'extras' pay back amount when I did the research.

    I have decided on BUPA for now, although will probably switch to NIB closer to the New Year to take advantage of single excess payable per calendar year.

    OTHER NOTES:
    I researched the majors, HCF, NIB, BUPA, Teachers Health, Medibank
    TOTAL COST PER MONTH - $140

    Good luck everyone on your journey, I hope this helps,
    If anyone has thoughts on BUPA VS. NIB, would greatly appreciate this as I am looking to go from BUPA >> to > NIB...

    Thanksss!!!



    Disclaimer; I don't work for any health insurance company, just completed a LOT of research which took lots of time and wanted to share my experience for your consideration, always read fund rules and check with your heath fund of choice!! ...notes eff. 8 AUG 15.
    Good information but not 100% accurate in all instances.
    We are with Bupa, and have birthed with them before, we are on mid range hospital. They cover some ivf at this level( not sure how much as we didn't need it),
    Excess is once per year per person. So if I went then my husband it's 2x excess, but if I went twice ( which I have done) it's 1x excess.

  3. The Following User Says Thank You to maternidade For This Useful Post:

    maybeebaby  (09-08-2015)

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    First point isn't true for some PHI.

    Medibank and BUPA will cover the birth even if it happens before the end of the 12 months period so long that your EDD was after the 12 month period.

    So you can start TTC in your first cycle 3 months after upgrading

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    Tamtam  (09-08-2015)

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    Medibank needs u to upgrade to family if you need bub to be covered. Bub can be added right after birth. I also look at single vs family. it turns out that it isn't a huge difference in term of monthly premium so we went straight to family plan. We didn't pick the top cover as it works out more expensive. I thought about Bupa because the annual limit for extra is combined. That means I can use hubby share. Also, I think the policy I looked at with Bupa also covers partner accommodation for birth. But the premium is so much more expensive.

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    ( reminder I'm with bupa) Good point we needed to change to family just before first bub was born so she could be covered if need be.
    Also look at policies surrounding kids after they are born.
    Bupa is gap free hospital for kids, not sure about the others.

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    maybeebaby  (09-08-2015)

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    With Bupa too and excess is capped at once per year per person

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    Thanks all! We found it really hard to sift through all the PHI policies, so many things to be awaree of, so just wanted to open discussion and help people with a few tips/questions to ask before signing up...



    Will check that excess policy and how many times you pay with Bupa again as they told me otherwise for all New policies.

    I should have mentioned, everyone's hospital policies will be different due to the products changing so regularly.

    I saw the Mid/Standard-Hospital cover, with Bupa, but it was only $3 cheaper per month than Top, and Top includes IVF services...Standard does not.

    I have only been reviewing the current products at the moment and what is open for New members to join.

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    Quote Originally Posted by maternidade View Post
    Good information but not 100% accurate in all instances.
    We are with Bupa, and have birthed with them before, we are on mid range hospital. They cover some ivf at this level( not sure how much as we didn't need it),
    Excess is once per year per person. So if I went then my husband it's 2x excess, but if I went twice ( which I have done) it's 1x excess.
    I'm with Bupa and went in to speak to them the other day about this... IVF is covered, but ONLY on top hospital cover. Otherwise all that's covered in your basic/mid hospital cover is pharmaceutical products which is a standard on most policies. They also told me there's a 12 month waiting period before you can claim on any IVF requirements (which is no good for us as we will need IVF sooner than that). Correct that excess is once per year per person on the policy.

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    maybeebaby  (09-08-2015)

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    So can you explain why you went with Bupa instead of TUH? My calculations out Bupa at $100 per month higher than Tuh...

  15. #10
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    Agh might be because we've been with them a few years...

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