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Health insurance: What to inspect when you’re expecting

Pregnant woman sitting on couch with laptop looking at health insuranceThere are few things more exciting than starting a family; choosing a name, decorating the nursery, long heart-warming cuddles. On the flip-side, there are few things less exciting than reviewing hospital options for the birth; fine print, countless choices, endless appearances of terms such as ‘sub-limit’… it’s enough to put you off having kids in the first place!

But at the end of the day, like avoiding soft cheese and letting grandparents touch your pregnant belly, it’s something you just have to do. And what’s more, you need to get it organised before you even get pregnant.

A good place to start is having a chat with your partner about where you want to have your baby and what type of care you would like to receive. In short do you want to go public or private?

Medicare covers most costs related to having a baby in a public hospital, however Medicare does not give you access to private health insurance benefits such a private room or the ability to choose your hospital and your doctor.

And while having a healthy and happy baby is the number one priority for your birth, you may be attracted to the flexibility and benefits that come with the private health system. But what do you need to look out for? And most importantly, how do you make sure you have the most appropriate policy to suit your needs?

1. When to take out a policy

As a general rule, you need to hold a private health insurance policy that includes pregnancy for a minimum of 12 months before you can claim on hospital costs relating to child birth. Doing the maths, this means you need to take out pregnancy cover three or four months before falling pregnant. Many couples choose to take it out as soon as they start thinking about starting or extending a family, and this is a good rule of thumb.

2. What to do if you already have private health insurance

A common misconception among soon-to-be mothers and fathers is that their existing couple’s policy will cover them for pregnancy. However the reality is that most cheaper policies don’t cover pregnancy at all, while others may only cover you as a private patient in a public hospital. As such it pays to examine your existing policy and make the necessary upgrades well in advance.

3. Ensure your baby is insured

It is important to add your baby to your family policy (or upgrade to a family policy) before it is born so they will be covered immediately from birth. This means that in the event your baby requires immediate hospital care, such as admission to a special care nursery, they will be able to be treated as a private patient and not be transferred to a public hospital (away from mum) due to lack of cover.

4. What out of pocket costs can you expect to pay

Short answer is … it can vary. But a standard range is anywhere between $2000 and $10,000 depending on which hospital and obstetrician you choose. GP and obstetrician visits, scans and blood tests costs are additional expenses not covered by private health insurance but you will be able to claim some of the cost back on Medicare.

5. A good place to start

Don’t tarnish this special time of your life by stressing out over examining every provider and detail. A more balanced approach is to take a deep breath and make a single phone call to a private health insurance expert like iSelect who can answer all your questions and give you all the essential information you need to get the right policy. Then guess what? You’re done!

Private health insurance isn’t the most exciting thing about having a baby but it is one of the most important.

– written by Laura Crowden


This blog post is sponsored by iSelect

iSelect has helped almost a million Australian families find the right private health insurance policy, including plenty of nervous mums-to-be! And if you’ve already got your private health insurance sorted, iSelect can also help you with energy, broadband and more.

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