Hi ladies ,
This is my first bub so I am really unsure about how things work in regards to rebates etc.
At my next ob appointment (23 weeks) I have to pay a $2000 planning fee. I only get $270 back from medicare. I also have full HBF cover but according to them this is not covered.
My question is why have I been forking out hundreds of dollars a month for private health insurance only to still be thousands of dollars out of pocket???
Am I having to pay this money to have the ob there as back up?
All of my girlfriends who went public didn't pay a cent. I feel ripped off. I understand that I have to pay my ob but I would have thought there would be some kind of rebate.
Has anyone else encountered this?
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30-05-2011 16:23 #1
30-05-2011 16:32 #2
The practice and management fee is to pay for the ob (insurance, birth attendance) and is not claimable on PHI who only cover you as an inpatient. $2k is a standard amount, I know some obs who charge up to $7k. No there is no fee in public but that is the level of care you get (bub delivered by whomever is available, shared room etc). I am reading a lot on here lately about people surprised at private ob fees, surely people look into this before booking in?
30-05-2011 16:33 #3Senior Member
- Join Date
- Nov 2008
Sorry to say but that's pretty standard
Your PHI usually only covers your hospital stay, and even then u usually fork out an excess, and then some extra if you need an anesthatist (?sp) or attending paediatrition for a c-section.
Your ob's management fee sounds pretty reasonable... I paid $3,700 at 21 weeks and got $400 back from Medicare, and have just paid $1700 which I will get nothing back from. I dont pay for any of my visits tho as they are included.
So as I said, it's pretty sucky but if it's important to you, worth it.
30-05-2011 16:33 #4Senior Member
- Join Date
- Dec 2009
its the planning and management fee, most obs charge it. once you paid it you should of then hit the medicare safety net so you should start getting more back from your drs appts (instead of the schedule 32 dollars it goes up to 80% of your out of pocket costs) (you will need to apply for the medicare safety net at medicare)
phi only covers you for in hospital stays, so when ever you see a specialst/ob you still need to pay for that and medicare will rebate a portion not the phi
i hope that makes sense, good luck with the rest of your pregnancy
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30-05-2011 16:37 #5
Very standard i'm afraid. I paid a $2k management fee for each child. One of the costs of going private. Private health only covers your hospital stay and delivery fee.
30-05-2011 16:44 #6
I've been paying for a higher level of PHI for years, to ensure I had full obstet cover when the time came, but I always knew that there would still be out of pocket costs as I work in the hospital industry. I'm only just over 7 weeks and the first thing I was told by the receptionist when I made an appointment with the obstetrician was that I would have to pay $2100 at 20wks and $930 at 32wks, I was a bit shocked that the fee was that high, especially given that although I'm garaunteed to see him for all of the antenatal visits, there can be no garauntee that he'll actually deliver the baby (I have seen soooo many situations even in private hospitals, where the midwives deliver and the dr only arrives later to check up on the patient! But babies come when they're ready not when the doc tells them too! LOL).
However my obstet includes all visits in his fees, and garauntees no out of pocket expenses for the hospital stay (he directly bills the PHI so you don't have to think about it).
If you're really not happy with paying for it though you can still cancel his services and go public, it's entirely up to you, but you'll have to decide quickly to get booked in somewhere!! Good luck with it!!!
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30-05-2011 16:52 #7In her eyes I can see a reflection of who I am and who I want to be.
- Join Date
- Jun 2010
Wow! We only paid $750 at 20 weeks for the pregnancy Management Fee.
30-05-2011 17:13 #8
My ob fee was $2500 and I got about $400 back from medicare. My ob was worth every cent. Health fund pays for a lot of the hospital. I got a letter from my health fund today saying that they paid $4000 so far on my behalf. The anesthesist was $750 and I have yet to get the pediatricians bill. Expensive yes, but would be a lot more without fund. The care I got was so good it was well worth it all.
30-05-2011 17:23 #9
My concern with going public was consistency of information. I thought we would get a different doctor and/or midwife every time we went in and as a first timer that made me really nervous. A few other things happened with the private Ob and that really put me off so we met with the staff at the local public and I said why I was hesitant to go public. As its turned out the senior Ob is to be my only doctor and has given me more information and ordered more tests than the private Ob even mentioned. The midwives have been so exceptionally helpful and comforting that I couldnt fault the public system if I tried. I've only been in there twice and they already know me by name. Also the public system have helped me out a lot with other aftercare services and referrals and there's a Children & Family Services agent there that has given me more information than I could have ever thought of.
To me, I'm getting a better quality of care and more diligent care than private. My private Ob seemed happy to take the appointments and the money but was not forthcoming with any information that I didnt ask for, and even then he was usually pushing me to the reception desk on the way out as we talked.
30-05-2011 17:29 #10
Yep pretty standard. My OB was $3k but I got $2k back (this was before
Medicare changed the rules on the rebate) but I'll still be using him again for number two (If he's still practicing then).
I didn't mind. Yes I was out of pocket for my OB but he was so worth it and considering I paid nothing for a $6000 hospital stay, I figured all up it wasn't so bad.
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