DH and I upgraded our PH insurance in July this year with the view to TTC next year. There is a 12 month waiting period on the pregnancy and birth services.
SO what I am wondering is, do we need to wait until the 12 month mark to have our FIRST consult with a private OB (6-10 weeks), or is it just the due date that should be (well past) the 12 month mark?
How to OBs generally bill - is it for each consult or one bill at the end?
Just trying to figure out when we're safe to start trying - our first happened first go, so although it might take time, it might not...
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03-12-2013 22:32 #1
Waiting period -how long before TTC?
04-12-2013 00:00 #2
My PHI doesn't rebate anything until the birth, so that would be a 3 month wait. I would double check with them what happens if you go into labour early in that scenario also check that they would consider you "covered" so that you could at least book an OB/hospital. My OB bills $130 at each consultation and then $2600 "management fee" for your first consult after 20 weeks (then back to $130 per visit, thank goodness!). Again, different OBs charge differently so you'd have to look around. As for the hospital visit, I'll pay $200 excess, $330 for DH to board three nights and if I end up having a c-section (heaven forbid!), I'll have to pay whatever out of pocket for the anaesthesiologist (but in that case, DH can't board so if it's less than $330 it's not too bad!). I also have to pay out of pocket to have a paediatrician look over bub after the birth.
Even though my PHI doesn't cover anything other than the hospital visit (none of the appointments with OB so far, etc.), I stockpiled all my receipts and just took them to Medicare and got back about $1100 which was nice. Even though it's expensive, I would definitely go the OB route again next time, twice now I've freaked out and he's squeezed me in and chucked the ultrasound machine on me to make sure everything's okay. He also does a quick scan at every appointment which is great.
04-12-2013 01:42 #3
I got my obs bill at 20 weeks to be paid by 25 weeks ($5200).
Id imagine you can't claim within the 1 yr of staring your PHI but doesn't hurt to ring them and ask.
14-12-2013 16:55 #4
OB wouldn't be covered by PHI, just all hospital expenses.
With our PHI, as long as the baby is born after the waiting period, it's all covered.
One thing to double check is that baby is automatically covered by your PHI in case of emergency or additional care requirements at the hospital.
14-12-2013 18:12 #5
Start now! You will deliver after the 12 month waiting period so your hospital expenses will be covered.
Just bear in mind that OB fees aren't included in PHI so that's another $3.5k+ to factor in.
If you decide to go public however, you won't pay anything.
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