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  1. #1
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    Default Public - private - private in public- private midwife and health insurance?!!!?

    Hi everyone,

    apologises, this may be a longish post.

    A bit of background: i'm 7ish weeks pregnant with my first. About 4 months ago i was referred to an OB for endo. A laparoscopy got rid of the endo -for now- but i still have a 2-3cm fibroid. After the surgery i have been followed by the same OB for a bit of help in terms of fertility. I like my OB, she is nice and patient and explains things quite well. It is also reassuring to see because she knows about my background and can keep that fibroid monitored as it should be.
    She is now asking me to make a decision on the type of care i would like to go with for this pregnancy.

    I do have private health and would love to go private. But, there is a clause in my policy saying that they won't cover "private midwifery cost if a doctor is required to intervene in the delivery".
    My OB explained that she is usually present for the delivery (or her replacement if she's not on call) and she charges a delivery fee. According to my private health, if the OB charges a cost, then it's considered an intervention, then they won't cover the private midwife's costs. Anyone else has something similar?
    Also, can someone explained what a private midwife is? Are all midwife in a private hospital private midwives? (I seemed to understand that a private midwife is a midwife who doesn't belong to a hospital, public or private) Is there a cost for the midwife present during delivery/labour at a private hospital?

    Based on all this, it seems as though we may not be able to afford going private, even though i'm concerned about not having a constant follow up with someone knowing my background. I have read about the option of going private in public but i get pretty confused about it.
    I seem to understand that the prenatal care is done privately but the birth is a public hospital, preferably with the OB who did the prenatal care but depending if she's on call. Is that correct? What about hospital cost for delivery? Do you then claim through medicare or private health?

    Final question (finally), my GP gave me a referral to see my OB regarding this pregnancy as she assumed that we would go private. If we are going public, what do i need and who do i get referred to ?

    thank you so much for your replies.... I am completely confused!!!

  2. #2
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    I think the clause about a private midwife would refer to a independent midwife not one that is hospital based.

    If you are covered for private obstetrics I would go privately.

  3. #3
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    This is why I went public.

    Private is so so confusing and more often than not there are out of pocket fees.

    I went fully public, had a csec, private room, intervention and surgery plus transfer for my daughter, 5 nights in hosp for me, 14 days for daughter. Not a cent out of pocket.

  4. #4
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    I'm going as a private patient in a public hospital. I see my Ob in her private rooms, she arranges tests, ultrasounds etc but I will give birth in the public system. As far as costs I have to pay for the drs visits, ultrasounds, and the Ob management fee. I get all my blood tests done at bulk billing clinics. Once I get into hospital though I won't pay anything more.

    Last time I went public through the midwifery group practice which was great and free. Didn't cost a cent. Unfortunately i didn't qualify this time (high risk) and wanted continuity of care again so found an Ob who would deliver privately in my public hospital. High risk publicly means you see a rotation of drs/specialists which I personally didn't want.

    For me low-risk (first pregnancy) public was a great option, I had continuity of care through my midwife. Now as high risk an Ob was the better option and going publicly for birth means the costs are also reduced once you are admitted (no gaps for paed, anaesthetist, theatre fees etc). If you want to go this option you will need to check if your Ob will deliver in a public hospital as many private Obs will not. I only found 2 who do that in my hospital (very large teaching hospital too). My Ob will deliver my baby or one of her team members if she isn't around.

    When I am admitted to give birth I just need to elect myself as a private patient, the hospital actually pays the excess (check with your hospital as heaps do this now) and the costs of the admission are covered by private health and medicare with no further out of pocket costs to me. The only restriction I have in my policy is that I have to be in a shared room if one is free, however my hospital doesn't have shared rooms in the post-natal ward so that's not an issue anyway!

    For me its the best of both worlds - I get the private care but I don't pay as much as I would have if I birthed in a private hospital. I also have access to the specialist team I need to see after birth, and if there are issues with baby/me I'm in the right place with access to specialists if needed without needing to be transferred or be away from baby in a different hospital.

    HTH with private as a public patient - it can be harder to navigate in the start but speak with your Ob and your private health fund to see what you are covered for.

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    Galdoria  (03-04-2017)

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    Quote Originally Posted by mummymaybe View Post
    I think the clause about a private midwife would refer to a independent midwife not one that is hospital based.

    If you are covered for private obstetrics I would go privately.
    This is exactly right. It refers to independent midwives practising privately but who you pay to come in for the birth in addition to the midwives who are employees of the private hospital .

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    Galdoria  (03-04-2017)

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    Thank you all for the above.

    I am meeting with my OB and her midwife on Wednesday and i feel a bit better armed for this meeting. Hopefully once i have information from them as well i should be able to confirm things with my health insurance and make a decision.


 

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