Navigating the maze of expenses for having a baby in a private hospital in Australia? Here’s a comprehensive guide to help you understand the cost breakdown without private health insurance (and how health insurance can save you $)

SUMMARY

✅ The cost of having a baby in a private hospital WITHOUT health insurance be up to $20,000

✅ Giving birth in a private hospital WITH health insurance may cost $3,000-$5,000 depending on your level of cover

✅ To be covered by private health insurance for pregnancy & the birth of your baby, you’ll need to hold the right level of cover for at least 12 months prior to the birth.

✅ Silver & Gold Hospital Cover for pregnancy starts at around $49 per week.

Welcoming a baby into the world is an incredibly rewarding experience. However, the reality of expenses can sometimes be overwhelming, especially when you’re thinking about giving birth in a private hospital in Australia. This article is designed to help you navigate the potential costs, so you know exactly what to expect.

Private Hospital vs Public Hospital: What’s the Difference?

  • Public hospitals are funded by Medicare and are relatively more affordable.
  • Private hospitals offer a more tailored experience—think private rooms and choice of obstetrician—but come with a higher cost.

Cost of Giving Birth in a Private Hospital WITHOUT Insurance

If you’re planning on giving birth in a private hospital without the safety net of private health insurance, expect to pay (a lot).

While the experience may offer personalised care and greater flexibility in choices, it does come with a price tag that can soar up to $20,000.

This cost encompasses everything from obstetrician fees and antenatal care to your hospital stay, and it’s all out-of-pocket.

Cost of Giving Birth in a Private Hospital WITH Insurance

If you’re leaning towards a private hospital birth but have the cushion of a private health fund, you can expect a more manageable financial commitment. Here’s a snapshot of what the typical costs could look like:

  • Room Accommodation: Daily rates run between $700 and $850, and you should plan for a stay of about 2-5 days.
  • Delivery Suite Fee: A vaginal birth will generally cost you $1,000, but if a caesarean section is needed, that bumps up to $1,200.
  • Obstetrician Fees: Also known as the pregnancy management fee, this cost can range from $2,500 to $3,400. Keep in mind, this amount can shoot up to $5,000 if your obstetrician chooses to charge above the Medicare scheduled fee. And if you’re expecting multiples like twins, brace yourself—the fee doubles.

Extra costs can include pathology tests, pain relief options, scans, medications, and specialist fees, such as those for an anaesthetist or a paediatrician. Additionally, your health insurance plan might require you to pay a hospital excess fee.

CHI TIP: While insurance certainly alleviates some of the financial strain, be prepared for some out-of-pocket expenses to pop up along this journey.

Cost of Going Public for Your Birth

If you opt for a public hospital birth, you’re looking at paying anywhere between $0-$1,500. The Australian public health system Medicare generally covers the lion’s share of hospital fees, including the delivery itself, whether it’s a vaginal birth or a caesarean section. You’re also covered for hospital visits throughout your pregnancy.

That said, you’re not completely off the hook. Certain extras like ultrasounds, scans, and blood tests might still require out-of-pocket expenses, although Medicare often offers rebates for these services. Any medications you need will also be an added cost.

Pros & Cons of Public Hospital vs. Private Hospital Birth

Public Hospitals

Pros:

  1. Cost-Effective: Medicare covers most of your hospital fees and birth costs.
  2. Access to Specialists: In case of high-risk pregnancies or complications, you have immediate access to a range of specialists and neonatal units.
  3. Bulk Billing: Many services like pathology tests and ultrasounds can be bulk-billed, meaning little to no out-of-pocket costs for you.
  4. High Quality of Care: Australia’s public health system is globally recognised for providing excellent medical care.

Cons: 

  1. Limited Choices: You can’t choose your own obstetrician, and you might see multiple health professionals throughout your pregnancy.
  2. Less Personal Space: You’re likely to be in a shared room unless a private room is medically necessary.
  3. Wait Times: Longer waiting times for check-ups and certain non-emergency services.
  4. Less Flexibility: Limited choice in your birth experience, such as birthing positions and pain relief options.

Private Hospitals

Pros:

  1. Personalised Care: Choose your own obstetrician and enjoy continuity of care throughout your pregnancy and birth.
  2. Private Rooms: You’ll likely have a private room, making your hospital stay more comfortable and personal.
  3. Flexible Plans: More say in your birth plan, from birthing positions to the involvement of a private midwife.
  4. Convenience: Generally shorter wait times for appointments and the option for extra services like antenatal classes.
  5. Extra Amenities: Think better food options, comfy furnishings, and even the option for your partner to stay overnight.

Cons:

  1. Higher Costs: Even with private health insurance, expect some out-of-pocket expenses that can range from $3,000 to $5,000 or even more.
  2. Waiting Periods: You may find some services aren’t covered, or you haven’t served the waiting period to claim maternity benefits.

Is it Worth Giving Birth in a Private Hospital Without Private Health Insurance?

Is it really worth giving birth in a private hospital without private health insurance? For most mums-to-be, the financial burden might tip the scales towards ‘probably not.’

Going the private patient route without insurance could rack up a bill as high as $20,000. While the quality of hospital care and maternity care might be top-notch, the cost can be overwhelming for many families.

However, if you have private health insurance, the story changes significantly. The costs become far more manageable – anywhere between $3,000-$5,000 for out-of-pocket costs depending on your level of cover, allowing you to enjoy the personalised care and amenities that come with a private hospital birth.

So, in a nutshell, the private hospital experience is worth it—but only if you’ve got the safety net of private health insurance.

Does Private Health Insurance Cover Everything?

Even with a good private health insurance plan, some costs just won’t be fully covered. Here are the key out-of-pocket expenses to be aware of:

  • Out-of-Hospital Medical Services: Includes private GP visits, blood tests, ultrasounds, specialist consultations, and obstetrician check-ups. Most of these can be partially claimed back on Medicare.
  • The Gap: This is the difference between the Medicare Benefits Schedule (MBS) fee and what your health fund covers. More often than not, you’ll need to cover this gap yourself, although some insurance policies might cover it.
  • Policy Excesses and Co-payments: These are your share of the costs when you’re admitted to the hospital. The amount can vary based on your specific policy and other factors like additional postnatal care needs for your baby.
  • Baby’s Pre-Release Check-Up: A paediatrician will check on your newborn before you leave the hospital. This, along with any follow-up appointments, usually isn’t fully covered but can be partially claimed back through Medicare.

In summary, private health insurance can really lighten the financial load when you’re adding to your family, but it’s not a catch-all. You’ll still need to budget for these additional expenses.

How Much Does Health Insurance for Child Birth Cost?

To be covered by health insurance for pregnancy, you’ll require either a Gold tier hospital policy or a Silver Plus policy that includes maternity coverage. Regardless of your choice, there’s a 12-month waiting period before the maternity benefits kick in – so it pays to think ahead.

Cost Range:

  • The lowest-cost hospital cover starts at roughly $47 per week*
  • The average price hovers around $69 per week*

*The quoted prices are tailored for a single individual earning under $90,000 and residing in Sydney.

Find the Right Cover for Your Pregnancy

Navigating pregnancy and all its ups and downs is thrilling, but it can also be a bit overwhelming, especially when it comes to healthcare. That’s why CHI has your back! Use our super-easy tool to compare policy plans and find the one that fits your pregnancy and birth journey.

✨ Don’t leave it to chance—find the right cover for your unique journey today. ✨

👉 Compare Plans Now

FAQs

1. What are the different care options available for pregnancy care in Australia?

In Australia, you have various care options during your pregnancy, including public hospitals, private hospitals, birth centres, and home births. You can also choose between different healthcare professionals like obstetricians, midwives, and GPs to guide you through your pregnancy journey.

2. How does the Medicare rebate work for pregnancy-related costs?

Medicare provides rebates for a variety of pregnancy-related services like antenatal check-ups, pathology tests, and ultrasounds. However, it won’t cover the full cost of these services, especially if you choose private care. It’s essential to look into the Medicare rebate rates for different services to get an idea of your out-of-pocket expenses.

3. Can I opt for midwifery services instead of a traditional obstetric approach?

Absolutely! Midwifery is an excellent option for those who prefer a more natural approach to childbirth. Some birth centres even offer midwifery-led care. However, if complications arise, an obstetrician’s involvement may become necessary.

4. What are my options if I’m considering a home birth?

Home births are increasingly popular in Australia but do come with their own set of considerations. You’ll need to hire a midwife experienced in home births, and it’s advisable to have a backup plan that includes quick access to a hospital in case of complications.

5. What should I expect in terms of total costs for childbirth in Australia?

The total costs can vary widely depending on your choice between public and private healthcare, the type of birth you have, and any unexpected complications. Public care is usually cheaper and may cost little to nothing, while private care without insurance can go up to $20,000.