Best Pregnancy Cover 2023 | Health Insurance For Pregnancies

Pregnancy Health Insurance Policies - What’s Covered and Will It Help Your Family’s Health Needs?

Thinking of starting a family soon? Starting a family is one of the biggest decisions you’ll make in life. The prospect of having a baby is both exciting and daunting.

Knowing you have the best health insurance for pregnancy can give you certainty and peace of mind. It also means you’ll receive the highest standard of care for you and your baby.

Many people start looking for pregnancy insurance after they’ve conceived and don’t realise that 12 month waiting periods apply.

Whether you need to upgrade your current health insurance or take out a new policy all together, finding the right cover that suits your health needs can be overwhelming.

That’s why we team have put together the following guide. We’ll take out the confusion by covering all the simple facts to help you make an informed decision for your family. If you think you’ve got a pretty good handle on the basics of health cover for pregnancy, you can always skip ahead and get started with comparing your options.

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What’s Covered Under Pregnancy Health Insurance Policies?

It’s no secret that having a baby is expensive. Beyond the costs of furniture for your nursery and baby goods, the unforeseen costs of medical treatment can be substantial. That’s why planning well ahead and making sure you’re covered for every aspect of pregnancy is important.

While you’ll have to pay some health cover expenses yourself, the right health cover can reduce your overall costs to a more manageable level. Not only that, you’ll be aware of any [out-of-pocket costs]out-of-pocket costs and can budget accordingly.

That means paying less for medical treatments and more on cute baby outfits!

As a general rule of thumb, there are three main elements of private obstetrics cover:

HOSPITALISATION

The expenses of your hospitalisation costs will be covered by private health insurance. This includes your accommodation at your choice of private or public hospitals, birthing wards, theatre fees, anaesthetist fees, and pharmaceuticals.

BIRTH

With private health insurance, the costs of your chosen obstetrician and paediatrician will be partially covered by your hospital insurance.

POSTNATAL

Private health insurance can also protect your newborn baby in the event he/she requires hospitalisation or intensive care medical treatments after birth.

What are the waiting periods for pregnancy health cover?

If you’re lucky you may find a private fund offering a 9-month waiting period for pregnancy health insurance, but most enforce 12 months. This is why it’s vital to take out a policy well in advance when you’re first thinking about starting or growing your family.

The waiting periods also apply if you’re upgrading your current level of private health insurance to include obstetrics cover. Health funds are very strict in enforcing these waiting periods and unlike other extras insurance, finding a pregnancy cover with no waiting period is unlikely.

Is Pregnancy Health Insurance Worth It?

Many Australians often wonder if it’s truly worth having private health insurance for pregnancy. Making the decision to take out health insurance for the first time or to upgrade your existing health insurance policy is a significant choice, and it does come at a cost.

While Australia boasts one of the best public health systems, there are families who desire the additional benefits that come with private health cover.With private health insurance, you gain access to a broader range of options for your pregnancy and birthing care - especially with hospital cover. Here are some potential benefits to consider:

Your insurance will cover the expenses associated with your hospital stay and labour ward fees
If you have special medical issues, you may have the ability to choose your own obstetrician, preferred doctor, or private hospital.
You may have the opportunity to enjoy a private room during the birth of your child.
Certain related services like fertility treatment or extras services like birthing classes may also be covered.

Without pregnancy insurance, you relinquish control over your healthcare provider during the birth of your child.

You will give birth as a public patient in a public hospital and often be unfamiliar with the doctors or midwives attending to you and your baby. In the event of complications with you or your baby, you may be required to pay unforeseen expenses out of pocket.

Starting a family is a momentous and life-changing event. Not only is it an exciting time, but it can also be accompanied by anxiety.

For many expectant parents, having the ability to choose where they give birth and the presence of trusted healthcare professionals during the delivery can significantly enhance their confidence and create a more relaxed experience.

Are there any additional costs of pregnancy with private health insurance?

Even if you’ve found the best pregnancy health cover for your needs, there will still be additional expenses you’ll need to pay out-of-pocket. The exact amount will depend on your fund and individual policy. These can include:

Out-of-hospital medical services

The costs associated with GP visits, blood tests, ultrasounds, postnatal classes, specialist consultations, and obstetrician check-ups that occur outside of the hospital tend not to be covered by private health insurance. Excluding postnatal classes, the costs of these services can be partially claimed through Medicare.

Excesses or co-payments

Any excess or co-payments stipulated by your health fund for hospital admissions must be paid for by you. This amount will vary from fund to fund. However, it mostly depends on the health of your newborn at birth and whether they require postnatal treatment.

The gap

Depending on your policy and health fund, any gap for in-hospital medical services will be paid for by you. This fee refers to the difference between what your insurance provider will pay and the Medicare Benefits Schedule fee.

Pre-release check-up

The pre-release check-up of your newborn baby is generally not covered by your private health insurance. This can be partially claimed through Medicare.

Newborn medical treatment

Most hospital policies will cover the costs of potential medical bills your baby may incur while still in hospital in the event they need immediate care. A waiting period for this applies and depending on your fund and level of cover, you may need to pay extra for this level of insurance. It’s worth considering switching to family cover before the birth of your baby to ensure he or she is protected.

To cut down your costs, you can ask your chosen health fund to recommend an obstetrician who uses the fund’s gap scheme and has an agreement with your insurer. You can also utilise shared care with a GP who bulk bills and ask your obstetrician to provide a detail of the costs before engaging their services. You can also consider being a private patient in a public hospital.

Won’t Medicare cover me for pregnancy?

Yes, Medicare will cover some aspects of your pregnancy if you don’t have private health insurance.

Some of your antenatal care costs are partially covered such as GP consults, obstetrician visits, blood tests, ultrasounds, and other specialised tests.
A partial payment of in-hospital costs including baby delivery and anaesthetic fees.
Some of your postnatal care costs are partially covered such as postnatal health visits and paediatric check-ups.

Depending on your circumstances, you may be eligible for a Newborn Upfront Payment or Parental Leave Payment from Medicare. This can increase your family tax benefit and help provide financial assistance for up to 18 weeks when you’re off work to care for your new baby.

Will ultrasounds be covered under private health insurance?

Private health insurance in conjunction with Medicare pays for a large portion of your in-hospital treatment. If your policy has a no-gap scheme, you’ll be insured with no out-of-pocket expenses.

Private health insurance, however, doesn’t cover the costs of services and treatments required outside of the hospital setting. These outpatient services include diagnostic testing including ultrasounds, X-rays, and pathology, and specialist consultations. If these services are covered by Medicare, they can generally be bulk-billed by the provider.

Will fertility treatments be covered?

Two fertility treatments that are commonly covered by private health funds include in-vitro fertilisation (IVF) and gamete intrafallopian transfer (GIFT). This is welcome news for many as assisted reproductive services can be expensive and usually several attempts are required to conceive, although there is no guarantee of success.

It’s important to note that to be covered by these services, you must have a Medicare item number and require admission to the hospital.

We recommend you speak with your fund prior to considering these services to ensure you’re covered for as much of the costs as possible.

Will my baby be covered under the pregnancy insurance policy?

Obstetrics insurance is designed to provide you with private health cover during your pregnancy and birth of your child. Depending on your health fund and individual policy, your baby may not be covered when he or she is born.

That means if you’re on a singles or couples policy with pregnancy coverage, in most cases your baby won’t be protected. It’s worth considering switching to family cover before your baby is born.

It’s important to note, some funds will require you to upgrade to family cover at least a few months before the birth of your child. With this in mind, comparing policies as early as possible is recommended.

Some key things to keep in mind

If you’re starting or growing your family and considering health insurance, there are a few key things to keep in mind, including:

Excess or co-payments

If excess or co-payments apply to your policy they’ll need to be paid upon your admission to hospital. If your baby requires medical treatment and also needs to be formally admitted, you’ll need to pay for the additional excess. It’s worth budgeting for this expense in advance to ensure you’re not caught out financially at the time of your baby’s arrival.

After your baby’s born

If your baby doesn’t require formal admission, a pre-release check-up will discharge you and your baby from the hospital. This isn’t covered by your private health insurance, but may be claimed under Medicare.

Upgrade to family cover

Consider upgrading your health insurance to protect your baby in the event he/she requires in-hospital medical treatment after the birth. Taking out a family policy can also help protect your child’s health in the future. Maybe they’ll require braces one day to assist in straightening their teeth or need orthotics to help rectify their feet. With the right insurance, you won’t need to worry about these unexpected costs.

Ready to compare?

To ensure complete coverage for pregnancy when you're ready to start a family, it's crucial to take proactive steps and secure private health insurance at least 5-6 months before conceiving. If you've determined that pregnancy insurance is the right choice for you, conducting a thorough comparison of policies will enable you to maximise the benefits of your obstetrics cover.

With our user-friendly comparison tool, the process of comparing policies has never been easier.

In just a matter of minutes, you can assess a wide range of extras cover options from health insurance funds in Australia. Once you've identified the policy that best suits your needs, you can enjoy the peace of mind that comes with knowing the health expenses associated with starting or expanding your family are fully covered.

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If you have any questions or queries with your pregnancy health cover, we have friendly staff who are all health insurance experts. You can call one of our team on 1300 806 119

FAQs

1. What does inpatient coverage mean in the context of pregnancy insurance?

Inpatient coverage refers to the expenses related to your hospital stay during pregnancy and childbirth. This includes accommodation at private or public hospitals, birthing wards, theatre fees, anaesthetist fees, and pharmaceuticals.

2. Does the Australian government provide any support or benefits for pregnancy insurance?

The Australian government provides Medicare, which partially covers certain aspects of pregnancy, such as GP visits, obstetrician visits, blood tests, ultrasounds, and postnatal care. However, private health insurance can offer additional benefits and coverage options.

3. How does pregnancy insurance cover breastfeeding-related services?

Breastfeeding-related services, such as lactation consultations or support, are typically not covered under pregnancy insurance. However, some health funds may offer extras or ancillary cover that includes breastfeeding services.

4. Is there a government rebate available for pregnancy insurance?

Yes, the Australian government provides a rebate on private health insurance premiums through the Private Health Insurance Rebate. The rebate amount depends on factors such as your income and age.

5. Do pregnancy insurance policies cover special care nursery expenses?

health insurance for pregnancy may cover expenses related to the special care nursery if your baby requires intensive care or medical treatment after birth. However, it's important to review the specifics of your policy to understand the level of coverage provided for special care nursery services.

Pregnancy Health Insurance Policies