GUIDES & RESOURCES

Everything You Need To Know About Pregnancy Insurance

There’s nothing more thrilling than preparing for a new family member to join your life. Keep reading to learn more about private health cover and pregnancy.
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Maybe you’re researching suburbs with top schools, or daydreaming about your future family adventures. Whatever stage you’re in, you know one thing for sure. You want to start your pregnancy journey on the right foot.

While it may not be top of your to do list, one of the most important things to get right before you start a family is to get your healthcare sorted. Will you have a natural birth? A cesarean? Public hospital or private? From the nitty gritty of private health care to whether cover for pregnancy is worth it for you, we cover the essential topics to help you get peace of mind before the big day.

Get private cover for pregnancy before you conceive

Many people leave organising private health insurance until it's too late. Unfortunately, you can’t take advantage of the benefits of pregnancy insurance if you’re already pregnant - unless your current singles, couples or family cover explicitly includes it. This is because there’s a waiting period of 12 months before a health insurer will pay your benefits.

If you want to get private cover for pregnancy, it’s a good rule of thumb to get it six months before you plan to conceive, or three months before at the bare minimum. Health funds are extremely strict on enforcing these rules and won’t waive the waiting period for health insurance.

What are the benefits of pregnancy insurance?

If you’re planning on conceiving soon, it’s important to remember that pregnancy is already covered by our public health care system. A question often posed by expecting mothers is whether getting private health insurance cover for pregnancy is worth it.

In 2013, over 300,000 women gave birth in Australia. Of those women who delivered in hospitals, 30% were private patients.* There are a number of benefits of delivering as a private patient including more choice, continuity of care, potentially better facilities and greater flexibility for you.

Pregnancy insurance lets you choose your doctor

One of the biggest benefits of pregnancy insurance is the ability to choose your obstetrician and have them support you throughout the entire pregnancy. By contrast, health providers under the public system will likely change every time you visit, and may include junior doctors (who will call a specialist when needed).

If you’re one of the many women who want the same healthcare providers to be with you throughout the birthing process, then private health insurance might be worth it.

Pregnancy insurance provides better accommodation and facilities

Another major benefit of private health insurance is access to better hospital facilities, such as a private room or higher quality food. This is in contrast to the public health care system where you may have to share a ward with other pregnant women.

Pregnancy insurance also gives you more freedom of choice in where you want to give birth as you can be admitted in both a private hospital or as a private patient in a public hospital in the maternity ward.

In some cases, private health insurance can allow your partner to stay with you overnight or cover hotel accommodation if it’s medically-approved by a doctor. If having control over how and where you give birth is a priority of yours, then private health care can be a worthwhile investment.

pregnancy insurance

Pregnancy insurance offers you more flexibility with your appointments

An additional benefit of private pregnancy insurance is that it gives you greater flexibility with appointment times. While this is a benefit in the lead up to pregnancy, it’s important to remember that when it comes to crunch time and you’re ready to deliver your baby - you’ll be admitted right away, no matter if you’re using private or public health care.

Pregnancy insurance can leave you with out-of-pocket expenses

Many people assume that just because they’re paying extra for pregnancy insurance, that most of their services will be covered. This is not the case. There are a lot of guidelines around what is and isn’t covered, which can leave customers with a lot of unexpected expenses. What is covered varies from provider to provider, so it’s crucial to do your research. Due to these differences it can be hard to compare private vs public pregnancy costs in Australia.

What does pregnancy insurance cover?

Typically, full pregnancy hospital cover will pay for hospital accommodation (and in some cases hotel accommodation for a partner, if it’s medically-approved by a doctor), theatre or labour ward fees, intensive care during and after the birth, pharmaceuticals administered in hospital, and the Medicare Benefit Schedule fee for your doctor.

What will your out-of-pocket expenses be?

If you don’t check your health policy, the cost of having a baby in a private hospital could be much greater than you expect.

Some of the expenses that aren’t typically covered by private health insurance include some specialist consultations (a paediatrician, for example) and any appointments made outside of being a hospital inpatient (like ultrasounds as an outpatient, or obstetrician appointments before birth).

These costs can add up, so it’s important to budget for unexpected costs when the pregnancy comes around. The good news is some of these costs can be covered by Medicare.

Remember to insure your newborn

Your newborn is not covered under your private health insurance after they’re born. To ensure that any possible complications with your newborn are covered under your private health policy, you may need to upgrade to family cover.

The rules around when you need to insure your newborn vary from provider to provider. Some may require you to upgrade to family insurance sometime between several months and a year before your baby is born. While others allow you to upgrade once your baby is born.

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If you plan on falling pregnant soon, there’s a lot you’ll need to organise. Sorting out the birthing process is one of the most essential steps when getting your pregnancy on right track. At iSelect, we can save you the anxiety, hassle, and time it takes to find the right health policy for you.

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