You’ve probably got a lot on your mind at the moment when thinking about when to start a family. Is our house going to be big enough? Are we in the right school zone? Are we ready for the great pram debate? Will we ever sleep again?
So many of us have been there! But before you solve those problems, there’s ensuring you’re properly set up for the birth itself. And the most important question for that is ‘Do we have suitable health cover?’ This is really question number one when preparing for having a baby.
No matter what your plans are, the answer to when should you get pregnancy cover as part of your private health insurance could be now. And that’s because once you’re pregnant, it’s too late. This is due to the general requirement of a 12 month waiting period which needs to be served before you can claim on pregnancy related procedures. Working out your health cover is integral to the planning process when having a baby.
The general rule is to get yourself sorted six months before you conceive so your bundle of joy is born safely outside the 12 month waiting period with your obstetrician of choice and your chosen hospital.
Firstly, something to keep in mind is that pregnancy is already covered by the public health system1. It’s not uncommon for expecting mothers or couples considering conceiving to ask ‘is private pregnancy cover worth it?’
And this is really a personal question depending on your situation, needs and expectations. It typically provides flexibility and choice for the expecting couple, and the potential of further continuity of care.
For many, this is a crucial benefit of pregnancy cover. Being able to choose your own obstetrician and have them provide ongoing support throughout your entire pregnancy is a significant comfort factor for many.
Within the public system, it is not uncommon to see whichever obstetrician is available at the time of your appointment, which may well be a different doctor each and every time. In many cases you see a midwife not a doctor through the pregnancy, and potentially a different one for each check up. Many parents who go private also like the ability to have a quick ultrasound scan of their little bub when they go for an obstetrician consultation.
These little touches can be very reassuring for parents to be to see their little person growing. In the public system, aside from a 12 week and 20 week scan, you may not get these regular scans as part of routine unless there is an issue.
The quality of doctors in the public system isn’t in question, it’s more around the comfort factor of having the same healthcare providers with you throughout your journey. If this is something you deem important, then private health insurance may be a worthy investment.
The environment you give birth in is something to genuinely consider. For some, it might not be a major issue, but for many this can make or break their decision. Private health offers the opportunity to access the hospital facilities that are important to you, ranging from choosing a hospital that has high special care nursery, so you aren’t separated if complications arise, to more of the comfort features, such as having your own private room all the way through to the quality of food.
In the public system, you may be required to share wards with others, which generally means your partner cannot stay overnight with you. So it’s something to keep in mind if you value privacy during what is ultimately a very intimate experience. With pregnancy cover, you’ve got flexibility, you can be a private patient in a private hospital or even a private patient in a public hospital.
Depending on circumstance, private cover can offer hotel accommodation (if medically approved) which allows your partner and even your other children to stay with you with a midwife around to support you. So, again, choice and flexibility is really the major benefit for each and every individual who has pregnancy cover. Not only in planning your experience, but for when those plans change, which as we all know isn’t uncommon.
Down the road you can also use your cover to access sleep school privately, which is good to know as often the public services have long waiting lists for these types of admissions.
While having pregnancy cover does provide you with extra cover and choice, it doesn’t mean that every service will be covered, or covered in its entirety. What is covered differs from provider to provider, so make sure you’ve thoroughly researched or discussed your plan to avoid any unexpected expenses.
As mentioned, cover differs from insurer to insurer and plan to plan, but we’ll do our best to give you a general overview. Typically, full pregnancy cover can provide you:
Having a baby in a private hospital can be expensive. For this reason, it’s important to understand your coverage before choosing a policy. Your obstetrician generally charges a pregnancy management fee. Medicare pays part of this, so does your health fund and there is often a component that you will need to fund – also known as the “GAP”.
In many instances, these expenses won't be covered by your pregnancy cover:
While this list is a lot shorter than the one above, these costs can add up. The good news is that some of these costs can still be covered by Medicare. Which is why, even with a good public health system, having private health insurance in combination can be a beneficial set up.
Pregnancy insurance is quite literal in its definition. It insures your ‘pregnancy’, but not your child once it’s born. Complications can still happen post-birth, and to cover yourself for those you’ll need to investigate the options you have under family cover.
Timing is also important here. Some providers might require you to have this cover in place for a set period prior to the birth. Some insurers might allow it, but the rules, requirements and options can differ from provider to provider.
Many insurers offer free cover for children up to the age of 18 under a family policy, so if you’re planning a family, it’s something to consider well beyond the birthing process.
If you’re planning on having a baby, there’s a lot you’ll need to organise. There is absolutely nothing to lose and everything to gain by comparing health insurance providers in any situation, but when it comes to the birth of your child it really should be of the utmost importance. Putting a plan in place for your birthing process goes without question, and having the appropriate level of care is an essential part.
You’ve also got a LOT of other things to organise and save for, so let iSelect do the comparing of policies for you from our range of providers. You never know how much you might be able to save.
Last updated: 23/11/2020
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