Health Insurance for Pregnancy
Health Insurance for Pregnancy
What’s the deal with Pregnancy Cover?
There’s no specific Health Insurance just for pregnancy, but coverage for pregnancy and birth is included in some Hospital Cover Plans. This means the birth itself, plus obstetrics treatment in the lead-up to it. You can also find coverage for IVF (assisted reproductive services) on some plans.
Do I need Pregnancy Cover?
It’s not mandatory to have Pregnancy Cover; you can give birth in the public health system. Private Health Insurance can involve out-of-pocket costs, but it will allow you to give birth in a private hospital and give you more flexibility and choice in your care.
In 2023, almost 5% of iSelect customers told us their main reason for comparing their health insurance was because they were planning on having a baby.1Based on iSelect health insurance customer data 2023. The average age of those planning to have a baby was 31.
Pregnancy Cover explained
Learn more about how Pregnancy Cover works in this short video.

Laura Crowden
ISELECT SPOKESPERSON
What out-of-pocket costs can I expect?
In the table below, we’ve gathered some of the costs you might encounter for common procedures as a private patient. Depending on the procedure, sometimes your Private Health Insurance chips in to help cover the cost; sometimes it’s just between you and Medicare. You might also initially pay more and have Medicare refund a portion of it.
The benefits of Health Insurance for pregnancy
You can choose your own doctor
In the public system, you often can’t choose which midwife or doctor you see. You also can’t necessarily see the same doctor over the course of your pregnancy. On the other hand, in the private system, you can choose your doctor. They’ll also treat you throughout your pregnancy, birth and afterwards. If this kind of choice and continuity of care is important to you, you probably want Private Health Insurance.
You could get money back for pre- and post-birth classes
Whether or not this is your first rodeo, you might be grateful for some practical support and advice. Some Extras Policies will give you financial assistance to take classes, both before and after the baby’s born. These could include topics like preparing for labor, breastfeeding and bathing your new bub.
You can (potentially) stay in a private, nicer room
In the public system, you might need to share a hospital room with others, which could mean your partner can’t stay overnight with you. As a private patient, you’re more likely to get a private room after you give birth, whether you’ve opted for a private hospital or a public one. In a private hospital, you might also have access to more pleasant facilities – and get to stay in hospital a bit longer if you want to.
You can access massage and some natural therapies
Pregnancy can be an exciting time, but we know it can also be tough on your body. This might be a time you need some extra help, whether it’s an acupuncture session to help with nausea or a massage to ease your muscles and joints – not to mention any stress you’re experiencing! Depending on your policy, many Extras Plans can help you access these treatments and more.
‘As a first-time mum, I was quite nervous about the pregnancy and birth experience ahead of me. I was fortunate enough to select the private system, which then allowed me greater peace of mind that I would receive consistent care from my preferred obstetrician and additional scans at each check-up appointment. The four-day stay in a private hospital allowed my husband and I the time we needed to adjust to the newborn bubble and to get the support we needed from midwives, paediatricians, women’s health physios and lactation consultants. Although going private hurt the bank account a bit, we chose to go private once again when my second child came along, as we knew we’d be guaranteed the consistency, comfortability and support we needed as we became a family of four.’
Jessie Petterd
Brand Manager, iSelect and mum of two
Who is planning on having a baby?
Everyone likely has a different idea of when the right time to start a family is. However, the average age of iSelect customers looking to start a family in 2023–24 was 31 years old. There was also common ground when it came to preferred policy types, with more customers looking to take out a single female policy, followed by those looking for a couples policy.
Helpful Tip:
There is generally a 12-month waiting period before you can claim on pregnancy or obstetrics services. If you want the option of having your baby privately and choosing your own obstetrician, then you need to take out or upgrade your policy before you even start trying for a baby! Unfortunately if you wait until you are already pregnant, it will be too late to opt to have your baby privately, unless you are willing to self-fund and pay the full out-of-pocket costs yourself (which is very expensive)
Frequently asked questions
What types of Health Insurance include pregnancy?
When it comes to Hospital Cover, generally only Gold Policies – or the rare Silver Plus Policy – cover pregnancy. When it comes to Extras, you have more freedom to choose your own pregnancy adventure. Prenatal classes? Acupuncture? Remedial massage? It’s up to you.
What are the waiting periods for Pregnancy Cover?
No matter what your plans are, the time to get Pregnancy Cover could be now. That’s because once you’re already pregnant, it’s too late. Generally, there’s a 12-month waiting period before you can claim pregnancy treatments on your Private Health Insurance. A good rule of thumb is to get your insurance sorted six months before you conceive, so your bundle of joy is born safely outside the 12-month waiting period, once you’ve locked in your obstetrician and hospital of choice.
What could my out-of-pocket expenses be?
Having a baby in a private hospital can be expensive. For this reason, it’s important to understand your coverage before choosing a policy. As well as your chosen excess, you might be expected to pay for all or some of:
- your hospital fees
- check-ups with your obstetrician
- visits with a pediatrician
- ultrasounds
The good news is that some of these costs may be covered by Medicare. There’s also potentially a gap between what a treatment costs and the cost it has listed on the Medicare Benefits Schedule. Unless your provider has a gap cover agreement with the hospital you choose, you’ll probably need to pay that too.
When should I upgrade to a Family Policy?
The definition of Pregnancy Coverage is pretty literal: It insures your pregnancy and birth, but not your child once they’re born. To make sure your baby’s covered, you’ll need to investigate the options under Family Cover.
Timing is also important here. Many providers ask you to upgrade your Health Insurance to a Family Policy three months before your baby’s birth. But some expect you to upgrade as much as a year in advance. So it’s worth checking directly with your fund.
If you’re trying for your first baby it could make financial sense to upgrading just the mum-to-be’s policy to cover pregnancy (single female), rather than paying for a more expensive couples policy. You’ll just need to remember to switch to family policy ahead of bub’s arrival!
Are IVF and assisted reproductive services covered?
The Private Healthcare System divides its Hospital Cover Policies into tiers – Basic, Bronze, Silver and Gold. Each tier has the same minimum treatments it has to cover, no matter which provider you choose.
You’ll find treatments related to pregnancy and birth in a category called, you guessed it, ‘pregnancy and birth’. Treatments like IVF are in a different category, ‘assisted reproductive services’.
Any Gold Plan covers both of these categories, while the lower tiers generally don’t. A ‘plus’ plan, like Silver Plus, contains the minimum treatments for its tier plus some additional ones. If you’re looking at Silver Plus, you’ll want to check whether it includes both ‘pregnancy and birth’ and ‘assisted reproductive services’.
Even if you’ve got Hospital Cover that includes assisted reproductive services, keep in mind that you might have to serve a 12-month waiting period before accessing treatment, and you’ll likely still have significant costs.
Does Health Insurance cover the cost of a caesarean?
Yes it does, as long as you’re covered for pregnancy and birth. That doesn’t mean you’ll have no out-of-pocket costs, though. Like with any treatment, there could be a gap between the cost of the treatment, different doctor’s fees (including obstetrician, anesthetist, and surgical assistant and what your insurance covers.
Does Private Pregnancy Cover have any exclusions?
If you’re on a plan with unrestricted cover for pregnancy and birth – that is, generally a Gold Plan – it will cover a broad range of treatments related to being pregnant and giving birth. Some treatments that might seem related, like fertility treatments, treatment of reproductive conditions and termination of pregnancy, fall under different clinical categories. But here’s the good news: if you’re on a Gold Plan, those clinical categories are covered too.
Does Health Insurance cover prenatal classes or birthing courses?
Yes, some Extras Policies have coverage for a range of classes related to labour, birth and being a new parent. Not every Extras Plan covers classes, so if it’s something you’re interested in, it’s definitely worth doing your homework (or getting in touch with us for some help!).
Will I be covered for twins or multiple births?
Yes, you’ll be covered for treatments related to being pregnant with and giving birth to twins or multiple babies. Keep in mind, though, that when you’re having multiple births, at least one baby will likely be formally admitted to hospital, which makes it more likely you’ll have baby-related hospital costs. Your newborns won’t usually be included in your Pregnancy Cover.
To make sure they’re covered for any treatments they need, you’ll need to switch to a Family Policy, sometimes as long as a year before they’re born.
Where can I compare Health Insurance Policies?
Whether you’re looking for Hospital Cover, Extras, or both, figuring out which policy is right for you can be overwhelming. That’s where we come in! Give us a call on 1800 784 772 and our friendly team of comparison experts can help you find a policy that matches your priorities. Or if you’d rather sort it out online, you can do that in just a few clicks.
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- 1.Based on iSelect health insurance customer data 2023.