Health Insurance Pregnancy Cover

When you start thinking about having children, one of the most important medical decisions that you can make is whether to take out private health insurance to cover you for pregnancy and birth-related services. Why should I take out private health insurance?

Private health insurance for pregnancy provides greater flexibility, giving you the choice of a private obstetrician and private hospital in which you will delivery your baby. If you decide to go through the public health system, and be covered by Medicare, it is likely each of your visits to the public hospital would be with a different health professional.

Having private health insurance can also be beneficial in the case of additional or unexpected medical expenses related to your pregnancy as it may help cover a portion of your medical fees.

When to take out private health insurance

You must remember that pregnancy and birth-related services usually have a 12 month waiting period with Australian health funds, so you should get covered as soon as you start planning to have kids. If you wait until you're already pregnant, it'll be too late.

If you've already got private health insurance, call your health fund or check your insurance policy to confirm that you're covered for pregnancy and birth-related services, as not all policies cover this benefit.

Also remember to upgrade to family cover (from singles or couples cover)  before your baby is due. This ensures that your baby can also be covered from the time of their birth, just in case any complications require that your baby be hospitalised after birth. Timeframes to conduct the upgrade vary from fund to fund, so it’s best to talk to your insurer about when you should upgrade. If you do not have family cover, your baby may not be covered as a private in-patient.

What's covered and what's not?

Pregnancy and birth-related services that take place in hospital as an in-patient, are covered by your health fund, including:

  • hospital accommodation
  • doctors' and obstetricians' fees up to the MBS
  • labour ward costs

Some health funds will even cover the cost of your pre-natal classes prior to admission to hospital. Check with your health fund to ensure that there will not be a gap for the cost of your treatment.

Medical bills that are not covered are expenses that take place outside the hospital, like your obstetrician's consultation fees prior to delivery and ultrasound costs. Also, once you've delivered your baby and are ready to leave hospital, your baby's pre-release checkup will generally not be covered by your health fund, as your baby will not have been formally admitted to hospital as an in-patient. Some of these costs can be claimed under Medicare instead.

Also keep in mind that if you have an excess or co-payment in place, you will have to pay that out of your own pocket.

Compare pregnancy cover options with Choosi

Choosi lets you compare health insurance products that provide cover for pregnancy and birth-related services, so that you can get the best value cover for your needs. Compare quotes in minutes!

These articles are provided as reference material to allow more informed decision making, but are not intended as being a complete source of information on any topic. All readers should make their own independent analysis on the topic to make sure they have considered the aspects that are important to them.