What you need to know about health insurance and pregnancy
When couples make the exciting decision to have a baby, the first thing that they think about isn’t usually the importance of health insurance. But even if you typically prefer to only use Medicare on a day-to-day basis, having private health insurance for the duration of your pregnancy and for when your baby is born is important. But how do you go about getting it? Here are a few things you might want to consider:
What benefits do you need?
Private health insurance allows certain privileges that you can’t often get through the public health system. For starters, you have the ability to select your preferred doctor and hospital. If you’re thinking seriously about having a baby, being able to choose a hospital close to your familiy and friends, as well as a doctor that you trust, is important. Under some policies you can also stay in a private room and access certain extras such as birthing or pre-birth exercise classes.
Typically, having a baby can be expensive, so it’s important to know what other aspects of pregnancy your insurer will cover. Generally, the three main elements covered by private health insurance policies in Australia are the hospitalisation, birth and postnatal stages of the pregnancy. Cover can be provided for accommodation costs, theatre fees, anaesthetists, pharmaceuticals, an obstetrician, a paediatrician and various other medical fees.
Will you be eligible?
In order to be eligible for pregnancy-related services, your policy needs to be taken out far in advance. In some cases, you may have to take out your policy as far ahead as three months before attempting to conceive. Many Australian health funds enforce a 12-month waiting period for obstetrics. Also, it’s important to check whether your baby is included on your policy. It’s quite easy to find a policy that will cover you as the mother but may not protect the baby once it’s born. You may need to upgrade to a family policy to cater to this.
What isn’t covered?
There are a few things that may not be covered under your private health insurance policy. Various medical services that occur outside of a hospital typically won’t be covered under a normal policy. These services can include:
Gap fees (the difference between the Medicare benefit you receive and the doctor’s fee) aren’t always covered either. Typically the gap fee will be paid by you, although some policies do cover it. You also generally won’t receive cover for your baby’s check-ups and you’ll have to pay any excesses or co-payments for hospital admissions.
What about IVF or assisted reproductive technology?
Not all funds cover IVF or other assisted reproductive technology services. Some funds may, but it should be noted that many of these enforce a 12-month waiting period. Typically, if various services or procedures occur within a hospital, your hospital policy should provide you with some form of cover. But please bear in mind that this varies across providers. Make sure you check with your insurer as to whether you’ll be able to claim for IVF or similar procedures before you begin.
Taking out private health insurance when you’re having a baby can be a scary thought. It’s not the sexiest topic in the world, but in reality, it’s often a necessity that you should consider. If you aren’t sure how to go about it, jump online and compare various policies to get an idea of what suits you best.
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Bessie Hassan is a mother of two and an Insurance Expert at finder.com.au, Australia’s most visited comparison website