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Health Insurance When You're Planning Kids
Planning to have a child?
Whether it's your first or your fifth, you have a busy and exciting time ahead of you. The last thing you want to do is worry about medical bills and quality of care, so it's a good idea to get your health insurance sorted out well in advance.
Why do I need private health insurance?
Private health care is the best way to ensure top quality care in a private hospital of your choice, with the obstetrician of your liking. You can even get your own private room in some cases. With private health insurance, you get all the benefits of private health care without the great whacking bill at the end.
The alternative to private health care is the public health system, which certainly has its benefits – if you're eligible for Medicare, you can get receive treatment in a public hospital, including birth and delivery. However, there are some disadvantages that you should be aware of:
- you won't be able to choose your preferred hospital or doctor
- you may need to wait up to several hours for each appointment, depending on availability of staff, and you may also see different midwives or residents for each appointment
- there's a chance that you won't be admitted into the delivery unit immediately if a bed is not available
- after delivery, you'll most likely be placed in a shared ward with other mothers, babies and all their visitors
- if there are any complications and you choose to see a doctor or obstetrician not allocated to you by the public system, you will most definitely be hundreds or thousands of dollars out of pocket.
Having a new baby can be stressful and expensive enough, without having to worry about these sorts of concerns. The best thing you can do for yourself and your partner is to get private health insurance cover to see you through this time. But you'll need to plan ahead and act early, because birth-related services generally require a 12 month waiting period before the benefits become available to you. That means you need to either join or upgrade to a plan that covers birth-related services, and pay your premium for 12 months before you can claim those benefits. Check with your health fund whether the waiting period is 12 months from joining, or 12 calendar months, to get a better indication of how long you may need to wait.
I already have private health insurance...
For those who already have private health insurance, a simple phone call or checking your policy papers will show whether you have cover for birth-related services. If you have a budget cover or a singles cover only, chances are you may need to upgrade your cover to include these services, which will require a 12 month wait. If you do have birth-related services as part of your cover, check the conditions and benefits that you're entitled to.
I'm new to private health insurance
If you don't have health insurance yet but want to get cover for the birth of your child, make sure you get a plan that covers you for birth-related services. Because you have to wait 12 months before you're eligible for birth-related cover, consider getting other features that you can use more immediately, like dental, optical and physiotherapy, to make the most of your cover.
How to choose your health insurance
When choosing your private health insurance policy to prepare for a new child, there are two features that you need to consider. These are:
1. Pregnancy and birth related services: This relates to antenatal care, delivery and post-natal care.
2. Assisted reproductive services: This refers to services and treatment for conception other than natural means, including artificial insemination, IVF (in vitro fertilisation), GIFT (gamete intrafallopian transfer) and ICSI (intracytoplasmic sperm injection).
The best way to get a great deal on health insurance cover that suits your budget and lifestyle is to compare health insurance plans offered by the health funds. Moneytime.com.au is a comparison engine that allows you to select the features you want fully covered by your health plan, so you can ensure that you are covered for either or both assisted reproductive services and pregnancy and birth related services. Moneytime only represents leading Australian health funds and all services are free – check it out for yourself and start comparing health insurance today.
What does private health insurance cover?
Having private health insurance means that your health fund covers:
- hospital costs at a hospital of your choice, including hospital accommodation, labour ward, delivery suite or birth centre
- surgery related expenses including operating theatre and intensive care if it is required
- medical costs including fees for your doctor, obstetrician, anaesthetist and paediatrician if required
- the cost of drugs supplied as part of your hospital treatment
- other therapies like physiotherapy, when they are associated with your delivery and provided by the hospital. These other therapies may also be covered as part of your Extras cover, if you choose it.
However, keep in mind that some doctors charge above the Medicare Benefit Schedule, so there may be a gap between the fee that is paid to the doctor by Medicare and your health fund, and the fee that your doctor actually charges. This gap will be payable by you, unless you take up a 'no gap' option to cover the difference. Before treatment is administered, find out if the doctor you choose is covered by your health fund's 'no gap' scheme so you're not left unexpectedly out of pocket.
Cover for your baby
In order to ensure that your new bundle of joy is covered from the time of their birth, make sure that you upgrade from singles or couples cover to family or single parents cover at least two months before the birth, regardless of whether or not the birth is premature.
Transferring to a family or single parents cover 12 months earlier (at the time you upgrade to include pregnancy and birth related services) is advisable, as it not uncommon for babies to be admitted to neonatal facilities, and if your baby requires treatment for conditions at birth that are considered pre-existing, it would be require 12 months membership at the family rate before the treatment would be covered.
In many cases, the premium for family cover is the same as couples cover, so the sooner you do it, the better.
You can compare prices for private health insurance policies for families on Moneytime today.