Health Insurance for pregnancy Background

Private health insurance for pregnancy

The table below shows family hospital & extras health insurance policies, on Canstar’s database, that offer pregnancy and birth cover.

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Health Care Insurance Limited | Silver Plus Advantage 750 & Active Life Extras
Health Care Insurance Limited logo
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Silver+ Glossary
$750 Glossary
$397 Glossary
HCF | My Family Silver Plus $750 Excess
HCF logo
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Silver+ Glossary
$750 Glossary
$416 Glossary
HCF | My Family Advanced Silver Plus $750 Excess
HCF logo
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Silver+ Glossary
$750 Glossary
$465 Glossary
Health Care Insurance Limited | Silver Plus Advantage 750 & Premier Extras
Health Care Insurance Limited logo
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Silver+ Glossary
$750 Glossary
$473 Glossary
Health Insurance Fund | Gold Top Hospital Excess $750/$1500 & Value Extras
Health Insurance Fund logo
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Gold Glossary
$750 Glossary
$553 Glossary
Health Care Insurance Limited | Silver Plus Advantage 750 & Healthy Extras
Health Care Insurance Limited logo
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Silver+ Glossary
$750 Glossary
$460 Glossary
Health Care Insurance Limited | Gold Hospital & Active Life Extras
Health Care Insurance Limited logo
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Gold Glossary
$750 Glossary
$464 Glossary
Peoplecare Health Insurance | Silver Plus Grow Hospital $750 & Simple Extras
Peoplecare Health Insurance logo
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Silver+ Glossary
$750 Glossary
$473 Glossary
Peoplecare Health Insurance | Silver Plus Grow Hospital $750 & Mid Extras
Peoplecare Health Insurance logo
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Silver+ Glossary
$750 Glossary
$522 Glossary
Medibank | Gold Protect & Essential Extras 60
Medibank logo
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Gold Glossary
$750 Glossary
$534 Glossary

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The initial results in the table above are sorted by Star Rating (High-Low) , then Monthly premium (approx) (Low-High) , then Provider Name (Alphabetical) . Additional filters may have been applied, see top of table for details.

About health insurance for pregnancy

Planning for a baby can be one the most exciting stages of our lives. It can also be a time that calls for important decisions around whether to take out pregnancy health insurance. Your choice can shape your prenatal care, where you have your baby, and some of the costs associated with having a newborn. Here are factors you may like to consider if you are weighing up the health care options for your pregnancy.

Do I need health insurance for pregnancy?

Whether or not you decide to take on health insurance for pregnancy will depend on your personal circumstances and whether or not you’d like to be able to choose your healthcare providers and hospital or birth centre.

If you’re planning a family, it’s not essential to have private health cover in Australia. If you’re happy to have your baby as a public patient in a public hospital, a birth centre (usually attached to a public hospital) or even at home, the public health system provides pregnancy services, often at little or no cost to you, through Medicare.

Prenatal (before birth) care, which can include visits to your doctor or midwife, various pathology tests and diagnostic imaging may also be funded, or partly funded, by Medicare.

If you prefer to have private pregnancy care services (also called obstetrics), and/or you’d like to deliver your baby in a private hospital or as a private patient in a public hospital, you will need to take out health insurance for pregnancy.

Explore: How to choose health insurance

The best time to take out health insurance for pregnancy

If you are considering taking on private health care for your pregnancy and the delivery of your baby, some forward planning may be essential. There are valid reasons to purchase a private health insurance policy that includes hospital pregnancy cover well ahead of time – even before you become pregnant.

The Commonwealth Ombudsman says all health funds apply a 12-month waiting period for pregnancy services, and that in most cases this rule is strictly applied. So it may be advisable to have appropriate cover in place for at least a year before your baby is due, possibly longer as babies can come early.

You may need to check with your insurer to see if your newborn baby is also covered by your policy. You may need to upgrade to a ‘family’ policy to ensure that your baby is covered if it requires any treatment, such as needing specialist health care while in hospital. There could also be waiting periods applied to this type of cover. You can use the table at the top of this page to compare private health policies with hospital-only cover for families. Change the filters to suit your requirements.

Explore: Pros and cons of private health insurance

Which are the best funds for pregnancy health insurance?

For families facing the cost of a newborn, it can be tempting to select the cheapest health cover available. Bear in mind though, not all policies will cover obstetrics.

According to privatehealth.gov.au, a Gold tier hospital policy is the only tier that covers for pregnancy and birth as a minimum requirement. That said, some insurers may offer Plus policies on other hospital tiers, such as Silver Plus, with these services included.

Once you are aware of the level of cover you need, it may be a good idea to compare family or singles health insurance policies that include pregnancy services to find a policy that best suits your needs at a competitive price. Also, consider what kind of excess you can afford to pay; for instance, choosing a higher excess will typically give you a cheaper premium, but it will mean you have to pay more when claiming on your policy.

Overall, it’s important to make sure the health cover you choose suits your needs and your budget during pregnancy, the delivery and post-delivery.

Frequently Asked Questions about health insurance for pregnancy and birth

While private health insurance can be an additional cost for expecting parents to wear, private health cover may offer potential benefits from early pregnancy through to the birth of your baby and beyond. Here are some of the factors to weigh up.

The Commonwealth Ombudsman notes that private hospital insurance won’t cover all the costs associated with your pregnancy. Medical expenses during pregnancy, such as the services of a GP, obstetrician visits, scans and blood tests, are unlikely to be covered by private health insurance, though these costs might be partially covered by Medicare.

Private health insurance is designed to offer cover to people for treatment while in hospital, and, if you elect to also take on an ‘extras’ policy, selected out-of-pocket expenses in other settings.

Generally, pregnancy does not require hospitalisation, unless there are complications, until it comes time to give birth. So, the type of policy you choose will determine what out-of-pocket expenses are covered during your pregnancy.

Extras cover may let you claim for some of the costs, such as remedial and pregnancy massages, physiotherapy and chiropractic care during your pregnancy and recovery period. Check any limits that apply to these services (such as a capped amount per year) and consider if you can make the most of them before and after the birth of your baby. Out-of-pocket expenses may apply.

You may have particular preferences about where your baby is born, your choice of obstetrician and whether you have a private room during your hospital stay following delivery. Having health insurance for pregnancy can help you fulfil these choices.

But it’s worth contacting the hospital and/or healthcare provider you’ve selected, to find out if they charge above the Medicare Benefit Schedule (MBS) listed fee. You may face greater out-of-pocket expenses if your obstetrician charges above the MBS fee and doesn’t have a ‘no gap’ agreement with your health insurer.

It’s also important to speak with both the hospital and your health insurer to understand exactly what you can claim for, and what you’ll end up being billed for. There may be expenses that are not covered by your policy, such as certain tests or medication, which you may be required to pay when you check out of the hospital.

Also, it’s a wise idea to check how much excess you may have to pay, including if you need to pay it just for your hospital stay, or if you also need to pay it for your newborn if they require care.

Health funds can have their own conditions around providing cover for newborns, so it’s a wise idea to check what type of policy you will need in advance of planning to become pregnant.

According to the Commonwealth Ombudsman, you may be required to upgrade your policy to ‘family’ level as early as 12 months prior to birth in order to cover your baby for possible conditions at birth.

Private health insurance policies for families may offer free cover for children until they are at least 18 years old, and potentially up to age 31 if they are still dependent. Again, this is something to discuss with your health fund as conditions may apply.

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As Canstar’s Ratings Manager, Josh Sale is responsible for the methodology and delivery of Canstar’s Health Insurance Star Ratings and Awards. With tertiary qualifications in economics and finance, Josh has worked behind the scenes for the last five years to develop Star Ratings and Awards that help connect consumers with the right product for them.

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