There are three main types of care available for pregnancy and birth. These include:
- Paid for care by a private obstetrician in a private hospital
- Paid for care by a private obstetrician in a public hospital
- Public hospital care that is fully covered by Medicare
You can select your choice of obstetrician and the hospital where you want to have your baby, noting that the choice of hospital you will have is limited to the private hospitals where that obstetrician works. Antenatal appointments will generally take place in the private suites of the obstetrician, with these appointments primarily led by an obstetrician (depending on your choice of obstetrician you may also have some appointments with a midwife).
Typically, you will pay fees to the doctor as well as the hospital, and also pay separately for some of the scans, pathology and other testing that may be required throughout pregnancy. If you require or elect to have the services of an anaesthetist or paediatrician they will typically also charge additional fees. (see more next section).
The benefits of this type of care are typically having your choice of obstetrician, less time spent waiting at appointments, and typically more appointments with a doctor.
It is possible to choose a private obstetrician and have the baby delivered in a public hospital. The obstetrician fees will remain the same as above, the antenatal visits will occur in the obstetrician’s rooms. Hospital charges will be your responsibility, but they will usually be covered by your Private Health Fund. There will still be additional costs for other doctors such as anaesthetists, paediatricans etc.
In public hospitals, all the services are free but you do not have your choice of obstetrician.
Antenatal appointments, medical and hospital fees are all available to be fully covered by Medicare for patients being treated in public hospitals who do not elect to use a private obstetrician. Standard scans, pathology and other testing are also provided free of charge.
Depending on the public hospital you attend, and the type of pregnancy you have, there are different types of care programs offered in hospitals. The type of care program you have will determine whether you primarily have antenatal appointments with an obstetrician (usually a trainee obstetrician overseen by an experienced obstetrician) or midwife also overseen by an experienced obstetrician.
Some hospitals will offer what is known as midwife led care, where you are allocated a team of midwifes who will lead your antenatal care and as well as your care in the birthing suite. This type of care remains overseen by an obstetrician and have access to full medical support if required at any point in the pregnancy or birth.
Under the ‘shared-care’ scheme, you may elect to have some of your antenatal appointments with your GP instead of at a maternity clinic in a public hospital. To be eligible for these services you must first have an initial assessment at the hospital and be assessed as suitable for this type of care. Your GP must also be registered as an accredited shared care provider with that public hospital. Under this type of program you would continue to visit the hospital for scans, antenatal classes, and any tests above and beyond those that can be carried out by the GP.
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An overview of costs for private maternity care
Private obstetricians will typically provide an overall quote for care throughout your pregnancy and birth that covers all standard antenatal appointments and the medical costs associated with a normal delivery.
These costs are usually well above Medicare and Private Health Insurance (PHI) rebates.
Whilst private health insurance will generally cover some of the cost of this private care, there is generally a significant amount out-of-pocket (i.e. an extra amount above what private health insurance pays that you will be required to pay directly to the obstetrician), and this will be explained in the quote provided by your obstetrician. You would typically be required to pay this fee in installments throughout the period of care.
According to private health insurer NIB, out-of-pocket expenses for management of normal pregnancy and birth by a private obstetrician were anywhere from $2,445 to $8,355 in 2015 and may be even higher now.
Your private health insurance should cover the cost of your stay in hospital so long as the hospital is on their list of covered hospitals (most are, but it is always worth checking). There may be an excess amount that you are required to pay yourself depending on the type of health insurance policy that you have.
Shop around, ring obstetricians rooms and ask what they charge for a normal pregnancy.
High prices do NOT relate to a higher quality outcomes.
A number of costs associated with maternity care are not included in the quote generally provided by private obstetricians and are also generally not covered or only partially covered by your private health insurance. These may include things such as :
• Pathology, scans and imagining (Xrays) – some tests, scans and imaging may be bulk billed but many will not be. Some private pathology and imaging centres do not bulk bill, typically requiring people to pay upfront and then submit a claim to Medicare for partial refund. Maternity care usually involves at least two scans of the baby by a Medical Imaging Service who charge out of pocket fees usually in the order of $100-300 per scan.
• Genetic tests which are increasingly popular for early detection of inherited conditions such as Down’s Syndrome, Edward’s Syndrome or Patau Syndrome, are not covered by Medicare or PHI and may incur significant out of pocket costs. These can be cheaper by attending a service run by a public hospital for these tests which are accessible for private outpatients.(see https://www.thewomens.org.au/health-information/pregnancy-and-birth/now-you-are-pregnant/genetic-testing-in-pregnancy )
• Anaesthetist costs -if you have an epidural or general anaesthetic during birth. Whilst your private health insurance may cover some of these costs, you may find that there is a significant out-of-pocket component that you are expected to pay. Because these costs depend on the specific anaesthetist who is working on the day you give birth, it is difficult to get an accurate quote of the likely cost ahead of time.
The cost maybe in the order of $0 to $1500 or so.
• Paediatrician costs -if a paediatrician is required to care for the baby after birth. As with the anasethetist costs, your private health insurance may cover some of these costs, but you may find that there is a significant out-of-pocket component that you are expected to pay, and again the specific amount of these charges depends on the paediatrician who is working on that day.
• Costs associated with special care nurseries if you baby needs admission to one after birth. The costs of these may be additional to hospital costs and you should check with your fund if your policy covers these types of costs
• Caesarean section
This cost is usually included in the fee for the obstetrician but the fees for other specialists involved will be separate. This will include costs for the anaesthetist, often a surgical assistant and a paediatrician.