View Full Version : Health Cover (NH)

Lisa an Gypsie
27-05-07, 02:39 AM
Hi Everyone,

Just wondering if anyone has health insurance? if so I'm after policies which don't have a 12 month waiting period for pregnancy related charges. Anyone who is/has been pregnant want to give some advice on the best one?

What would happen if you found out you were pregnant and didn't have health cover??? what expenses would there be? I'm asuming if you used the public system then there would be none???

Disclaimer: am not pregnant...just enquiring for a friend and my personal interest :)



27-05-07, 02:51 AM
Had 2 babies under Private and would not have it any other way!! Heard heaps of horrible stories about Public (heard some good too though)but always heard positive remarks about going private. Medibank Private is the best for Pregnancy even other health funds told me that they said come back to us when you've finished your family as then they are better. I know of none with less than 12 months waiting for pregnancy. Can't comment on Public expenses but I don't think there are many. In fact I think Private actually costs you more (cost me about $1500 all up, that included emergency ceasar). I still can't recommend Private highly enough though. Good luck to your friend with her pregnancy it's an exciting time and scary at times also but in the long run the best thing I've ever done!

27-05-07, 02:56 AM
Cant help you with who offers no 12 month waiting period etc Lisa, but I do know various friends who have had their first child WITH health insurance and got slugged with a $6000 bill once she was out of hospital after the birth. Her second child was done through public and she said the care was the same, if not better (would you believe it) and it didnt cost her a thing.
My OH and I looked into getting private H.I. and decided the costs definately outweighed the gains, so are just public. Im sure that if you had serious health issues, private would be better, but for us that maybe have to visit the hospital once a year for a broken bone, that just doesnt cover the costs of $50 a week.
(and yes, I did think you were talking about yourself being pregnant, lol)


Lisa an Gypsie
27-05-07, 02:57 AM
What about if you have no access to private facilities (only one hospital in town and it's public), is it worth getting the insurance if you are unlikely to use the private side much?


Lisa an Gypsie
27-05-07, 03:01 AM
Hence the disclaimer :) lol


27-05-07, 03:04 AM
I do know of a couple of people in a similar situation and because it was a small town and wasn't busy they had excellent care althought they had no complications either. I beleive where it is of benefit is when it's a busier town as that is when they are rushed off there feet and can't get rid of you quick enough! Maybe you (or your friend) can speak to the midwives at the hospital and just ask them. Make sure you do have Ambulance cover though in case there is an emergency and the baby has to be flown to a specialised care unit. Otherwise that would cost alot!

Lisa an Gypsie
27-05-07, 03:10 AM
Ambulance cover in QLD is covered under the Ambulance levey...so I'm guessing they would be right there.


27-05-07, 03:25 AM
Our daughter was born under the public system (in Qld). We joined a private cover the day after she was born. Our town is only relatively small and has one hospital (public) so having her didn't cost me anything (except ALOT of pain and screaming! LOL :D ). There were complications with her birth (emer c-section)
Having never been in hospital before I can't compare private vs public. My stay was nice, I had a private room. My only complaint was an evil midwife who seemed to have a bad day EVERYDAY.
Our reasons for private cover are all the extra's (ie. dental, eyes etc.) I would much prefer to be in the private system for all of those things than waiting in Qld's dodgy public health system.
With pregnancy though I certainly would consider doing it all public again, I have had friends have their children through the private sector and have been left with MASSIVE bills to pay once bub arrives.

Lisa an Gypsie
27-05-07, 03:46 AM
Hmmmm so the best deal for her to do would be to have the cheapest and best cover for eyes, dental etc and not worry about the extra waitin period in relation to pregnancy....just trying to work out the cheapest option as they are not extremely well off.


27-05-07, 03:49 AM
I have never had children, so have no experience of my own, however... my sister has had 2 babies through the public systme, with excellent results. First baby emergency caeser on a public holiday!! Second natural birth no issues. Both cost exactly zip.. Excellent medical care (in a country city hospital, so may be different in city??). How could you ask for better. I have had Hospital plus super extras cover for some time, but really due to tax requirements rather than cover?

27-05-07, 09:09 AM
I work in private health insurance. The 12 month wait is standard, sorry. It's to stop people only paying for the short period they need it, pay a few hundred dollars, get paid out $1000's, and then drop out of health insurance. It's only fair, otherwise how else would the funds keep themselves solvent, and all the other members would be paying for those few people. If I have a child, I will choose to go private, but I believe in many cases, the public system is excellent. I would want a private room, but then I'm a bit of a snob in those sorts of ways. If you wish to go private and avoid large gaps you have to pay for yourself, choose a health fund involved in the Access Gap Scheme, and find an obstetrician who will participate in that scheme. You will still always have gaps when you see the obstetrician for consultations prior to having the baby. Like with any specialist, they're entitled to charge more than just the amount Medicare will cover. Health funds can't help you with these outpatient (out of hospital) consultation costs. Hope this helps. This is a very condensed reply, as it is Saturday and I am NOT at work! ;)

27-05-07, 09:18 AM
It still explains an awful lot though. Thanks for the information :)


27-05-07, 09:32 AM
I looked into private health insurance when i was pregnant with my little boy. For me money was a big issue. Once i stopped work it made a massive difference to our budget. By that i mean we had no money. I went public the whole way.... and would do it time after time..... I had to have an emergency ceasar and by little boy was in the special care nursery, all this on a public holiday and i had the best of care!!!! I had my own room, in big city hospital and round the clock care. The midwives would come in all through the night as my little one had troubles trying to feed. When i came home i had no unexpected bills waiting for me.
I just paid the excess to have all the extra scans 3D, 4D etc. and even these were only about $150.
I definately recommend the public health system.

What will be, will be. There is no point in worrying about tomorrow

27-05-07, 11:27 AM
Humm interesting topic... My first question to people is, do you insure your car? do you insure your house? do you insure your belongings? do you insure your horse? WHY? if you are sick or ill and have to go on a public waiting list, and wait months for anything not LIFE threatening you will most likely loose or have to sell some or all of the above, esp if you can't work to cover it....

I have always had private health, and the biggest misconception is that if you pay the monthly fee, the rest won't cost you... Well not quite, I am sure many public hospitals are great, however the main difference is CHOICE, and INSTANT treatment....

By going private, yes you will have to pay a gap fee, but you will get to choose who operates on you? where you go to be operated on? and when you want it to happen? (in conjuntion with your Dr timetable of course) but I am talking weeks not years.....

I have had 2 children both in the private system. It cost me approx $1200 for my Obstetrician, who was at both births throughout all of the delivery, I had complications with both births, first was over 24hrs and needed to be manually turned (which a midwife couldn't do) and then a highly assisted delivery (without going into detail)

Second baby went into distress and I lost Consciousness for a while, whist delivering I had a number of dr on call, my ob, a peadiatrician, 3 midwifes, and an anaesthetist. Once delivered it was noticed the baby had a heart murmer, and was sent to the special care unit, I got to choose which Paediatrician I wanted, and later a cardiologist.

For both births I was given a private room that resembled a hotel suite, with ensuite etc and my husband could stay the whole time for the 6 nights I was there.

I know with my cover if you go to a public hospital as a private patiant, you are entitled to a private room, and choice of Dr.

As for ongoing care, my 2 child has been diagnosed with 2 VSD's (holes in the heart) which if not closed over by Oct, will most likly require surgery. Being private patients, we can choose the Cardiologist (only a few do the procedure we would choose- catheter umberella V open heart), and even if it has to be done at the chidrens, will not have to wait on the public waiting list, we can get it done asap...

We have also made plenty of trips to the emergency room in the middle of the night with various issues (convultions, burst ear drums etc) and going to the private hospital emergency dep, we have always been seen within 10mins of arrival, and the $200 flat fee can be claimed by medicare. Most people don't realise that even if you don't have private health, you can go to a private emergancy department, they cannot turn you away, as long as you are willing to pay the flat fee.

So really Private is most def not the cheepest, however if you want CHOICE it is the way to go... PS I never imagined how much we would use it.

We also use the extras - osteo etc.

27-05-07, 11:49 AM
Hi Lisa unless i had major medical problems i wouldnt worry about health insurance, i would rather put the money into a bank account for emergencies!
When i had TD i went public, the services i received were fantastic! i was in a 4 bed room with a private bathroom, while a lady across from me was in a 6 bed room with no bathroom, she was a private patient who had paid over $600 for this privelege!
the only thing she got to chose her own doctor! well when TD was arriving they could have bought in the garbage man all i cared about was getting the little bugga out LOL.
cheers Pauper

Birthdays are good! they mean your still alive!

27-05-07, 12:01 PM
Many of my friends have chosen to go public, esp for childbirth, and I think it is totally up to your expectations and preference.

A private patiant can choose to go public without the cost, however obviously not visa versa, not sure why the lady opposite you had to pay $600 unless that was the dr fee, or her level of cover was very basic and didn't include obstetrics.

We have 4 people covered on our policy which works out to be $1.67 per day each.....Less than a cup of coffee....

I don't understand why people have a problem with taking responsability for their own medical expenses....

In the US if you don't have medical benifits (as they call it) you pretty much won't be touched at any hospital... and I have lived there...We don't really know how lucky we are to have the system we have, and everyone likes to knock it, yet no one want's to pay.....

PS my obstetrician bulk billed all my visits, and the gap fee covered any type of birth, which he was there for. One went from 11.30pm Thursday to delivery at 12.05am Saturday....His visits were never rushed and each consult he used his mobile scanner so I could see the baby and hear it...He also picked up that I had was a ++ of the menangitis (spell ?)(GBS) virus, which meant I had to be given antibiotics as soon as labour started to prevent the baby from contracting it at birth (high mortality rate). This test is not usually done in the public system...

27-05-07, 02:50 PM
I thought it was routine to do the swab at 28 weeks (I think) whether private or public....if its not well it bloody should be!

I have only had one baby and had him privately. I wanted to live there!! My obstetrician sounds like missmolly's...bulk billed and just had to pay the gap. It does cost a bit but I had a private room the whole time with an ensuite and they didn't push me to leave. I can't say much about public...but my best friend has a baby at the old Mercy and was in a room with 3 others (and 3 other babies)..it was a nightmare...the 18yr old next to her was on the phone to centrelink the whole time arguing!! My cousin has also had 2 babies in a public hospital and was in a double room...ok but no real privacy. I think you just need to shop around for hospitals & find one that will suit your needs...whether this be private or public.

Lisa an Gypsie
27-05-07, 05:22 PM
Can't really shop around for hospitals as there is only one in town and the next one is 10 hours away...or more.

Ok, food for thought, might have to ask some questions from some others who have had children here



28-05-07, 02:09 AM
Here in Bathurst we are just about to get a brand spanking new hospital that has cost $97,000,000 (yes that is correct), and it is public.

I have never been in a health fund, although I worked at a private hopsital in Administration dealing with patients and health funds. Our public hospital in Bathurst is staffed by the same doctors and specialists as in the Private Hospital.

I had my 2 children in the Bathurst hospital, received excellent care. Recently Amanda had to have a fractured bone fixed in her wrist and had to have a bone graft - all covered in a public hospital by the surgeon that also operates in the private system - cost nothing. Hubby had to have his back operated on just before Christmas again cost nothing.

28-05-07, 08:55 AM
It does actually cost, it costs the taxpayers....

I currently have 3 friends all on waiting lists, one for a knee reconstruction (been waiting over 12mths has had to stop her work as a gardener), one for wisdom teeth (waiting 3mths and living on painkillers and antibiotics for infection) and the other for her son who has the same as my daughter, a VSD (hole in heart) and has been waiting 5mths to have the hole closed. All three have said they wished they now had private so they could have been attended to sooner.

My Obsetrician only works in 2 private hospitals, as do most of the DR at both our closest Private hospitals. Our closest Public is just on an hour away (and you wouldn't send your dog there) the next is pretty much the city...

Just yesterday we had a major accident on the Hwy and as per usual they sent the Air ambulance (which usually comes over every second day or so) because our public hospitals are always on bypass, they just go straight to the city...

28-05-07, 09:32 AM
Yes, but being that we are all taxpayers it is the right of someone to choose whether they would prefer to use the public system for certain things. So yes, you are right in your statement that it costs the taxpayer, but being that I have worked for quite a long time, sometimes in not so flash jobs AND paid taxes I have to right to choose public for the arrival of my children. I have the right to choose public for accident and emergency based on the fact that at the end of the day it will cost me ZIP - I have paid my taxes for that right.
The town that I live in only has one hospital and it is public. So regardless of whether I have private cover or not I don't get to choose my doctor, or in my case midwife (as much as I would have loved to! :) ). I don't get to choose the hospital that I am admitted to. Living in the country we don't get that option.
I am in no way trying to start an argument so please don't take this as being an attack on your post. I just want to point out that as a taxpayer we all have the right to choose whether the public system may suit our circumstances better for different treatments. I think this is what Lisa's original query was trying to ascertain.

Eclipse :)

28-05-07, 10:07 AM
I had my little boy in March of last year he was quite sick when he was born and required seven days in a NNICU at a major SA public hospital, he received the absolute best of care whilst he was there and was seen to by the best paeditricians in the hospital. The best part was that the little baby girl right next to him that was born 14 weeks early was transferred from a private hospital and saw the exact same doctors.

linda 1
28-05-07, 03:04 PM
I had both my children in public hospitals as a public patient.
no cost involved,specialist care as required.regional hosp..close to home.I had my own obstetrician for pre-natal care and although he could not make the delivery, this happens in private situations also.
So if you enquire locally you will find a gp/specialist who will treat you as a public patient in your local/regional public hosp.
To many people think public patient for delivery means only the big maternity hospitals with whatever doctor is available and this is just not the case.


29-05-07, 02:35 AM
I have private health cover. I chose to go private for dental, physio etc and the main reason was because of horses. I figured the more I have to do with them, the higher the risk of injury so I sought out private health insurance and have been very happy ever since.

I had my wisdom teeth out and paid hardly anything for it - thank GOODNESS I only have four of them because going to the dentist is something I never want to do again :)

I then got pregnant and had a ob who was very good. I ended up withh gestational diabetes and had to have regular checks with my diabetes contact and that included trips to the Mercy Hospital to see a specialist. I had most of my appointments made for me, which was great as my memory isn't the best these days :)

I had to have an emergency c-section due to complications. My ob came into the hospital as fast as possible and took one look at me and said 'get her into surgery immediately'. Off I went. I was in a PUBLIC hospital for the birth of my son and I must say I did experience wonderful care the whole week I was there.

My sister went public (same hospital). She also had gestational diabetes. However her appointments had to be made by her, she had to wait hours to see someone each week, she didn't have her own specialist that she could see now and then to check she was doing ok and had to carry around a card with all her records on it so that whoever was looking at her that week could find out what had happened the week before etc.

IN the end I had to fork out about $2000. My sister did not pay a cent (although she didn't have a c-section). She still got fantastic care throughout her stay.

Would I go public next time around? Nope. I will stick with private as I was more than happy with it and because of the risk of me getting gestational diabetes next time aroudn I find it much better to have the extra health cover.

29-05-07, 02:44 AM
I am 14 weeks pregnant now. Been with this insurance company for 15 years with extras and 4 years with private hospital cover. Just called to make sure everything would be ok and found they had changed the policy I was in so that it no longer covers pregnancy or birth as of April 1st this year. It will now cost me more than $50 more a month to change the policy to have this covered, which is what I had on the 31st March. Not happy Jan! I suggest anyone out there check to see what they are paying for, as allot changed on April 1st apparently.

The good thing is I can change insurance companies with out a waiting period. And I will be.