thread: Out of pocket costs

  1. #1
    BellyBelly Member

    Mar 2005

    Out of pocket costs

    I'm new to belly belly, just 3 months pregnant. I decided to go private as I have private health insurance but it's starting already to become awfully expensive.

    I knew the obstetrician would be expensive (he charged me $110 for the first visit and then $75 thereafter.) and I see him every five weeks until 30 weeks then at 33 weeks, then 36 weeks and weekly until delivery.

    My first scan (12 weeks) that cost $139 and my second will cost $165 (19 weeks) plus I just got a bill out of the blue for $90 for my first lot of blood tests that were done almost 4 weeks ago.

    I also have to pay out-of-pockets for my Obs of $910 plus my excess for private ($250-$400) plus hospital out-of-pockets.

    Are these costs are typical for private patients? I know I get some back from Medicare but I feel like they saw me coming!

    Please any suggestions would be welcome.

  2. #2
    BellyBelly Member

    Apr 2003
    Western Australia

    Hi Corr

    Welcome to Bellybelly and congratulations on your pregnancy.

    Firstly, yes, these costs seem pretty typical of private costs to me. You will get some back from Medicare so all up, it's not too bad.

    I would much prefer (for me that is!) to go private and have continuing care by the same health provider from the beginning of the pregnancy right through to birth and post-natal care. That way, you have the same thoughts and opinions throughout and won't end up getting differing advice (which might confuse you).

    Secondly, come and join us HERE and chat in the Pregnancy Belly Buddies!! We all love to chat and you might find quite a few ladies having similar symptoms and problems as you (not that you necessarily have any problems lol!) Just click on the month you are due and fill in some details (if you so desire!) When are you due? September/October? Loads of ladies there!

    Best wishes and welcome again!!

  3. #3
    Registered User

    Aug 2004
    Hunter Valley, Wine Country, NSW

    Hi Corr

    I`m also under a private Ob.

    My first appointment with him at 10 weeks was $105.

    I have seen my Ob every 4 weeks up until 24 weeks, then every fortnight, then from next week (36 weeks) it will be weekly until my little man is here - these visits cost us $50 each time.

    Mu ultrasound at 20 weeks was $110, from memory I think we only had to pay about $40 after the medicare rebate.

    Oh thats right the private insurance for OB was $800.

    Yes you do have to pay for all your blood tests, I know just a urine test is $66 and 5 weeks ago I had my Strep B swab and Gestational Diabetes Test these two in total came to $195.

    Once you reach the medicare threshold it gets a lot better as you get quite a bit back, from our $800 we had to pay they told us we`ve be over $200 out of pocket, it ended up being far less then that.

    Going private we have to expect to pay more then someone going private but I wouldn`t have it any other way and we don`t have a lot of money ourselves but the care has been excellent and I`m sure he`ll look after me when bubs comes along.

    Take Care


  4. #4
    Platinum Member

    Nov 2004

    Hi Corr,

    Yes your costs are very similar to my costs for going Private. The OB fee is approx $700 plus the visits and the hospital will be $500 excess and $280 for out of pocket. I have had second thoughts but have decided to definately go private because of the private room with a double bed and other benefits.

  5. #5
    BellyBelly Member

    Jan 2005
    Mount Waverley, Melbourne, Vic

    Congratulations on your pregnancy!
    I am starting to worry about my costs now, I am seeing a private ob and i was charged twice as much for my first appointment! (I did have an internal scan to find out my due date though, so maybe thats why)
    I checked it all out with Medicare and also the midwife who sat down with us before our first appintment explained it all really well. We get a fair bit back from Medicare, we also have private health insurance. At the hospital we had to pay a deposit of $200, where patients with no private cover have to pay $4000, which is huge for a deposit IMO. At 20 weeks I have to pay the ob $1500 which is not claimable from medicare, but after that I get most of the actual birth cost back. And my excess is $250 for hospitalisation. I didnt have to pay for my blood tests as it was just done at a local pathology clinic, but I do pay for all my ultrasounds, and a standard fee for each appointment.

  6. #6
    Registered User

    Oct 2003

    Hi Corr,

    Congratulations on your pregnancy. I'm not pregnant yet, we start ttc in June/July for our second baby. When I had my son Liam 4.5yrs ago all I paid was my obs fee for each visit and I claimed back from medicare what I could. I didn't pay anything at the hospital except for the anaethetist and paediatrician for Liam and that's it.

    Now, it's all changed with the obstetrician's fees and out of pocket expenses. I've found out my ob's fees, who is currently my gynaecologist, and we're trying to work out if we can afford it or not.

    The first visit is $125, second, third, fourth and fifth is $480 each and the sixth is $65, all adding up to $2100. We will get a minimum of $1100 back, maybe more as we just went past our safety net with Medicare. On top of this, our excess for the hospital which is fine and any other expenses I have while having the baby as I will be having a c/s.

    It's very confusing isn't it?. I'm wondering if I'm better off going public and doing a shared care with my gp, dr and midwife team at the hospital?. Any suggestions girls?. It is so expensive to have a baby these days.

  7. #7
    Melody Guest

    Hi Corr,

    Congratulations & welcome to BB.

    My own experience has been that I paid roughly $120 for my first OB visit (including an u/s) & from here in I will be billed all at once around 30 weeks by him. That bill will be around $3000 but I will get a lot of that back from Medicare. I have paid $200 to the hospital as a booking fee & then I will pay $350 excess.

    I pay each time I have a major u/s (12w & 19w) but that too is claimable on Medicare.

    If you havent already make sure you go & register for the Medicare Saftey Net (this is not an automatic thing)

  8. #8
    BellyBelly Member

    Mar 2005

    Thank-you so much everyone for your replies.
    It is just so helpful to know that I am in the same boat as most of you.
    The good news is I spoke to my health fund and I have no out-of-pockets for my hospital stay, just my $250 - $400 excess.

    With everyone's replies I have noticed a big difference in out-of-pockets cost for obsetricians especially for those who (I assume) first saw one before 1 January 2005 and after.

    The one thing my GP stressed was that I had to get booked into an obsetrician REALLY early in my pregnancy. I turns out that a lot of them have gotten out of the game because of public liability insurance costs, (well in Victoria anyway). I actually wasn't too concerned about the obsetricians fees because of this, but I was upset to get a bill for blood tests for $90 when I was lead to believe they were bulk-billed. Then I asked a girl who went through the public system and she said she didn't pay a cent for her bloods or ultrasounds.

    To be honest although it is expensive I am a little hesitant to go public when I have private health insurance.

    Oh, by the way Nixie I have a letter from my obsetrician saying my out-of-pockets ARE claimable through Medicare (if you are registered for the safety net), so yours should be too.

    One thing I am definately going to be asking is the future costs for my blood tests before I have them. In fact I am going to be asking about everything so I don't get any rude shocks again. I might even enquire if I can be bulk-billed in future, well for my bloods at least.

    Well I better go water my money tree!
    Thanks again for all your answers

  9. #9
    BellyBelly Member

    Aug 2004

    Just out of interest, I had a woman tell me yesterday that she went private for her baby's birth, but didn't have any cover.
    Apparently it worked out cheaper for her not to pay health insurance and still go private given the amount she got back from her insurance company for her costs. (ie I'm guessing health insurance for a family with obstetrics is upwards of $150/month??)
    Makes you think huh?

    I have cover (only $40/month singles), but not obstetrics and DP and I decided to stay public for this baby. We have had very few problems with Shared Care, and I have not had to pay for ANY tests, including ultrasounds. But then again - its luck of the draw who delivers my baby, and there wont be a private room.

    Its all whats important to you. I'm pretty healthy so its easier for me to make these decisions. A friend has lots of medical problems, and feels much more comfy being private. Its individual's call.


  10. #10
    Platinum Member

    Nov 2004

    All of my blood tests have been through Medicare so they haven's costed me anything. On the OB's referral, he makes a note that it is Medicare.

  11. #11
    BellyBelly Member

    Jan 2005
    Mount Waverley, Melbourne, Vic

    Corr, most of mine is claimable, except that one payment of $1500 unfortunately
    I am registered for the Medicare safety net so I should get most of the rest back at least.

  12. #12
    ok take 2 of going back to work.....

    Nov 2004
    Giving the gift of life to a friend..

    Here's my experience..
    When I was preg with DD I went to by GP clinic & 2 OB's worked there so i just started seeing one, mind you I was already 20+ wks! I was bulk billed for each appt & paid only for 1 u/s which was about $120, but got approx 60% back, had her in a public hospital & no charge!

    This preg I went back to same OB, I have been 2 times & charged $34 initial visit paid upfront & from Medicare got back about $27, paid $130 for an Ultrasound & got almost $70 back, saw OB last week & was charged $40 upfront & no fees for blood tests etc..., went to medicare this morning & received $31 back.. Which is what I will pay for each visit now, so basicall about $9 per visit, baby at public Hospital for free.

    My friend is seeing a private OB, mpays over $100 per visit, plus had to pay for blood tests & ultrasounds even though he has a machine in his office he sent her for a hi tech one..?
    Just found out she has growths on her lungs & should have had these removed prior to trying, but she was unaware of the disease, she was told by OB, that she will ahve to have these scanned to see how much trouble they will cause as labour can cause a bleed out &/or heart attack, al;so he mentioned if any complications she will be sent to the nearest Public hospital coz they can cope better & have the facilities for labour/birth complications...
    She asked me this morning (we are 3 days apart) how much I have spent so far & she has spent about 4-5 times as much already!!!!

  13. #13
    Lou Guest

    Going Private

    This is my first baby and we have private health care. I decided to go private (despite the gap fee and other extra charges) because I did not have a particular Doctor where I live (you can never get in to see the same Doctor anyway)and the experiences I have had with the Doctors here have been negative. I have heard from a lot of other women who are pregnant or have had babies here, that there has been a lot of conflicting info given depending on which Doctor you see and some have failed to organise tests such as the RH test. I will be having my baby in Tamworth at Tamara Private and the care I have recieved so far has been excellent and worth every cent. Thankfully the safety net will cover some of the gap fee. I have only just realised though, that I will have to pay a co-payment as well as my excess? i knew about the excess but must have missed the part about the co -payment. Please tell me If I am wrong!

  14. #14
    Resident Samsquanch

    Jan 2005
    Down by the ocean

    I've had to really think about this!
    When I had Angus nearly 2 years ago, I had to pay $130 for first visit to OB which included 1st u/s of which I got back about half. The monthly visits cost $55 and medicare rebate was about $30. A gap fee of $400 had to be paid before I was 30 weeks.
    I didn't have to pay anything for the blood or glucose intolerance tests.
    The ultrasound at 23 weeks cost around $160 and I got over half of that back. It was at a seperate clinic.
    I have full hospital cover with and excess of $250 so when we checked out that was all we had to pay. I opted to pay that amount of excess as our monthly premiums would be lower. I know you can also have a co payment option if you wish.

    Where is your OB?

  15. #15
    BellyBelly Member

    Mar 2005

    My OB's in Noble Park so it's hardly an expensive area!
    Thanks for all your help everyone!

  16. #16
    BellyBelly Life Subscriber

    Oct 2003
    Forestville NSW

    I have to say I went public and all I paid for throughout PG was one scan and after the medicare rebate I paid $50 total. I did go to a couple of extra Dr's appts and paid for them, but in a normal year I would have probably gone to the Dr as much....

    I also had a fantastic hospital which was amazing. Some public hospitals are not as set up as this one was. I had my own room, I knew the team of midwives, I shared my ensuite with one other woman....We had a kitchen on our ward stocked with breakky food all day long. It was fantastic. BUT not all hospitals are that nice, and if it wasn't the closest one to us, we would have second thoughts and might have chosed private, because we had the health insurance at the time.... I'm glad we chose public.