Obstetrician costs in the private system

[snowchickie79]

Wow.. Interesting reading the different stories here..

I think it's really different for individual OB's how they charge.

Mine was a flat fee at 20 weeks ($3500). I was not charged at any of my appointments other than Medicare (just like going to my GP). So the only thing I paid my OB was the 20 week fee. Because of the safety net we got a very large portion of that back so were only out about $500 for that fee.

You do need to take into account though that with a private OB you also get private fees for the rest of the items such as ultrasounds, blood tests etc. Because we had to have CVS and I ended up with GD our additional expenses were higher than I had anticipated. I also had an epi which cost us and you don't get alot of that back. Plus DD was in nursery for a night which majority was paid for by my health fund but we still got a small charge for that. I only had to pay the hospital my nighly excess of $50 plus we attended an antenatal class at the hospital so there was a separate charge for that.

All in all though I would go private again as I got the best service and attention and my hospital was fabulous.

[~Kaz~]

It is interesting to read the different experiences we've all had. I am assuming most of you who have posted are in capital cities or large centres??

I am in a country town and there are only three obs here. (I say "only" but I think that's pretty good given the population). They all take both private and public patients so the care is the same regardless. I have only just had to make the decision of whether to "go public or private" in the last couple of weeks. So far I haven't been hit with any big bills - one scan I paid a few hundred for upfront but it was ordered in a way that I can claim it on medicare. Everything else has just been standard consult fees which are no more expensive than seeing a GP. I hope I don't get hit with a large fee now that I've decided to go private!! (for the single room after the birth - it's the only difference as far as I can tell). The other interesting thing the ob told me is that I can "change your mind and switch back at a later stage in the pregnancy" if I want to. The important thing at this stage was to get me booked into the hospital but it wasn't even raised as an issue until I was about 24 weeks.

[eworc]

I just found out I am 11+ weeks pregnant last week (1st pregnancy) and the GP has recommended me a list of OBs. I have shortlisted it to 2 and have been given different quotes:

OB1
Total payment of $7000 which is broken down into 3 payments
(1) Initial consultation $300 (which can be claimed - do I claim this from Medicare or my private health insurance. How much can I claim)
(2) Week 20 $4400 (which can be claimed - do I claim this from Medicare or my private health insurance)
(3) Week 30 $2600 (which cannot be claimed and out of pocket)

OB2
I was told that the the out of pocket expenses is $2500

My questions
(1) My first call to OB1, I was told I only have to pay the out of pocket of week 30 $2600. But when I call OB1 again the 2nd time, I was told that I can only claim only partial payment (1) & (2) via Medicare which would add up to $4500 (so expensive =(. I am quite sure my private health insurance covers me on OB fees as well. Is this not correct?
(2) Seems that OB2 is cheaper if that's the case?
(3) Besides these OB fees, I know there is additional fees on top e.g. tests, ultrasound, etc. Hospital stay is additional costs too? What other costs are expected to involve generally?

Your feedbacks/comments would be greatly appreciated...thanks

[Miss E]

Congratulations on your pregnancy eworc! I'll do my best to answer your questions...

1. From what I know, your private health insurance only covers your time in hospital. Your OB fees can only be claimed through medicare. With my OB they do make a direct claim on my private health insurance but that is for the actual birth.

2. By the sounds of things OB2 is the cheaper option. In my experience the OB's rooms are pretty accurate when they tell you your out of pocket expenses.

3. There are quite a few other costs. Your scans, NT screening and blood tests are all claimable through medicare. We're at 22 weeks now and so far have been out of pocket around about $600 for those bits and pieces after claiming them through medicare. I think all up I am expecting the tests/scans etc to leave us about $1000 out of pocket, but it depends on whether we will need further scans down the track.

The other thing to consider is when you will reach your medicare saftety net. When you've had out of pocket medical expenses of more than about $1,050 you get 80% back on everything. But some reason (not sure why) some OB's have a fee that you can't claim towards your medicare safety net.

Whether or not you have additional costs for your hospital stay depends on your level of private cover. We have an excess of around $250 and then have to make a co-payment for each night we're there, but those costs are capped at about $500. To find out just give your insurer a call and they will be able to tell you your situation. The other things that you could have further out of pocket expenses for are an anaesthetist (I've heard an epidural can be up to $1,000) or a paediatrician.

Hope this helps! Good luck with everything!

[eworc]

Thanks Miss Excited for your valuable feedbacks and congratulations on your pregnancy...no wonder your nick name is Miss Excited - I am sure you are!!! 22 weeks - not too long to go...

1. Thanks for the clarification - now I understand why OB1 told me that I can only claim my OB fee with Medicare. Sounds like the private health insurance only covers from the point of hospitalization. I will call my private health tomorrow to clarify as well.

2. OB1 told me that the initial consultation $300 and week 20 $4400 can be claimed via medicare but I am not sure how much I can claim. Would anyone know how much I can claim from medicare. OB2 only told me $2500 out of pocket expense. I still need to do some extensive research to find out more about the 2 OBs. OB1 seems to be recommended in many of the blogs/forums. Would you/anyone happen have any reviews on Dr Vicki Nott and Dr Shelley Rowland?

3. Thanks for the clear breakdown of the additional costs. I have a better understanding now

So once I reach $1050 out of pocket, I am eligible to claim 80% on my subsequent fees? I better make sure I start tracking all these costs so that I know what position I stand.

Will definitely give my health insurance a call to find out about my claim. I am on a corporate plan and normally I can claim quite a fair bit back for most of the things. Hope it's the same for my pregnancy fees too.

Once again miss Excited...thanks for your detailed explanation. It helps a lot for me since this is my first experience. Take care!!!!

[~ Mylitta ~]

Hi there i had my bub at freemasons in july, costs were:

$300 deposit to hospital
1st appt $160 got i think $80ish back from medicare
20 weeks $3000 about $1800 back from medicare

figures may be slightly out
that was all for ob

then had anethatist and peadiatrician costs.

good luck with it all

I'm seeing Pregs too and he's fantastic. My costs are about the same, except it must have gone up a little because my 20 wk figure was $3400. The girls were fantastic about payment though and offered for me to pay it over a few months worth of visits. I haven't taken the receipts to medicare of my private health insurer yet, so not sure how much I'm getting back yet.