Private obstetrician & medicare safety net

[LionsandBears]

Thanks Nai - I called back and asked. I didn't want to look silly, but meh

Apparently the first appt I get $100 back from medicare. Nothing back on the 20wk payment, $500 on the 30wk payment. The remainder of the total is claimable on tax. So total out of pocket is $6,685.

I'm trying to work out if it would be worth it.

On top of this, we'll be needing a lot more scans, which we prefer to get a private OB sonography specialist to do. We'd be able to get a lot back from those through medicare (about half I think).

We have a $500 excess on PHI as well.

[MamaPan]

It also depends on when you hit the medicare safety net - with both boys i hardly ended up out of pocket as we hit the safety net and got 80% back on medicare.
the gap is the diff b/n the standard medicare rate and the private rate - but that is what you get when you are UNDER the safety net (i think).

you could also call medicare and ask them how it work with the safety net (it is confusing)

[M D]

Tashybabe - that seems expensive compared to mine.

1 st appt + scan -$240 about $80 ish back
subsequent appoint's (monthly to 30 wks, then fn to 36 then wkly) - $140 medicare $38.55 each appt (capped at 10 appts then $40 each appt)
Pregnancy management fee - $1700 and I only get about $450 back on that.

He then charges a delivery fee which is what ever my PHI will give him there is no gap for this one.

For my admission to hospital I just have my excess which is $300 payable once only.
If I have a epidural that is an extra $500 ish dollars with partial claimable on my PHI and medicare.

I thought my Ob was expensive but he is well worth it. With my DD my pregancy was text book with no troubles but I needed the reasuring and the straight talking from him so he was worth every cent.

This time around we don't have the extra money we did but once I saw my Ob for the first appt I was 150% satisified we had to find themoeny for him. Your mental health plays such an important roll for your pg and after care.

If spending the money on your Ob is what you feel is best for you then thats what you should do. Don't let anyone tell you they went another option and that you should do the same, you do what feels best for you.

[HotI]

My pregnancy was 'high risk' just based on the potential for issues due to my medical condition, going public was better because many unexpected extras were covered without extra costs. I was able to get care during pregnancy when there were issues, but not with the same carer each time. Next time i'm going with an independent midwife. I would recommend an IM over an Ob.

[LionsandBears]

Thanks Kate. That's reassuring.

I have a thread about public too: https://www.bellybelly.com.au/forums...d.php?t=154153

We'll still have our IM, it would just be for birth instead of the whole pregnancy. TBH, I'd prefer just our IM. She's great, she knows our history, we have hour long appts in our living room which DH can attend without taking time off work. It was her advocacy that meant we ended up with a vaginal breech and not a c/s.

It's for the just-in-case scenario. Just in case we have a m/c, what happens if you're in the public system and need a D&C? Just in case bub is sick, does a private OB make any difference?
If I want/need inducing or a c/s, what's the difference between private and public? The main benefit I can see is continuity of care. We were lucky with the last bub to get a consultant who can do vaginal breech. That may not happen again.

Aargh - it's all doing my head in. Why can't you engage an IM for everything and just call in an OB when it's needed?

[Miss E]

We'll still have our IM, it would just be for birth instead of the whole pregnancy. TBH, I'd prefer just our IM. She's great, she knows our history, we have hour long appts in our living room which DH can attend without taking time off work. It was her advocacy that meant we ended up with a vaginal breech and not a c/s.

It's for the just-in-case scenario. Just in case we have a m/c, what happens if you're in the public system and need a D&C? Just in case bub is sick, does a private OB make any difference?
If I want/need inducing or a c/s, what's the difference between private and public? The main benefit I can see is continuity of care. We were lucky with the last bub to get a consultant who can do vaginal breech. That may not happen again.

Aargh - it's all doing my head in. Why can't you engage an IM for everything and just call in an OB when it's needed?

For me it was continuity of care, the fact that I could stay in hospital for longer and get more help with breastfeeding and that DH could stay with us, that made it worth the money. And I have to say after having a CS, it was great to have DH with us cos he was able to care for DS that first night while I was still bed ridden.

I have a friend who had a very similar labour and emergency CS to me in a public hospital. She had to wait 5 hours for her epidural after she'd requested it because the aneathisist wasn't available and ended up having 2 shots of pethidine in the meantime. I had my epidural being administered within 20 mins of asking for it in the Private hospital. Also, because her DH couldn't stay with them the first night, her little girl had to spend her first night in the nursery simply because she was bed ridden and couldn't care for her.

That said, I think our public system is very good and I'm not sure if I will be willing to fork out the money for private next time around... If you have an IM and go public you will be able to just call in an OB when it is needed, it's just you won't necessarily get to choose which one iykwim?

HTH

[Loula]

Why can't you engage an IM for everything and just call in an OB when it's needed?

Im sure my OB would be happy to do this

[Miss E]

I don't think the Medicare Safety Net applies to obstetrics anymore... but I could be wrong...

For me I ended up having to have an emergency CS and I did get a bill from the anaethsist (sp?), from memory it was about $400 - $500 and that was after medicare and PHI.

The first OB I saw was very expensive, I was going to be out of pocket about $6,000 for his fees alone (and that was with the Safety Net). I spoke to a few people and rang around to find someone else who could fit me in, then got another referral from my doctor for a different OB (who I ended up loving) and we ended only being out of pocket about $3,500 (with the safety net) for his fees, then there were scans, blood tests and the PHI gap, so all up were out about $5,000. His offices were in Clayton and weren't nearly as fancy as the first one whose offices were at the Freemasons, but I found him much more personable, very passionate about childbirth and very supportive and encouraging of my wish to have a natural birth. Happy to PM you his details if you're interested. I guess what I'm saying is OB's pricing is very different, but I think like any business a lot of it has to do with where they're located and the costs they have of having their offices, rather than just their experience iykwim?

[MamaPan]

yep i would agree w what Miss E said re the diff obs, go with someone who you gel with and who has good references... (assuming you have chosen someone you are comf with). the fees do vary a lot and some of them are kind of 'trendy'... but may not be the person you want... (or may be and thats why they are popular).
i wasnt sure if the medicare safety net thing changed (it was all changing aruond when DS2 was born)