Public Hospital?

Hi everyone

I'm fairly new to Australia (from America), and I don't have private health cover. I'm wondering if anyone who has gone through pregnacy and delivery without private cover could share their experiences with me. Will Medicare cover U/S's and blood tests along the way? When it comes time to deliver (I will be delivering via a planned caesarean due to previous myomectomy to remove fibroid tumours), what all will I have to pay for? I know Medicare covers the hospital, but will it cover the procedure and the doctor's charges? Sorry for asking so many questions, but maybe if I get your opinions I can be prepared for whats to come.

Thanks!
Stephanie :)

Dont know about this darling (but someone will!).. just wanted to say welcome to BB.. and Australia too I guess! :) Where in the states are you from? hope you're liking it here.

K

Hi Stefnie,
I'm sure there is someone here who can give you a breakdown on costs, some of it will be out of pocket but keep in mind that after the birth the govenment grants you a $3000 baby allowance that will help defray costs.

Kerrie

Kirby - I'm from Long Beach, which is near Los Angeles. I've actually been in Melbourne for almost 2 years now.....but it seems to take much longer than that to figure out the Medicare system lol. For example, I have been seeing a gynacologist here for about 6 months, she is helping me with PCOS so that I could conceive, and I already had an appointment scheduled with her for next week to review my progress BEFORE I knew I was pregnant, so when I found out I was I called her office to see if I should just keep the existing appointment but change it into my first prenatal appointment. They said to keep the appointment but that I will need a new referral because it is a new "condition"! What the? So I guess I have to go see my gp and pay for an appointment just so I can get a referral. Seems ridiculous to me. Anyhow, if anyone has any input on public hospitals, I'd appreciate it. Has anyone gone through a high risk pregnancy through a public hospital? I will be on heparin injections throughout my pregnancy and post partum and will have to have a planned caesarian when the time comes.

Thanks for your help!
Stephanie

Hi Stephanie and welcome to BB.
Yep, the medicare system is complex - and going to your GP to get a new referral for a new condition or when your referral runs out has always bugged me - seems to just be a waste of money for the govt to be funding trips to the GP just for a referral. anyway enough of my whinging.

Public hospitals will vary with the "model of care" they offer for pregnancy eg. most have midwife only clinics where you see mainly widwives but see a doctor 3 or 4 times, usually again just when a referral is need for a test or u/s. some have homebirth clinics, some have where you see the same widwife all thru antenatal to postnatal. I think some have high risk clinics. Where do you live in Melbourne? I went to box hill hospital and they are good but check out your local public hospitals services. They usually have that detail on their websites.
charges will vary - most public hospitals will send you for test on site so there will be no charge but for ultrasounds sometimes they send you to a private ultrasound place and therefore there will be cost on top of what medicare gives you.
Then for inpatient stay - you can elect to be a public patient and get no choice of doctor and then all your hosptial charges will be covered. Or you can be a private patient in a public hospital if you want to choose your own doctor (but the docor has to practise there of course) then you will get bills from the doc. and I think also theatre fees and anaesthetist as well. If you don't realy have a preference for doctor then there is no point doing that.
Probably best to ask your gynae when you see them. good luck

Hi - A friend of mine recently had her second child by elective CS at a public hospital and had her own doctor. She had to pay the gap (between what the doctor charges and what the government will pay) for each monthly/fortnightly/weekly visit.

Also, the gap on three ultrasounds - which is about $80 a time. Like they charge around $130 at the time, but you can claim about $50 back thru medicare.

ALso, her doctor charged a one off fee and there was some sort of fee for the epidural at the time of the birth.

BUT then, once you get to $500 out of pocket expenses, isnt that when that safety net thing kicks in and you can start getting some money back ?

Good luck - I've been a patient in both public and private hospitals and apart from food being delivered hotter and the icecream not melted at private, didn't find much different.

Barb.

So what does private health insurance cover that medicare doesnt cover?

I know private health insurance probably differes greatly depending on what levekl of cover you have.. but can anyone tell me a rough idea of the difference?

Karina,

To be quite frank, the only thing private health insurance is good for with regard to obstetrics is the ability to choose your doctor. If you go public, you will just have to have whoever is on duty, but that said, the public hospital system in this country is fantastic. If you are in a private hospital and, God forbid, you or your baby have a complication, you may end up being brought to the nearest major public hospital anyway simply because they have all the facilities on site that you are ever likely to need.

I know many people who have had their babies in a public hospital and they have no complaints. On the other hand, I have heard many gripes about others who have paid top insurance cover and gone private, only to walk away with bills of almost $10,000 for out of pocket expenses.

Seems ridiculous, doesn't it?

Ohh ok. So you cant choose your doctor if your going public?

If ou go public, are you liley to have out of pocket costs? like epidurals tc, or is that included?

I thinks thats crazy, to spend all that extra on private cover then still have to pay a massive amount of out of pocket costs. Argh!

There are plenty of costs involved beforehand though. Any gap your doctor charges (mine is $15) will be charged each visit with the rest paid by Medicare. The doctor may arrange to receive the cheque from Medicare or you may have to pay the full amount upfront and get a refund from Medicare.

The ultrasound also has a gap between what Medicare allows for and what it actually costs. Mine was about $80 that I had to pay and the hospital arranged to receive a cheque from Medicare for the rest.

So it's not exactly free, especially if you have to have a lot of ultrasounds due to complications.

Ohh k. I never knew anything about any of the costs involved in actually having a baby and costs beforehand for checkups and US's so this topic has been really helpful. I hope i didnt hijack it or anything. 8-[

Thanks everyone for all of the information, very helpful. I have an appointment this week with my current gynaecologist - she doesn't bulk bill and only delivers at Casey Public Hospital in Berwick (Melbourne). From what I understand they are only set up for low risk deliveries. Should I have her refer me to another doctor, or should I have my gp refer me to the hospital (Frankston is where I'd like to have the baby) or what? I definately want to keep the out of pocket expenses down, but also want to be sure that I have the c-section somewhere that is ready to handle any unforeseen emergency that (God forbid) should arise.

Thanks again for your help, and I'm glad my post has been helpful to others as well - hi-jack any time!

-Stephanie :)

I have been privately to a GP who delivers at the hospital I was going to 3 times and through the antenatal clinic once. Each time i was a public patient. The difference with antenatal clinci was I got the dr on call for the delivery, no choice about that. The other way I pd the medicare gap ea visit $15 and $500 after the birth for the Dr attending the birth. This way I got to choose my Dr, which I definetly recommend.

I didn't pay for any Ultrasounds and I had one at 12 weeks, one at 20wks and then one a week bf delivery to check size.

I was happy with the public hospital, the quality of care was great and I actually enjoyed being in the room with someone else, gave me someone to chat to. If you go in public you can stay for a week and still pay nothing.

Good luck with everything
Michelle

Stephanie, I had my son Alex at Monash Medical Centre in Clayton. He was five weeks early and I was in hospital for a month before he was born.

I had an emergency c/s and Alex and I were both in hospital for ten days after he was born.

I was a public patient. If I had chosen to go private, I would have had $100/night for out of pockets, plus the anaesthetist, obstetricians (I had two), paediatricians (two) and hospital fees. It would have been well over $10,000.

I now can't get private health insurance for obstetrics. They just won't cover me!

Monash also has a NICU and SCN, so if you're expecting a child early, or that might have problems, try Monash.

I'm currently in their High Risk clinic and don't pay a cent for any ob visits or ultrasounds.

Thanks for all of your help! Its put my mind to rest to know that I will be able to have the baby without too much out of pocket expense, even though I don't have private cover.

Shannon - Good luck with your upcoming delivery! Oh, and yes, I do have a Medicare card...thank god! A few months after I moved here I ended up in the Emergency Room at Frankston Hospital with a pulmonary embolism, there were tests and scans and a 3 day stay in the hospital, plus 2 days of home visits for Heparin injections, then blood tests every few days for months......it cost a fortune, and we're still trying to pay off the hospital bill! This happened exactly 1 month before my wedding, and about 6 weeks before I was eligible for Medicare - talk about lousy timing!

Thanks again everyone
Stephanie

I'm having my baby at a public hospital, have private insurance but haven't decided whether to go private or public. I have not seen an OB and hopefully won't as my GP practices obstetrics and will deliver the baby unless a c-section is required, which may be a possiblilty...this is why I'm thinking I might have to go private. I've heard nothing but horror stories about 3 (I don't know if there are more) of the OBs at this hospital that I'd get to see if I went public. If I choose to go private I get to choose my OB and can get a really nice female OB about whom I've heard great things.

I just don't know whether its worth it on the off chance that I'll need a c-section..when do you have to decide, is it when you book in?

Hi there! Sorry I didn't see this before. I am from San Diego originally, but have been in Australia for 10 years now (wow what a long time!!!)

I had Matilda in the public system and the only thing we paid for was our u/s. I had an emergency c/s and did not pay a cent to anyone. I think because I went through the public system entirely. I also had not one complaint about the way things went. I did have a dodgy OB but I think because we had a big communication break down during a stressful day ( the day after I was supposed to be induced...) other than that no complaints whatsoever & our next will be via c/s at the same hospital :)

I see my OB who wrks as a GP also, he can do C/s also if required...
Up until 20 wks you pay about $8 out of pocket to sere him, but after 20 wks it is Bulk Billed, it then costs me about $50 per U/S I have had 2, but hospital etc are all Free as I have him attend but through the Public system....

Maybe you can get to see an OB/GP....?

Good Luck

Can you go privately to the dr you want and just go into hospital as a public patient cos thats what I did, cos I wanted my dr.
Cheers michelle