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I'm so confused.
Please help me understand.
So I have private health insurance and want to give birth (eventually) in a private hospital in a private room.
My insurance will cover that part.
Do I have to have a private OB?
Can I not just rock up when my waters break ?
If I have an OB in that hospital how much do I have to pay for?
If you want to go to a private hospital, you need to have a private Ob book you into one - you need both the Ob and the hospital if you go private. You also need to choose an Ob that will work at that hospital - most have around 3 hospitals they work in. You can't just turn up as an Ob needs to book you into his time schedule for care (they can only do a certain amount of births obviously in a given period of time) and hospitals can only cater for a certain amount of women.
Obs have their own fees. You have to ask your Ob how much he charges and what the 'out of pocket' is, which is the amount you cannot claim back from anywhere.
Ps. labour starting with waters breaking is approx 1/3 chance - it seems the majority start with contractions or inductions going by a long running BB poll.
Thanks kelly.
So if I get an OB and he books me into a hospital. What will my out of pocket expenses be like?
Completely depends on the Ob - they dictate their own fees. Also with the structure of Medicare changing, it is confusing... but in 2002 I was out of pocket 2400 for my daughter, but for my second it was only around 900 from memory - but memory is bad! I think it's changed again since, maybe some girls can help you out. But again - each Ob has very different fees.
Sorry I just read that other part of your message about fees.
So are there cheap and expensive obs?
Anyone know a cheap one that uses Frances Perry in Melbourne?
I think there would be an average, but some are much more expensive, particularly the more experienced ones or specialists, e.g. in IVF, high risk...
Also bear in mind this cost doesn't include scans, tests, blood tests etc.
Ok so if I don't want an OB does that mean I have to go public?
Can't I have a midwife at a private hospital?
Yep - if you go private you need to have an Ob assigned to you regardless. Unless you want to pay for the Ob AND the midwife, you can have both, which is pricey as you can imagine.
If you go public, you don't need a private Ob or private midwife as you will get whoever is on at the time - you can't choose, but you can be a private patient in a public hospital if you don't want the cost of the Private Hospital but want a private midwife or Ob. Confusing isn't it!
Daves Girl
My OB delivers at Frances Perry, St V Private and Freemasons.
My OB's fee is $2600. This is broken down into 2 parts - $1600 at 20 weeks and the other $800 at 30 weeks. The $1600 portion i will get 80% back from Medicare as i have reached the threshold, the $800 portion i dont get anything back on this component.
I had to have a CVS and this was done in a private ultrasound clinic and was expensive, all up about $900 for the procedure and lab work, i got about $500 of that back from Medicare.
My 18 week scan was also done at a private clinic and it cost $180 of which i got $80 back from Medicare.
Also blood tests/lab work i have not been bulk billed and have been entitled to the scheduled medicare rebate for these. So once again out of pocket.
So yes, going via an OB and via private ultrasound clinics is not a cheap excercise. And i would say my OB's fees are average.
I also know they change frequently, as OB's have idenmity insurance that goes up every year and hence they pass this on to their patients. My girlfriend used the same OB last year and i know she payed less than me, not sure how much less. Also my sister in law that used him 3 years ago, payed half what im paying now.
Also I believe if you need for some reason a C/S, it will cost you again!!!
My friend had Insurance, had her private Ob & went to Knox Privtae, eventually needing a caeser, in total with OB appointments, bloods, U/S, the Hospital & caeser etc, she told me she was $7000 out of pocket from falling pregnant to having baby in her arms!!!
I almost died...
I go Public, I see MY own OB (he works in a GP as well) it cost me about $8 per visit, no charge for any boood tests at all, 2 U/S which after Medicare were approx $45 each... That is it... I will have him deliver baby if there are complications if not Midwives will do it & I am comfortable with this as DD was delivered by Midwives. I will see OB at the GP surgery for 6 wk check up & that's it!!!
I can go see him anytime at the surgery as a regular patient as well!
Maybe going Private in a Public Hospital is a cheaper option for you?
I also have friends that have Insurance but they go Public..
A work friend has full insurance through her hubbies company & she has a congenital lung disease & her private OB ($180) per appointment has told her any complications & she will be immediately sent to the nearest Public Hospital as Private hospitals do not have all the facilities!
She is so annoyed now as they have had lots of U/S & Bloods done & it's been really expensive so far & baby hasn't been delivered yet!!!!!
Tracey I think you may be right that going private in a public hospital is best for me.
Does this mean I can have a private room?
Im on a wait list for a private hosiptal at the moment my OB said that the worst case is that i deliver in a public hospital as a private patient. But this does mean that if this happened at the Royal Womens in Melb, the best i would get is a room i can share with 1 other and the worst case would be a ward of 4 women. So no private room, even though you are a private patient. Not sure if its different at other hospitals.
Hi Dave's Girl
Even if you're a private patient in a private hospital doesn't mean you are guaranteed your own room (well at some hospitals). Just depends on what's available.
And fees will also depend on your private health insurance and what it covers.
Our insurance has a list of doctors which participate in Access Gap Cover. Their website says that when you receive medical treatment in hospital as a private patient, Medicare pays 75% of the Commonwealth Medicare Benefits Schedule (MBS) fee and Defence Health (my insurance) pays the remaining 25% of the MBS fee. If the doctor charges above the MBS fee, you may have to pay the gap. But ... Defence can help cover the gap, in full or in part, if there is an agreement between the doctor and Defence Health or if the doctor agrees to use Access Gap Cover (which is Defence Health's gap cover plan).
I'm still learning too but I've been doing a lot of reading to try and understand it all.
So yeah, I guess the fees will also depend on who your health insurance is with.
Thank Fee. I think Australian Unity has that Gap cover thing too. I'll check it out today.
When I had DD at the Angliss, the first night I was in with one other woman,whom had 2 older kids so she kinda helped & talked me through heaps of stuff etc...
Next day she left & the morning I was leaving another woman was coming in.
I know my friends whom have had kids at Angliss enjoyed sharing a room with 4 others as it can get boring in Hospital!!!!
Dave's Girl,
I haven't had my baby yet, so i can't say for sure, but the obs I use is supposed to be very good (a lot of ppl i know use hi, and from our 2 visits, he seems to be very good), and be one of the cheapest Obs around. His name is Dr Peter Wein, and he delievers at Frances Perry (where i'm booked for), St V's Private, and Masada (i'm sure at plenty of others, but these were the ones i was interested in).
I'm also very confused about all the fees, mainly cos if i'm more than 4 days early i'm not covered by my private health insurance and have to go public, and although I can pay for my obs to come at deliever me (i'll probs go Royal Womens i guess), i don't really think its so worth it. So i have to work out some arrangement about only paying the pees (he also does them in 2 lots, 1 around 20 weeks, and the other 30 weeks i think) but i only want to pay them if i use him.
Just so everybody knows this, Latrobe health is the only health fund (that i know of at least - and i called a lot of them), that only has a 9 months waiting period for obs, rather than 12 months like all the others. Even if you are already preg, they don't consider this a pre-exisiting condition (after a lot of phone calls to confirm this). However, i don't think they pay out as much in benefits to your obs. I know that HCF (which happen to be one of the cheapest i found, but had to switch from them due to the 12 month thingy) pays out one of the best. Just thought i'ld share this info with anyone it can help :D
All the best
I received the schedule of fees from my OB on Tuesday. We have to pay $1700 around week 20, and he said depending on our situation, Medicare will pay back between $800 and $1400 of that. So out of pocket could be as little as $300! But then there's each visit which will cost $35 (medicare will cover some of that) and our first visit and scan will be $160. As far as I can see that's all we'll be paying. My understanding is there's little or no gap with regards to his services whilst in hospital. So I'm pretty happy. Just have to pay the $1700 upfront tho.
BTW.. we have top health cover with HCF (DH's work pays for it) so I'm guessing everything is covered.. including the baby. I must ring and confirm that tho.
Thanks everyone.
It's all so helpful to me!
Ok, i must be slow because i still dont get it.
So I can have my own ob (my gp is also an ob), but have baby in public hospital? And are all obs private, or are some public?
If i had private ob and baby in public hospital, do i still pay the same as if i had baby in private hospital?
Thats Ok Karina, i'm still confused a some of the finer points myself... I recomend asking the receptionists at you obs, cos they know all the ins and outs.
My obs works publically and privately. If you go into a public hospital as a public patient you get whatever obs is on duty. If you go in as a private patient (i think you don't pay bed costs, but i'm not sure about this one), i know i was told i could request my obs at the Royal womens, buti still ahve to pays my obs fee, which is like $1700 on average I think.
Be careful about asking about the medicare rebate, because they recently just changed the threshold, so i'm not sure how much you can claim back and when..
I don't think you pay nearly as much to have a baby in a public hospital, even as a pirvate patient with your own obs, then in a pivate, but once again it depends on your health insurance, the obs, the gap in the hospital fee and what the health insurance will cover etc etc...
Even if you are a private patient in a private hospital, it doesn't mean you will get your own room (norm depends on hospital and avaliability) - my dad and my FIL both recently had opperations and both times didn't get private room (well, my dad did in the last 3 days of his stay)..
I can't tell youhow many times i've called my health insurance asking them qns so i'm 100% sure about what i'm up for.... I recomend doing this, and writing down who u spoke to and when, cos sometimes they give you different answers
All the best...