Printable View
Hi there,
I've just been advised of my out of pocket costs for my Obstetrician, and nearly fell off my chair when I discovered that we're looking at over $3,500 out of pocket just for obstetrics ? that's without the hospital co-payments, aneasthetics, pediatricians etc. We're planning on going through the private system and having the baby at Freemasons. Just wondering if this is normal???
i've read of people who's out of pocket costs have been $4800 and higher.
it's pretty "normal" in the private system i think
Unfortunately, yes, that sounds pretty normal. For the Ob, I paid about $80 per consolt, $1500 pregnancy planning fee and then about the same again for the delivery. I'm still in shock because the bills are still rolling in. And the government doesn't think we need the $5000 baby bonus.:rolleyes:
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
Thanks... Just wondering who your ob was? It still seems a lot cheaper than what mine has advised... I am thinking I may have a look at changing...
Gotta love the way they wait untill you're nine weeks and all booked into the hospital before they tell you their costs
Hi,
Surely I'm not the only one who has not paid anywhere near that much out of pocket????
A lot of it depends on how much the Obs charges versus how close you are to the Medicare safety net.
I paid:
$150 deposit for Hospital (not sure if this is refundable or what exactly but not from Medicare, this is just an out of pocket expense)
$280 for first Obs visit, of which I received $120 back from Medicare
We also paid for scans and some other tests, all of which we claimed back through Medicare and all of which contributed towards the safety net threshhold.
Then I paid nothing more for the Obs until I received the "big" bill at 20 weeks, which was around $3,200. However at this point DH and I were well over the threshhold with Medicare and we received 80% of that back - so over $2,500. All up out of pocket is just short of $1,000 so far.
And for the care I have received from my Obs, I am delighted with this cost and was more than happy to pay it.
I've been told that all hospital costs for the delivery will be handled by my health insurance - so we will pay our $150 excess and that is it.
This includes any anaesthetists costs or (hoping we don't need it) pediatrics.
I think the important thing is that it is not really so much about how much the Obs costs (though I'm sure there's a good deal of variation and its definitely worth ringing around if you're concerned) - it is about what your private health insurance covers (for hospital costs) and how close you are to the Medicare safety net (for costs prior to birth).
Medicare can tell you how close you are by the way - give them a call.
Ocean Princess, you're making feel a little bit more positive about the whole thing. Just wondering who your OB is and what hospital you're going with?
I've spoken with my health insurance etc and am more comfortable with what they cover. For me it is more about my OB's fees which seem extremely high.
At 20 weeks they send you a bill for $1700 which they advise is not claimable from private health or medicare (even under the safety net)
Then at 30 weeks they send you a bill for $3,500 which isn't claimable through private health, but can be claimed under the Safety Net (so after the first $1,000 you can get 80% back of the remaining $2,500 = $2,000)
So all up I'm looking at $3,200 out of pocket for OB alone, plus the costs for my initial and follow up consults...
Am seriously considering changing OB's but am finding that the couple who I have called this morning are already booked up...
Any recommendations anyone can give would be very much appreciated
I got a similar bill from my OB who told me that it was not claimable. I took it to medicare anyway and got some money back, despite my OB saying I couldn't. So I agree with earlier posts, ring medicare and ask them.
Miss, I'm with Dr Samantha Hargreaves, she has been fantastic. Delivers at Frances Perry, St Vincent's or I think Freemasons. Not too sure about Freemasons though.
We chose St Vincent's.
Those bills do seem excessive :o
GL with your search.
Having said all of the above, please don't quote those figures back at any Obs - for all I know they have a different charging system for different patients etc.
Just ring some of them up and find out fees.
Thanks heaps for that. Just called her offices, but she is all booked out for my due date :( Seems everyone is... I might just have to swallow the costs...
Agh, bad luck... doesn't surprise me though as when I rang to book her I was 5wks pg and the receptionist said "Yes, we should just be able to fit you in, lucky you didn't call any later!" :o
Pregs Pillay is who i saw he is fantastic
Why is that? I'd be speaking to my health insurer and/or medicare.:
At 20 weeks they send you a bill for $1700 which they advise is not claimable from private health or medicare (even under the safety net)
Then at 30 weeks they send you a bill for $3,500 which isn't claimable through private health
My health insurer has a 'bonus' amount applied to our insurance each year (though we haven't used ours yet and I think it's at it's limit :o ). Do others have this? Its something like $200 per year for families and $100 per year for singles? And you can apply it to anything that is claimable on private health, but they won't pay on medicare item numbers. So if you claim something on your private health and there's still a gap, you can use your bonus to cover the gap, KWIM?
Don't forget that lots of your other health costs go towards the safety net too.
For us, as soon as the out-of-pocket costs for my husband and I (make sure your entire family - defactos count too - are registered as one for the safety net), go over about $1050, we are covered by the safety net. The way things work for us is that with
- "normal" GP visits, for various things, for the both of us for most of a year
- less normal but unavoidable visits to specialists etc for both of us (husband in particular has some ongoing health issues, so has had a few of those this year)
- ultrasounds for me with the pregnancy, at 6, 8, 12, 20 weeks so far
We are already at th safety net for the year, before we pay the sum that is claimable to our ob. That means when we pay the $2800 claimable to the ob in a couple of weeks time, we'll get 80% of that back right away.
For you, depending on the time of year you are due, you might not hit the safety net before paying that large OB bill. But all that means is that you get much more back on your costs later on in that year: GP for the baby, ultrasounds, etc.
I think for our entire pregnancy and birth, we're looking at something like:
$200 initial OB fee, think I got $60 back from medicare
$2800 OB fee at 20 weeks, will only have to pay $560 of that due to safety net
$1400 final OB fee, not claimable anywhere
Hospital should be entirely covered by health insurance
Ultrasounds have been about $200-300 so far (for 3 ultrasounds), and will hardly cost anything from now on, because we are at the safety net.
So a total cost of around $2500 in total. It's a lot of money, and to pay it we have to reduce costs on other things, like not owning a car. But I am so far very pleased with the level of care and service I am getting from everyone: obstetrician, midwife, ultrasound technicians, etc. I think it's worth it.
Anyway, if you want to put it into perspective, that baby will cost you sooo much more than this until he/she hits 18 and can be independent.... Relatively speaking, the cost of these first 9 months in utero is small! :)
I'm going private & am in S.A. My Ob fee is $2700.
We pay $1732 at 24week visit (this is claimable at medicare) then remainding $900 at 32 week visit.
I'm going private and between our private health insurance and medicare safetynet we are hardly out of pocket at all so far perhaps around $1000 and for the care I have received from my Ob it is sooooo worth it.
LOL... so true!:
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.
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.
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
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!
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!!!! :p
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.: