ok i am going to sound like the biggest dumby EVER!! BUT can some please explain to me in SIMPLE terms how does it all work out going private to have your bubba?? i am talking fees/cost etc....
We are in HCF top hospital which covers pregnancy etc... BUT i have had all other 3 kidlets PUBLIC and next time round i am wanting to go private....but i can't get my head around everything.
OK so you get a referral to an Ob of your choice.
You go and see them. You pay for all visits and any scans and bloodtests. You can claim this at medicare but not from your PHI.
You usually get charged a management fee at the halfway point, this isn't (I'm pretty sure - my Ob didn't have one) claimable either. After the birth they then charge you depending on the type of birth you had. If you use an aneasthetist, his bill will be separate. The hospital stuff is claimable with your PHI.
They will refer you to the hossy they work at.
When labour starts you ring them and go in....you don't generally meet any midwives before that point.
You will end up substantially out of pocket especially with a reduction in medicare safety net for OB fees from 1 Jan 2010).
So you pay:
- Ob appts (mine are $100 per appt, $36 back from medicare)
- All scans (240-$400ish for NT, only a fraction back from medicare)
- [Blood tests have all been bulk billed - no cost]
- OB 'Planning and Management of Pregnancy Fee'. This varies hugely from OB to OB. Previously you could get a fair bit back if you were at the medicare safety net, however this changed from 1 Jan. Even in 09 I was out of pocket $2000 from $4000 PAMOP fee.
- PHI excess for hospital - whatever excess your cover has. Mine is $450.
- Anaesthesist fee - if you need an EPI or spinal or c/section you pay anything that medicare doesn't cover. I understand that this may be $1200 and upwards.
So! The main benefit is that it covers the thousands of dollars that you would otherwise pay for your hospital accomodation. But it is far from a free ride unfortunately!
I went private this time and have been suprised by how much I got back from Medicare once over the safety net (bummer this has changed now), my OB is also quite reasonable so it might pay to do some research before selecting an OB.
I paid $100 for the first 2 visits with my OB (got a bit back from medicare). I then paid $4000 fee (in 2 half payments) that covered all of my visits from that point on and the birth costs (they still take my Medicare card at each visit but no extra cost to me), from the $4000 I got $3000 back (this will have changed now that we are in 2010). I also had to pay for US's between $160 and $260 each (bit back from medicare). Hospital excess $500, so all up around $2000 to $2500 out of pocket (don't know the exact amount).
My OB had a sign in his waiting room saying that he charges at/under AMA recommended fees. I guess the one thing you can't control is the anaesthesist cost because I imagine you just get whoever is on at the time you need them (if you need them that is).
It does add up to a fair bit of money (even more now), I will have to weight up public vs private if we have a 3rd due to Medicare cutting the rebate amounts.
The management fee is partly claimable. Of my $4k, $1600 was 'Gap' amount therefore not claimable at all. Of the remaining $2400, it was claimable. I got $2K back dueto being above the medicare threshold. That is the area that will change from 1 Jan.
My difference from the PP is that her $4K OB fee included a number of appointments, so medicare claims could be made against the appointment component (I assume).
When you say 'fees after the birth' - not sure what you mean? Your time in hospie is covered by your PHI (less your excess). SOme OBs include a 'free' 6 week postpartum checkup, mine charges $100. He is expensive!
Health funds/going private to have bubs
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