One of the most common misconceptions about private Obstetric care is the cost.
"How much it is going to cost for a Private Obstetrician"? Unfortunately for expecting parents it can feel like you are trying to find out
"how long is a piece of string"
or
"how many grains of sand on a beach?"
But rest assured it doesn't have to be that way.
We have put together a little Q&A of or most commonly asked questions in our practice about Obstetric fee's and out of pocket cost's
What's the costs? how does it all work?
According to Birth Choices report with private health insurance the overall cost can range from $2500 upwards of $20,000, which is sure to make your wallet weep!!!
However,
the average out of pocket costs for our Obstetric fees for our practice actually around only $1863.70 for our GMHBA health fund members for Obstetric Care
It's really important to remember to that any outpatient services are generally Medicare claimable and any inpatient (hospital) cost's most of the time are claimable on your private health insurance.
Do Obstetrician's all bill the same?
No, It is also important to remember that all Specialists' bill differently so it is important to do your research before hand.
It Is always a good Idea to find out if their are any out of pocket costs such as :
- Planning and management fee amount?
- Out of pocket fee after the delivery "GAP" to be paid ?
- Ongoing Consultation fees, both initial and on-going?
So I have taken out private health insurance , how does it all work?
It’s a good idea to ask your private health insurer and your obstetrician about costs.
We advise all of our Obstetric patients to take the time to do a quick
HEALTH FUND CHECK LIST:-
1) Does your policy cover you as: Private Patient in a Private Hospital for Delivery of your baby
(if you know the hospital you are delivering at state the hospital also)
2) Obstetric cover; does you cover include Obstetric cover? -
3) Confirm you Expected Due date with the Fund
4)Ensure you will be covered at the time of delivery
(Have you have served all of you waiting periods in relation to this)
5) When do I need to add you baby onto you membership?
(if you are on a single policy you may need to change over to a family policy a few months prior to baby being born, your health fund should advise you on this)
6) If need be will you baby be covered for special care nursery admission?
7) Do you have a hospital excess? This amount will be paid to the hospital and is separate from the Obstetrician's fee's.
I'm not pregnant yet, but hoping to be in the future, what do I need to do before then?
- It is a really good idea to consider the abouve checklist even prior to falling pregnant. The average Obstetric cover for most health funds policies is actually 12 months before you can actually claim any pregnancy related expenses.
- Make sure you private health insurance actually includes 'Obstetrics' in the policy, It is quite easy to get bamboozled in the health fund Lingo but if you use the checklist above you should be on the right track
- Register for a Family Medicare Safety Net:
What is a Medicare Safety Net & Why is this important?
- It provides a higher Medicare benefit for out of hospital costs.
- Your doctor’s/specialist visits will still cost the same, but we’ll give you a higher benefit back.
Our Obstetric Patients will reach the out of pocket threshold of $2093.30 when you pay your 28 week planning and management invoice.
It is important to register with the Medicare Safety Net for yourself and your partner.
This will allow you to claim any out of pocket costs & reach your safety net sooner Important things to remember about the Medicare Safety Net:-
- For a Family Safety Net, confirmation of who the family members are needs to occur before we can Medicare will pay higher benefits.
- Medicare will calculate the Safety Net on a Calendar year: 1 January to 31 December. (not financial year)
- It applies to both single/defacto or members of a registered Medicare Safety Net family.
Medicare Safety Net :
For medicare safety new a Family is classified as any of the following: # a married couple - not separated, with or without dependent children
# a couple in a de facto relationship, with or without children
# a single person with dependent children
- If you’re registered as a family or couple, Medicare will combine your medical costs so that you are more likely to reach the thresholds sooner. -
Dr Saj's Patients will reach the out of pocket threshold of $2093.30 when you pay your 28 week planning and management invoice. - Your planning and management fee will put you over your Medicare safety net and last until 31st December that same year. (Hospital fees do not contribute to this safety net) . Reaching the out of pocket threshold: Each time you or your family claim from Medicare will keep a record of the out of pocket amounts during the calendar year. How do I know if I have a registered Medicare Family Safety Net? When your family gets close to the threshold amount Medicare will tell you. You can then confirm your family members and get the higher Medicare benefit when your family reaches the threshold. If you’re single Medicare automatically pay you the higher benefit when you reach the threshold. You can check your Medicare Safety Net balance any time using your Medicare online account through myGov or the Express Plus Medicare mobile app. https://www.humanservices.gov.au/customer/services/medicare/medicare-safety-net
So My friend had a baby and she received other bills after the delivery, what would these be for?
Hospital Fees: You can get part or all of the cost of your hospital stay back from your private health fund, if you have one. quite often this is just your hospital excess and your health fund can tell you what this cost will be.
Ultrasounds & tests: You will need to pay for the costs of some tests and ultrasound scans but most of the time these are Medicare rebatable and often the difference is quite minimal once you meet you medicare safetynet.
BIRTH CLASSES: You might have to pay for birth classes if the private hospital doesn’t include them in its package. If so these are most often claimable from your health fund.
Paediatrician: we advise our patients on the peadiatrican as costs these often invoiced to you after you leave hospital and are medicare claimable once paid. In most instances their is very minimal out of pocket costs if the baby is born in the same calender year in which you have reached you Medicare safety net.
to give your baby a health check. You can often get some money back from Medicare and your private health fund.
Anaesthetist. If you have an epidural, You can get some money back from Medicare and/or your private health fund.
I still have questions what can I do?
Still unsure, contact our rooms and we can certainly advise you on our practice fees and ongoing care Ph : 03 5222 8858 or via Email admin@gcog.com.au