We have an increasing number of pregnant women who are not in health funds contact us for information on fees for private pregnancy care.
Below is a guide as to what you can expect and where possible bills will come from. It is impossible to do an exact calculation of the cost you will be in for as it will vary because of unpredictable developments in pregnancy and childbirth and because fees for the same service will vary from one doctor to another.
Dr Sykes’s fee
Whether or not you are in a health fund is irrelevant for your ‘out-of-hospital’ pregnancy care, as long as you have Medicare cover. That is because health funds only contribute to ‘in-hospital’ care costs.
We are a ‘no gap’ practice for health funds which means we send our invoices for delivery and inpatient care directly to the relevant health fund for remuneration without there being any gap for the patient to pay. But as you are not in a health fund you will need to pay in full the delivery fee by 35 weeks pregnancy. You can claim a portion of the payment from Medicare. Please ask my secretary for more information.
Norwest Private Hospital has special prepaid packages for 1 night, 3 nights and 5 nights stay. Phone our office for more details.
If there are complications of pregnancy that necessitate you being admitted before delivery or need admission to intensive care, etc. your hospital fee will be more.
If your baby needs to be admitted to the Special Care Nursery for six hours or more there will be an extra fee.
Other doctors’ fees
As well as Dr Sykes’ fee and the hospital fee you will be invoiced separately by other doctors who are involved in your care or the care of your baby. This will include a paediatrician, possibly an anaesthetist (if you have an epidural in labour or Caesarean section) and possibly a surgical assistant (if you have an elective Caesarean section).
If you have a very complicated pregnancy, delivery or postnatal period other doctors may need to be involved in your care, who will invoice you directly. There can be part reimbursement of doctors bills through Medicare. If you had been in a health fund with an appropriate level of cover, the health fund would also contribute part reimbursement for medical services while you are an inpatient.
Health fund waiting period
Some health funds will still cover the baby as long as you join a minimum of two months before your delivery and have the baby on your cover.
Each health insurance company has varying policies with your cover for pregnancy so you would need to call them to find out their specific requirements. We consider the cheapest option is single parent cover and be ready to add your baby to your policy.
A list of health funds is on the Australian Government Private Health Fund website. You can also compare fund on this official government website
See also the website article How much will it Cost? for more information on billing and possible out of pocket expenses.