Best health insurance plans for pregnancy

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The first chapter of parenthood is a momentous time, full of excitement, anticipation and – yes – there’s a dash of stress as well! For many Australians, planning to start a family involves taking out private health insurance or upping your current level of cover to a higher tier. After all, only with the right pregnancy insurance can you guarantee your obstetrics fees will be claimable.

So while you’re worrying about what to name your little one and what colour to paint the nursery, make sure you also take some time to find the best health insurance for your growing family. From maternity benefits to postnatal care, understanding your insurance options is the key to a smoother, more confident pregnancy journey.

What’s the best private health insurance for pregnancy?

Choosing the best private health insurance for pregnancy first requires you to understand the types of services involved in this lengthy process. It might be worth looking for policies that include comprehensive maternity benefits, covering a range of services from prenatal care to delivery and postnatal support. This should include visits to your obstetrician, ultrasounds and hospital stays.

Compare health insurance policies and see which ones allow you to choose your preferred healthcare providers. As this is a very personal and sometimes overwhelming time in your life, you want to make sure you can choose an obstetrician and hospital that you trust. Some family policies might also include extra services like childbirth education classes, lactation consultations, postpartum check-ups and mental health care.

Key features to look for:

  • Maternity cover: The best pregnancy policies cover a broad spectrum of maternity services, including prenatal visits, ultrasounds, hospital stays, postpartum check-ups and more.
  • Surgery inclusions: Even if you don’t initially plan to have a Caesarean (C-section), sometimes it’s the safest way to bring your little one into the world. Make sure your preferred policy includes all the costs of having a C-section, including things like fees for the anaesthetist, surgery assistant, etc.
  • Flexibility in providers: Look for policies that allow you to choose your preferred obstetrician and hospital.
  • Additional support services: It might cost a bit extra, but having pregnancy insurance that goes beyond basic coverage and includes support for birthing classes and lactation consultants, for example, can give you more peace of mind.
  • Waiting periods: Be aware of the typical 12-month waiting periods for obstetrics services and general maternity coverage. You’ll want to plan well ahead of time before you fall pregnant to ensure you can claim on the various expenses of childbirth.
  • Out-of-pocket costs: Even with the top level of pregnancy insurance, there may still be some gap fees or out-of-pocket expenses for your pregnancy. It might be worth drawing up a budget to make sure you aren’t left with an enormous bill postpartum.

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What’s covered by health insurance for pregnancy?

Here in Australia, health insurance for pregnancy generally covers a broad range of services to support expecting mums and dads. Maternity coverage includes prenatal services like obstetrician appointments, diagnostic tests like ultrasounds, as well as the hospital stay during delivery.

Many pregnancy health insurance policies these days also include postnatal care, which might include things like lactation consultations, postpartum check-ups (several months afterwards), as well as other necessary medical support after you give birth. This can be a huge weight off your family’s shoulders at a time when you are spending all your time caring for a brand-new little human.

What’s most important is that you take enough time to review the specifics of different insurance policies before you switch, and then weigh up the key factors like waiting periods, out-of-pocket costs, extra support services that are included, and of course the monthly premiums.

What does Medicare cover?

In addition to private health insurance, Medicare will cover a portion of your medical costs during pregnancy, including things like visits to your GP, some prenatal tests, as well as some of the fees for obstetric services during delivery. However, it won’t cover all the expenses, and if you are only relying on Medicare then you will most likely give birth through the public hospital system.

So if you want to give birth in a private hospital or have certain elective procedures like a planned Caesarean, then you will need to complement Medicare’s cover with private health insurance.

Does pregnancy cover also include IVF?

Because in vitro fertilisation (IVF) can end up costing tens of thousands of dollars each time you undergo treatment, many Australians turn to private cover to shoulder some of these costs.

While private health insurance is not a necessity for IVF or other fertility procedures – Medicare will cover a portion of fertility treatment costs, especially after reaching the Medicare Safety Net threshold – it can reduce certain out-of-pocket expenses. For example, Medicare may cover egg pick-up (EPU) and embryo transfer (ET), but not hospital fees or anaesthetics. That’s when you’ll need a private health policy.

Can I get health insurance for pregnancy if I’m already pregnant?

Getting health insurance for pregnancy while already pregnant can be tricky due to the 12-month waiting period on most pregnancy policies. During this time, you won’t be able to claim any benefits on your pregnancy health insurance.

If you become pregnant before getting private health insurance, this can be a huge headache. However, if you're something like six months into the waiting period and discover you are pregnant, you’ll be able to start making claims before the baby arrives.

As with all things, planning can save you time and money, and help you avoid a load of stress!

Is it worth getting private health insurance for pregnancy?

Whether or not private health insurance for pregnancy is cost-effective for you and your family will depend on your circumstances, especially your budget. The good news is that here in Australia we have Medicare to cover a big portion of pregnancy-related expenses.

However, private health insurance can offer you a huge range of extra benefits – some of which are very important to the average Aussie, like being able to choose your preferred doctor and obstetrician or staying in a private hospital after giving birth.

Private health insurance for pregnancy might also cover certain out-of-pocket costs that Medicare doesn’t allow you to claim on. To decide if it's worth it, think about your preferences and financial situation, and see if any of the various policies align with your circumstances.

Pros and cons: Pregnancy through public vs private

Public system – Pros:

  • Cost: Public maternity care is generally more cost-effective as it’s covered by Medicare.
  • Access: Public hospitals are widely accessible around the country, so you’ll have access to care no matter where you live.
  • Duty of care: Public hospitals have so many skilled healthcare professionals who can take care of you – and bub – on this journey.

Public system – Cons:

  • Limited options: You won’t have the freedom to choose your healthcare provider or where the baby is delivered.
  • Waiting times: Public healthcare often involves longer waiting times for appointments and surgeries.
  • Shared facilities: In most cases, you’ll end up sharing a hospital room due to high demand in the public system.

Private system – Pros:

  • Your choice: You can choose your obstetrician and get to enjoy continuity of care.
  • Comfort and better amenities: Private hospitals tend to have more comfortable, private rooms and other facilities you can take advantage of.
  • Shorter waiting times: In general, private healthcare has shorter waiting times compared to the public system.

Private system – Cons:

  • Cost: Private health insurance and out-of-pocket expenses can put a dent in your hip pocket.
  • Accessibility: Private hospitals can be limited in more regional parts of Australia.
  • Standard level of care: Basic maternity services are similar across both the public and private systems, so the additional cost might not always translate to better care.

Final word

Getting pregnant – whether it’s your first bub or you are growing your family with another little one – is an incredibly exciting time. But it’s also stressful, especially when you have to start thinking about the financial implications.

The good news is that private health cover can swoop in and save the day (and your bank balance!). So plan, compare policies online and make sure you see out the waiting period before it’s time to welcome your new baby!

Simon Jones
Written by
Simon has spent more than 15 years covering the technology and finance sectors as both a journalist and content marketer. He is fascinated by the convergence of AI and big data, and spends what little free time he can scrape together either wrangling two kids or expanding his gin collection.

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