26 March 2019
You're about to embark on some of the most rewarding times of your life. But just like all big milestones, this one requires thought and preparation. Once you've made the decision to have a baby, get everything in order to make sure you're covered.
Plan ahead, there are 12 month Waiting Periods
There’s a 12-month waiting period before you’re able to claim most pregnancy-related expenses. This means if you’d like to take advantage of private care during your pregnancy, you need to already have an appropriate level of health insurance before you become pregnant.
If you have hospital cover with another health fund it is important to check your cover. Many funds have policies that exclude pregnancy or limit you to births in public hospitals or limit the benefits they pay.
Police Health’s hospital cover has no exclusions – so pregnancy-related services are included as standard.
Generally hospital charges only relate to mum
If everything goes smoothly with the birth, the baby is not officially admitted into hospital and so the mother is the only person that the hospital bills are for.
But if, for example, there are complications and the newborn needs extra care, or if you have twins (or a multiple birth of any kind), the child with complications or your second and subsequent baby will be admitted as an in-patient in their own right and therefore a bill will be raised against their name as well as that of the mum.
We recommend that you add your newborn baby to your health insurance policy as soon as possible.
There are some requirements around adding a newborn child to your cover, and if met, then the newborn will be taken to have met the same Waiting Periods as the Contributor. For this to happen, family, couple or single parent family policy holders have six months from the date of birth to add the child and single policy holders have two months to add the child. The child must be registered from the date of birth, and if you have single cover, the new premium must be paid from that date. If these requirements are not met, then the child will have full Waiting Periods imposed.
The good news is that if the Contributor of the policy has served all the required Waiting Periods and the requirements for adding a newborn child to the policy are met, then the newborn will have no Waiting Periods before benefits are payable.
The other positive is that if you do have multiple births or there are complications requiring the newborn to be admitted to hospital, you will generally have time to add the child and have the child covered for treatment.
If you are in doubt about the coverage of the newborn, please give us a call on 1800 603 603.
Don’t forget to officially add your newborn child to your health insurance policy as soon as possible and within the required time frames. We just need their full name, gender and date of birth in writing, so please email us at email@example.com. Feel free to send us a pic too, our staff love to see our newest members!
What’s covered, what’s not
As a private patient going through pregnancy, there are still a few out-of-pocket expenses that you’ll need to pay.
Typically appointments with your obstetrician or specialist that happen outside of hospital or as an out-patient at a hospital cannot be covered by health insurance, but often Medicare will pay a benefit. The amount you pay out of pocket will depend on what your obstetrician or specialist charges in relation to the Medicare Benefits Schedule, so ask your specialist to give you an estimate of expenses up front before you commit.
If the baby has a paediatrician appointment in hospital this is claimed from Medicare and there will likely be out-of-pocket costs to cover. Where the baby has been admitted as an in-patient of the hospital both Medicare and health funds can pay benefits – meaning smaller or no out-of-pocket costs.
Where your health insurance will be of value is coverage for the birth.
Every health fund’s coverage is different. But Police Health Members with Gold Combined or Gold Hospital cover can have peace of mind knowing they’re covered for the following;
- Hospital treatment, including accommodation as a private patient in a private or public hospital
- Doctors' bills while admitted in hospital
- Comprehensive cover for ambulance – two month Waiting Period applies
With your Police Health cover, you also won’t be faced with any Excess payments or Co-payments.
IVF and Assisted Reproductive Services
For information on IVF and Assisted Reproductive Services, including what’s covered under your Police Health policy, click here.
Still have questions?
There is a wealth of information on all things pregnancy and private health insurance here. Of course, if you have anything you specifically want to ask, just call us on 1800 603 603.
For specific questions regarding your pregnancy, speak to your obstetrician, midwife or general practitioner (GP).