Starting a family or expanding your family is such an exciting time in your life. Pre-planning this family event relating to your private health insurance is vital, if you wish for your maternity admission to St John of God Hospital Ballarat to be covered by your private health insurance company.
Many people only begin to think about adding maternity cover to their private health insurance policy once they have conceived. Unfortunately, it is then often too late.
Most insurers have a 12-month waiting period before you can claim for maternity or obstetric related services. If you have not served a full 12 month waiting period on your private health insurance policy, you might be disappointed to find you are not covered for birth in a private maternity hospital.
If you find yourself in the position where baby is due and you have not served waiting periods, you are still welcome to utilise the Maternity services at St John of God Ballarat, but you would need to do so as a self-funded patient.
Waiting periods with private health insurance companies mean, you cannot claim for a particular service until that waiting period has been served. For maternity or obstetric related care, this is generally 12 months.
You may have served a 12 month wait by the time your baby is due to be born, however we also need to consider the care you may require leading up to the birth of your baby.
If you require an admission relating to your obstetric care while you are still within the waiting periods, your fund may not cover your antenatal admission. (Antenatal - meaning before birth, during your pregnancy or relating to your pregnancy)
It is therefore important to think ahead and investigate your private health insurance options as soon as possible, even if you aren’t planning to conceive for another year.
Private Health Insurance Checklist
Here are some important questions to ask your health fund as you are planning your pregnancy.
Are Maternity/Obstetric services covered in a private hospital on my policy? (If your fund asks you for CMBS item numbers, you can quote 16519 or 16520.)
Some health insurance policies will cover you as a private patient in a public hospital for maternity/obstetric services – but if you are choosing private hospital care for maternity services you would have extensive out of pocket expenses. Do ensure that your policy covers maternity in a private hospital.
Have I served waiting periods for maternity/obstetric services?
This is an important question to ask, because if waiting periods have not been served, there could be significant out of pocket expenses. If you have served your waiting periods, that's great! If not, make sure you write down the date of when they will be served by.
Am I on a single, couples, single-parent or family cover?
Will I have an excess or co-payment to pay for a maternity/obstetric admission?
Knowing this information will give you a better understanding of your out-of-pocket expenses for when baby arrives. Make sure to write down what your excess is and if there are any co-payments, exactly how much they will be.
Again, this is another important question to help understand the possible out-of-pocket expenses that you may incurr as part of your pregnancy. As some health funds have different rules, this is a good question to ask so you have a better understanding when planning out expenses.
Other helpful tips
Change of name
Another very important consideration regarding being a privately insured Maternity patient, is that your name must be consistent in three places:
- On your Medicare Card
- On your health fund insurance policy
- On your hospital record at your nominated St John of God Health Care hospital
So if you are recently married or have changed your surname, please check that your name is listed the same way in these three places.
Having a private Obstetrician
All maternity/obstetric patients must be under the care of a private Obstetrician to have their baby at one of our private hospitals. Ask your GP regarding a referral to a private Obstetrician.
Final Notes on St John of God Hospital Ballarat maternity services
St John of God Hospital Ballarat welcomes all women to use our maternity and obstetric services. You do not need to be privately insured to have your baby at St John of God Ballarat, and we can provide you with a clear outline of fees should you choose to self-fund your maternity admission.
We can also provide a fee estimation for patients who hold basic or public hospital insurance cover for maternity/obstetric care, if you wish to have your baby at St John of God Hospital Ballarat.
We understand that planning a hospital admission can be complex!!
St John of God Hospital Ballarat staff are able to assist you with all aspects of your maternity / obstetric care, and we look forward to working with you to ensure your pregnancy and maternity experience is a positive one!
If you would like to discuss your health insurance you can contact our Patient Liaison Team below:
Phone on (03) 5320 2118 7am – 5pm Monday to Friday
or e-mail on:
[email protected]
