Understanding the costs of having a baby

Having a baby is a joyful time. There is a lot to get excited about, but there’s also a lot to plan for and consider, including the financial implications of bringing a little person into the world. Understanding the costs of having a baby in a private hospital isn’t always easy and it’s important to know what to expect.

 

Your hospital costs usually fall into one of two categories when having a baby: 

• Services you receive when you are admitted (known as in-hospital and medical treatment)
• Services you receive as an out-patient after the baby is born (known as out of hospital medical services or extras treatment) 

If your cover includes Pregnancy and Birth^§, and you’ve served your waiting period, Medibank will pay benefits towards your care in a private hospital.

 

Once you’ve got your head around potential costs of having a baby, it’s a good idea to think about the following: 

Ask for Informed Financial Consent

Informed Financial Consent is a way for you to find out exactly how much your in-hospital treatment will cost, so that you can agree to it before it happens. Before you are admitted to hospital, your doctor or obstetrician should provide a breakdown of all out-of pocket costs you are likely to incur during the hospital admission. Make sure that you obtain an Informed Financial Consent and agree to it before you finalise your choice of hospital and obstetrician.

How to reduce your out-of-pocket expenses for pregnancy

To help reduce out-of-pocket expenses for our hospital members, Medibank has entered into agreements with a number of private hospitals across Australia as part of our Members’ Choice network. This means that by visiting a Members’ Choice hospital you’ll generally get better value for money compared to a non-Members’ Choice private Hospital*.

It’s important to be aware that Medibank’s agreements with Members’ Choice hospitals are subject to change. If you are unsure of whether a hospital is participating in our Members Choice program, call our team on 132 331 to speak to an advisor.

You can search for a Member’s Choice hospital here.

Ask about our GapCover Scheme

Our GapCover Scheme has been designed to minimise your out-of-pocket expenses. When you go to hospital, there is usually an extra amount between the fee your doctor charges you and the total benefits you receive from Medicare and us. The GapCover scheme can help close this gap amount. To find out more please call us on 132 331 or search for a GapCover Scheme hospital here.

It’s important to be aware that it is up to the provider whether they want to participate in GapCover and their decision can be made on a case-by-case basis. Please contact the provider to discuss this prior to seeking treatment.

Ensure your newborn is covered for in-hospital treatment

Generally, a healthy newborn is not admitted to hospital as an inpatient. Because the baby is not an in-patient, it’s important to be aware that any treatment, tests or doctor’s visits (e.g. a pre-release check-up by a paediatrician) are outpatient services, for which Medibank cannot pay any of these benefits. This means you will only be eligible to claim a Medicare rebate for those services and may incur out-of-pocket expenses.

In some cases, a newborn may need to be admitted to hospital in their own right, e.g. they might require treatment in a special care nursery or an intensive care unit. To ensure the costs associated with the baby’s admission are included under your cover, we recommend you add your baby to your membership within two months of their date of birth. 

Call us on 132 331 to add your baby to your cover.

Out-of-hospital costs and extras treatment

Out-of-hospital or extras treatments are services you receive as an out-patient. All private health insurance funds, including Medibank, are not permitted to pay out-of-hospital medical services when a Medicare rebate applies. 

Medibank’s Growing Family packages contain a range of extras services to support you during pregnancy, birth and beyond. Click here to find out more.

All services listed below are subject to annual and other limits – please check your Cover Summary in My Medibank for details.

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