Key Points
- Delivering a baby in Australia without Medicare can cost between $10,000 and $18,000.
- The cooling off period for private health insurance to cover pregnancy is generally around 12 months.
- The process to manage pregnancy is different for international students or temporary visa holders.
Sadia Khan was pregnant when she came to Australia in 2012 on a student visa with her husband.
While their consultant had bought health insurance for them, the couple claim they were unaware there was a 12-month waiting period before they would be covered for pregnancy-related expenses.
Now working as a professional banking consultant, Ms Khan said it had been very difficult for them to pay all of the medical expenses – totalling around $18,000 – at that time.
Because I was not covered by my insurance, I had to pay all of my expenses out of pocket which was a lot of money.Sadia Khan
“If you are on student visa, then they refer you to a private hospital and you have to choose a private gynaecologist,” she told SBS Urdu.
While visits to a GP were covered by her insurance, she had to pay the full costs incurred by her gynaecologist including his fees, all scans and other costs, she said.
What is waiting time/cooling off period?
According to insurance comparison website, , “the waiting period for pregnancy and birth-related benefits is typically 12 months”.
This means that a policy holder would need to have held an health insurance policy for at least 12 months prior to being able to claim benefits related to pregnancy, including prenatal care, childbirth, and postnatal care.
The 12-month waiting period is often set as a maximum waiting period by the Federal Government.
This regulation aims to ensure that individuals do not purchase health insurance only when they need pregnancy-related services, which could potentially lead to adverse selection and increased costs for insurers.
The cooling off/waiting period for coverage of pregnancy costs is normally 12 months. Source: Moment RF / d3sign/Getty Images
“When you don't have Medicare and have private insurance, it's important to know what level of insurance you have,” Dr Mian said.
Dr Mian said most hospitals or even insurance agencies cooperated to provide patients with information about their medical expenses, coverage, and out-of-pocket charges.
What is shared care?
In a GP shared care arrangement, the individual's GP plays a central role in providing prenatal care. Most of the routine prenatal check-ups and appointments take place at the GP's clinic.
These appointments may include initial pregnancy confirmation, general health assessments, and discussions about the pregnancy.
Dr Mian said that due to very busy schedules, hospitals often encouraged patients to see GPs for at least the first 15 weeks of pregnancy.
After that, if there were no complications and patients had opted for shared care, they only needed to visit their hospital at 20 weeks, 32 weeks, 36 weeks and 38 weeks, she said.
If you don't have any complications, you can visit a GP under shared care for most of your prenatal services.Dr Afshan Mian
Dr Mian said a patient’s GP was also able to arrange all pregnancy-related scans and tests for the patient.
According to , “GP shared care is an arrangement between a GP and a birthing hospital or other birth setting. You see your GP for most pregnancy appointments, and you also have appointments at the hospital in early and later pregnancy.”
Dr Mian mentioned that the cost of this arrangement could be anywhere between $10,000 and $18,000 depending on the level of insurance, paperwork and options, so it was very important for women to choose wisely and complete all necessary documentation.
Dr Mian also said that expenses could vary case by case and according to the treating GPs' fees.
The cost of prenatal care, childbirth, and postnatal care can vary significantly based on several factors, including the level of insurance coverage, the specific healthcare services received, and the choices made by the patient.
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