Health insurance for pregnancy

Private health insurance for pregnancy is optional, depending on your preferences. 

If you want to be a private patient and have Gold Hospital cover with Pregnancy and Birth included, you have the option of choosing your Obstetrician and the hospital you want to deliver in, subject to doctor's availability and Hospital resourcing. However, a 12-month waiting period applies once you sign up or change your Hospital cover to include this.

On the other hand, if you opt to be a public patient, Hospital cover that includes pregnancy and birth isn't required, because these services are funded by the public hospital system. There are no waiting periods if you are a public patient however you may not be able to choose your Obstetrician or receive care from the same doctor throughout your pregnancy journey. You'll usually have your baby in the public Hospital closest to where you live.

Whatever your journey looks like, whether that be private or public, it’s a personal choice. All of our Gold hospital products include pregnancy and birth if you’d prefer to be treated as a private patient.^#

Your extras cover can help pay towards physiotherapy consultations and hydrotherapy sessions that could help relieve the pain or assist with other pregnancy-related complications you may experience.^<

Your extras cover can also help pay towards general dental.^< Hormonal changes may make you more prone to gum disease. Seeing your dentist regularly can help to catch any problems early before they start causing more serious issues.^<

Our Growing Family Extras could also be a suitable option with some welcome support during the pregnancy journey through antenatal classes, pregnancy compression garments and more.

You could look for services like physiotherapy, general dental and remedial.

Get in touch with our team to explore options based on your health needs and budget.

If you’re planning on starting or extending your family, it’s important that you’re aware there is a 12 month waiting period for private hospital admissions for pregnancy and birth. Remember babies can also come early, so it’s important to take this into account when you start planning your family.

If you’re joining Medibank from another Australian health fund, you don’t need to re-serve waiting periods for any services that were included on your previous cover you’ve already served, provided you join within two months of leaving your previous fund.

Although private health insurance will pay benefits towards the in-hospital services you receive during your pregnancy if you have Gold Hospital cover with Pregnancy and Birth and have served the relevant waiting periods, you may still have out-of-pocket expenses to pay.

For inpatient medical services, Medicare pays 75% of the Medicare Benefits Schedule (MBS) fee for your obstetrician, anaesthetist and any other inpatient medical services while you’re admitted to hospital. Medibank pays the remaining 25% of the MBS fee if relevant waiting periods have been served. 

You will need to pay any out-of-pocket costs for charges above the MBS fee — this is known as the ‘gap’. You could reduce this by choosing doctors who participate in our GapCover Scheme. You can contact the provider to discuss this prior to seeking treatment

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.*

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.

We recommend that you talk to your obstetrician, the hospital and Medibank about what costs you can expect and how you can reduce them.

For more on this topic read our article: Understanding the Costs of Having a Baby

No, they’re not. To ensure your little one is included in your Hospital cover, you can contact us for more information on how to add your baby to your policy before giving birth.

If you're on a single membership:

You’ll need to change to a family or single parent family membership to add a dependant. If you do this within two months from the date of their birth or inclusion in your family unit (e.g. through marriage, adoption or fostering) they won't have to serve any waiting periods the policy holder has already served. Where a child is added outside two months, they’ll have to serve all waiting periods applicable to the cover.

If you're on a couple or family membership:

If your policy is available as a Family membership, you can add a dependant to your membership within 12 months of their birth or inclusion into the family unit and they generally won't need to serve any waiting periods the policy holder already served on the membership. This change can be backdated or commence from the date of application or any future date you choose. Where a child is added outside of 12 months, they will be subject to the regular waiting periods.

Adding a dependant child may affect the premiums you’ll need to pay. Contact us if you need support on how to add your baby to your policy before giving birth.