Making the choice between public and private.

Your birth options: private vs public

Choosing where to have your baby is a big decision. There are a few factors that might come into play – you may feel attached to the idea of going somewhere where your friends or family went to. It might be important to you to give birth at the closest hospital, to have choice over who treats you, or maybe cost is an important factor. Whatever your motivation, you’ll need to decide whether you want to give birth in a private or public hospital and if you want a private obstetrician or not. Here we explain what decisions you need to make about where you give birth, and which Medibank health cover is most suitable to meet your needs.

What is pregnancy and birth cover?

Some Medibank hospital covers pay benefits for pregnancy and birth services, which refer to the accommodation and amount of services you get in hospital during your pregnancy, birth and after the delivery. It also covers benefits towards the delivery of your baby and any complications that might happen during your pregnancy that require a hospital admission. Your options for where you give birth will depend on whether your Medibank policy has cover for pregnancy and birth. Medibank’s Hospital covers have the following options:

  • Gold cover – where Medibank pays benefits towards pregnancy and birth related services, in either a public or private hospital.

  • Silver, Bronze and Basic cover – where Medibank pays no benefits for pregnancy and birth related services.

Your hospital options

One of the main decisions you’ll need to make is whether you want to have your baby in a private hospital or a public hospital. Here are your options:

  • As a private patient in a private hospital. In this scenario, you need to have pregnancy and birth services included in your policy in order to claim benefits. If you do not have pregnancy and birth services included in your cover, Medibank does not pay any benefits and you will need to pay for all costs associated with the pregnancy, birth and delivery.

  • As a private patient in a public hospital. In this scenario, we recommend having Restricted Obstetrics cover in your policy.

  • As a public patient in a public hospital. In this scenario, you do not need cover that includes pregnancy and birth services as this is funded by Medicare.

One of the main things to remember is that if you're planning to have a baby, and you'd like to use your health insurance to give birth as a private patient, your cover must Include pregnancy and birth services. There is a 12-month waiting period before Medibank pay benefits for pregnancy and birth services, so you’ll need to have had cover in place for at least 12 months before the baby is born. Babies can come early, so it’s important to take this into account when planning your family.

Making your decision

When it comes to making the decision, talking to your family and friends about their experiences can help. So can getting advice from your GP. But it’s important that you are aware of the pros and cons of each option so you can make your decision based on what’s most important to you. The table below helps you to understand your options.

Source: *Medibank 2016/17 data. Data is based on all births at private hospitals between 1 July 2016 and 30 June 2017. ** Medibank 2016/17 data. Data is based on all Medibank-funded births at public hospitals between 1 July 2016 and 30 June 2017. *** Australian Institute of Health and Welfare 2017. Admitted patient care 2015–16: Australian hospital statistics. HSE 185. Canberra: AIHW. ****Medibank 2016/17 data. Data is based on all Medibank-funded births at private and public hospitals between 1 July 2016 and 30 June 2017.

Cost Disclaimer

Private Health Insurance Funds are only permitted to cover inpatient services. This means you need to have been admitted to a hospital in order for the benefit to be paid. During pregnancy, you are likely to have many outpatient appointments (when you are not admitted to hospital), including scans, tests, and visits with your obstetrician/GP. Private Health Insurance Funds are not able to provide benefits for these appointments.