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Answered: Is public or private healthcare better for childbirth?

Lucy Dean
Pictured: Medicare logo, Australian cash and baby born with private health insurance. Images: Getty
Which is better, private health insurance or public cover? (Images: Getty)

It’s the question many soon-to-be families around Australia will ask: “Am I better off sticking with public health cover, or should I take up a private health insurance policy for when our baby is born?”

Unsurprisingly, the answer depends on your circumstances and desires.

But, according to Finder insurance specialist Sophie Walsh, a good place to start is by understanding that you need to have held private cover for at least 12 months before you can claim on pregnancy and obstetric services.

It’s also worth noting that insurers are growing more strict with their requirements, which means having a premature baby can impact your coverage.

"The advice from insurers to the Ombudsman was that in all instances the waiting period of 12 months for obstetrics applies, even to cases where a baby is born only a couple of days before the end of the waiting period,” the Private Health Insurance Ombudsman said in 2016.

That means that if you’re paying for the average gold level policy with pregnancy and obstetric care, you’re looking at $171 a month or $2,051 for the year before you require the cover.

Then, if you have private health insurance, the overall cost of private obstetrician (OB) pregnancy care, private hospital birth and postnatal care can be anything between $2,500–$20,000.

However, if you’re giving birth in a public hospital, out-of-pocket costs will be small or non-existent.

So why do people go with private health cover?

The level of care you’ll receive is the same.

So, it comes down to choice. If you’re giving birth with a private health policy, you’ll have a greater ability to choose your obstetrician and hospital.

“If the closest hospital is a private one and being close to home is important, private health insurance could be worth it. Similarly, if there is a private OB you would like to see, private health insurance will give you more choice,” Walsh told Yahoo Finance.

The same goes for a private room. “A private room can reduce the stress associated with pregnancy and often means that your partner can share the room with you throughout the birth.”

And while the public system will give you all the time needed to recover, the average stay will be one to two nights if there aren’t any complications.

“The private system can give you a chance to take a few extra days to recover before you head home with the average stay lasting between three to five days.”

If you’re after birth-related services like pre- and post-natal classes, diet plans, massages, lactation support and acupuncture, this is where private health insurance comes in handy.

What do parents who’ve had kids already say?

This is where it gets interesting. Finder surveyed 2,013 parents with kids under 12 and found that while three in 10 had their first baby in a private hospital, four in 10 said they would use the private system for their next child.

Were you covered for pregnancy through your private health insurance policy at the time of your first child’s birth?


No, didn’t have private health at the time

38%

No, my health insurance didn’t include pregnancy cover

11%

Yes, and we had our child in a private hospital

29%

Yes, but we had our child through the public system

23%

Source: Finder survey of 2,013 parents with children under 12, September 2018

At the same time, nearly one quarter of pregnant women decided to deliver their baby in a public hospital - despite having private health cover for pregnancy and obstetric services.

According to CHOICE, part of this could be explained by the lower rate of interventions in the public system and often better facilities for those with high-risk pregnancies or unwell babies.

And there is also the cost factor - even with private health insurance, using the private system to give birth will come with fees.

“Many private health insurance members may be surprised when it comes the out-of-pocket costs associated with having a baby in the private healthcare system,” Walsh said.

“They may not realise that even though they have paid a premium for top hospital cover, there are thousands of dollars of additional costs on top of what their policy will cover.”

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