fish.01

We had a baby last year at the Mater Private (bub #2) in Brisbane. The whole experience in the hospital was great. Lots of professional personal attention in a hotel like environment.

Private Hospital Insurance is only for in-hospital costs (accommodation and actual birth) and our private insurance covered all of it.

My wife had a mandatory c-section performed by one of Brisbane's most respected Obs (Dr Yared) and his anaesthetist charged us nothing either.

My wife had post birth issues and was referred to another private specialist by Dr Yared and he saw her around 3 times in his rooms and performed additional day surgery (including another anaesthetist) and my wife was out of pocket around $10 for all of this extra stuff.

I think this again shows the value of asking to be a No Gap patient when you use a private specialist.

Our main cost, as others have mentioned, is the costs borne in the doctors rooms which private hospital insurance has nothing to do with. The main fee here is the pregnancy management fee which was around $2000.

LINZI

I was here on a 457 visa pregnant and gave birth to my son in a public hospital (Mackay) with no problems at all. I did not see the same OB all the time, I saw someone different, so that is one of the downsides but at the end of the day they where still aiming for the same thing a healthy baby. The only cost was some scans that where extra everything else was through Medicare this was in 2007.

Good luck

DownUnderPaddy

We had both our kids (a couple of years apart) at the nearby family birth centre. Only ever dealt with middies. Medicare covered the lot. Nothing but praise for the public system from us.

BadgeIsBack

My wife had 3 babies in the public sector.

No costs, no scars, no stretches, no issues, no fuss. Infact she got invited back as a 'star' pupil. To be honest, she would have more.

Caveat: we started breeding when the SE was still growing: its quite possible that there would be standing room only now and that we might feel we'd get more attention in the private sector now.

My personal, perhaps cynical view is that c-sections seem more the norm in the private sector. Perhaps too convenient? Someone once said that a midwife-led hospital see childbirth as something a mother can deal with, and that doctors see childbirth as a potential thing they can fix and intervene with.

Lily77cat

so just getting this straight as we hoping to come over to oz from nz.
we have permenant residency here in nz but are really poms! confusing i know.

so if we came on a 457 temporary work visa- and i was preggers or going to get preggers it wouldnt cost us anything to have the baby in oz as i think there is a reciprocal agreemtn with nz.

if we got insurance which i think you have to now with a 457- family with bupa, platinum platinum with no excesses and covers pregnancy is about 600 a month. we could go private adn it not cost us anything??

but if we came out on a company sponsored permenant residency and i was preggers it wouldnt matter we would be covered to go public??

oh and if we have have permenant residency do the babies get to be australian by birth right like here in nz??


cheers for the help- hey we got two kiwis now we might aswell try for two ozzy babies aswell eh??

then the whole family could have different passports and confuse the hell out of any immigration officer when we travel

JAJ

At least one parent must be an Australian citizen or permanent resident at the time the child is born for the child to acquire Australian citizenship at birth.

elice_in_oz

Sorry Lily but you seem as confused about Medicare as you were about visas Some answers in red Re-read this whole thread and hopefully it will all makes sense.

fish.01

Hi Elice, Really good advice.

One little question. I am probably misinterpreting the meaning of the bit in red above but does the fact that medicare pays most of the bill and PHI pays the gap up to the scheduled fee and then the user pays any other gap above the scheduled fee not make it complementary? Everyone chips in?

Lily77cat

ooo

i dont know then.

the reciprocal seems less for nz residents like no gp stuff and they wont issue a medicare card.

ummmm that might mean not covered for baby....

:-(

Lily77cat

have google it and lots of plaes say you not covered under reciprocal for having a baby from the uk either?? but you guys say you are??

ummm....more digging i think

elice_in_oz

TBH Fish, that's always been a bit murky to me. From memory, when I went private for obstetrics, I would pay my consultations, then get something back from medicare (up to the scheduled fee) but nothing from the PHI. I was also completely out of pocket for the OB-GYN's gap payment (that covers their insurance premiums or something) as neither medicare nor the PHI covered that. For the hospital stay, all delivery fees and room stay in a private hospital were paid by PHI but I still had to pay something for the anaesthetist who came to give an epidural at 3am because apparently out-of-hours anaesthetist interventions were not covered by the PHI (who probably think that babies should be more considerate and only arrive between 9 and 5!). I seem to recall medicare paid part of that though. All this was 6 years ago and as I went public with Boy 2, I could be confusing things a bit.

I haven't really needed PHI for any major intervention (luckily ) so I am not sure whether my analysis is right. As far as I understand, if you get something back from medicare, you can't get anything from PHI as in the case of a normal GP visit that is not bulkbilled. Eg: I go to the GP and pay $55 for the 5 minutes consultation . Medicare gives me back around $34. A proper complementary system (like the one they have in France) would mean that you could claim the $21 gap from your PHI (or an amount thereof depending on your level of cover) and therefore NOT be out of pocket at all (except for the ridiculous insurance premiums of course!). The system that I have used here does not seem to work that way at all although as I said, I have been fortunate enough not to have needed expensive treatments, so I might be looking at it from a skewed perspective Does the above make sense?

elice_in_oz

The reciprocal agreement with the UK is for immediate and essential treatment. Pregnancy requires essential treatment, even if it is just routine visits to the GP or the hospital, blood tests and of course delivery. So if you live here as a temporary resident from the UK and you become pregnant, you will be treated pretty much like any Australian on medicare.

Pregnancy is not a chronic illness that requires long expensive care. If you were to be unfortunate and be diagnosed with a chronic illness that requires expensive tests and medicines, they may well turn around and ask you to pay or go get treated in the UK for free on the NHS as they can't tell how long you might need the treatments and medicines for. Pregnancy normally has an end date and is not considered a chronic condition (yet ) and also, it would probably be discriminatory against women to ask them to pay or to send them back if pregnant as men will never get pregnant and therefore would be treated differently

Lily77cat

http://www.medicareaustralia.gov.au/...rants/visitors

from the uk
Your entitlements
As a resident of one of these countries you are entitled to the following for any ill-health or injury requiring treatment while in Australia:

free treatment as a public in-patient or outpatient in a public hospital
subsidised medicines under the Pharmaceutical Benefits Scheme
Medicare benefits for out-of-hospital medical treatment provided by doctors through private surgeries and community health centres.


from nz
Your entitlements
As a resident of the Republic of Ireland or New Zealand you are entitled to free treatment as a public in-patient or outpatient at a public hospital and access to subsidised medicines under the Pharmaceutical Benefits Scheme during your visit to Australia. This covers any ill health or injury needing medical treatment while in Australia. To access these benefits you should show your passport at hospitals or pharmacies. You are not entitled to Medicare benefits for non-hospital medical care and you will not be issued with a Medicare card.



red is only bit different so cant access subsidised gp service

ummm......maybe pregnant for nz resident might be covered

nicolac34

Just interested (I'm not pregnant) when considering Public vs Private - if you want an elective c-section can you get this with Public or do you have to go Private?

Just heard rumours that the UK was going down the line of giving women the choice on the NHS, wondered if Oz was similar?

fish.01

Oh ok, I see where you're getting confused. Private hospital insurance covers procedures in hospitals only. It has nothing to do with private medical specialists or private GP costs.

Each procedure in a private hospital has a govt mandated scheduled fee. The private hospital specialists (eg OB/anaesthetist) are free to charge more than this fee. As I understand it the bill is met roughly as follows:
1) 75% of scheduled fee paid by govt medicare.
2) 25% of scheduled fee paid by your private hospital insurance.
3) anything above the scheduled fee paid by you (The Gap).

You can ask your specialist to treat you in hospital as a No Gap patient. ie you will be charged the scheduled fee only so you will then pay nothing at point (3) as govt medicare (1) and private hospital insurance (2) will cover the whole bill. (Note: An anaesthetist for example can charge more than the scheduled fee whether a nightime callout or not)

Outside of a hospital, private specialist and private GP bills are met by a combination of govt medicare and yourself. A few things are not govt medicare billable at all so you will bear full cost. I will emphasise that private hospital insurance is not involved at all.

If you wish to avoid paying the gap charged by some private GP's you must find a bulk billing private GP or visit a public hospital and if you want to avoid paying the gap seeing a private specialist you must either find a private specialist who bulk bills (rare) or visit a free public specialist at a public hospital outpatients clinic similar to the NHS.