Jump to content

PHI but we've waived obstetrics


  • Please log in to reply
17 replies to this topic

#1 mummame

Posted 04 December 2012 - 05:47 PM

Okay,

I may have found myself in the situation of a surprise pregnancy and we waived obstetrics, believing we would not be adding to our family any time soon. I had DD in June 2011 and I think I called off the obstetrics soon after that.

So if we wanted to go back to the private hospital where all 3 of my children have been born am I right in assuming we would pay for everything? The $5000 delivery fee. Has anyone been in this situation? Is there any sort of loopholes I can get through? This is all a big surprise and I was not planning for a few years so therefore had not increased our cover. I may have to go public, was trying to avoid this, not really liking the public hospital here.

TIA

#2 lamarque

Posted 04 December 2012 - 05:52 PM

Yes, if you're not covered by PHI and you choose to go to a private hospital, the expenses are all yours.

I'd also imagine the 5K delivery fee doesn't include the OB's fees etc.


#3 EsmeLennox

Posted 04 December 2012 - 05:54 PM

You could perhaps negotiate with your health insurer to pay the equivalent of the premium you would have paid had you not waived the obstetric cover? Not sure you'll get anywhere, but I'd give it a shot, especially if you have been with the same insurer for a reasonable period of time.

#4 lep_78

Posted 04 December 2012 - 05:56 PM

unless you have a spare $20000  or more sitting around i would go public. For the private hospital you could ring them and they should be able to give you an idea of cost. you will have delivery room cost, room cost, OB cost, Pead cost, if you have an epidural or C=Section the cost of the anaethetist, operating room cost, assistant cost. then if your child needs special care nursery there will be a cost. then the cost for blood tests, scans and heaven forbid any intensive care costs. having a baby can have many complications that you might not factor in that will cost you if you need to be admitted. Personally i wouldn't risk it.
congratulations on the pregnancy.

#5 SeaPrincess

Posted 04 December 2012 - 06:00 PM

QUOTE (Jemstar @ 04/12/2012, 03:54 PM) <{POST_SNAPBACK}>
You could perhaps negotiate with your health insurer to pay the equivalent of the premium you would have paid had you not waived the obstetric cover? Not sure you'll get anywhere, but I'd give it a shot, especially if you have been with the same insurer for a reasonable period of time.

I think this would be your only chance, and definitely worth a shot!

I think $5000 is nowhere near enough.  Accommodation alone at one of the hospitals where I had a baby was $500/night, 5 years ago, so even a minimum stay of 3 nights would be $1500.  During that pregnancy I spent a total of a month in hospital, so you wouldn't want to have anything go wrong.

#6 Mousky

Posted 04 December 2012 - 06:02 PM

My guess is wwwaaayyyy more than $20000. If you have baby at 34 weeks (minimum baking for lots of private hospitals) and you have any complications, you might need to sell the house.

#7 Melissam12

Posted 04 December 2012 - 06:05 PM

What is your local hospital?
Private midwifery care might be cheaper than private obstetrics if you have a private midwife in a public hospital.

#8 Jax12

Posted 04 December 2012 - 06:09 PM

QUOTE (Jemstar @ 04/12/2012, 03:54 PM) <{POST_SNAPBACK}>
You could perhaps negotiate with your health insurer to pay the equivalent of the premium you would have paid had you not waived the obstetric cover? Not sure you'll get anywhere, but I'd give it a shot, especially if you have been with the same insurer for a reasonable period of time.

Give it a shot but don't hold your breath.  DS's due date was only a week or two out of the waiting period from when I added maternity cover and they wouldn't budge.  Not even after having been covered by them for nearly 30 years.  I threatened to change providers, called around to see what others would offer...no luck.

But that is a different scenario to yours OP so you never know.  If you can't get private cover I would go public if I were you.

Good luck

#9 MrsShine

Posted 04 December 2012 - 06:11 PM

You could possibly see if any Ob's in your area deliver in the public hospital, then you'd only be out of pocket their pregnancy management fee but have the baby as a public patient? You still get all the benefits of OB care but just not pay for the private hospital admission, epidural separately and all of that.

Otherwise yes, if there is group midwifery offer you could try that which is 100% free.



#10 mummame

Posted 04 December 2012 - 06:16 PM

The reason I said $5000 was that has been the cost of the bill I have always been sent at the end of my pregnancy, meaning thats why the PHI has paid. I know all the other costs as I have gone private for the other 3 babies and the OB cost is about $2000 as well as all the scans etc. I am assuming I would be up for the bill cost AS well as everything else, so it really wouldn't be worth it. I may be able to get in with a penalty fee as PP have suggested, that was my first thought too, just giving them a call to see what they can do, not sure if it will work but worth a go!

#11 Hooray Henry

Posted 04 December 2012 - 06:30 PM

I have the Statement from my Health Insurance Provider here, they paid $9203 (of a bill of $9703) for the hospital stay following the birth of my son in August.

On top of this I paid my OB $200 for the initial visit, $100 for subsequent visits, and $5000 pregnancy management fee.  I also paid for scans.

This was for an uncomplicated repeat c section.  

Hope this gives you some idea of the cost.

#12 IsolaBella

Posted 04 December 2012 - 06:34 PM

Like PP my hospital bill alone was close to $10 k. OB was around $3k.

My sister ended up having a 35 wk bubs and she had complications herself and ended up in ICU..... Their bills were around the $40k mark.

#13 Soontobegran

Posted 04 December 2012 - 06:38 PM

I wouldn't be too hopeful about the PHI being kind to you unfortunately.
My DD 2 had been in top PHI since biirth but hadn't added obstetrics to hers as she was not planning a baby.
She got pregnant and as soon as she found out she went to them and asked if she could back pay the 2 months at the higher rate and then pay the full year in advance would they let her take Obstetrics and they said NO. She even went to 2 other insurers asking the same thing and they all had the same answer.
Good luck OP but to go private in private without PHI will potentially cost you many thousands of dollars.

#14 elmo_mum

Posted 04 December 2012 - 06:48 PM

i was booked at a private hospital in melb

at pre pregnancy info night, the admin man went through the costss if paying yourself
$10000 for a vag delivery, no complications, 4 night stay
$15000+ for c sect - no complications 5 nights
+pead + aneathetist  + obs



bear in mind, poss complications - i ended up having surgery at 16w and hospi stay from 17w-24w (transferred to public)
my phi "bill" was $17000 + i still had pathology and u/s

if i were you i would either:
go public all the way
fin a private ob in a public hospital - then you would pay their fee - poss $5k

good luck

#15 No-pants Agnodice

Posted 04 December 2012 - 06:58 PM

QUOTE (soontobegran @ 04/12/2012, 07:38 PM) <{POST_SNAPBACK}>
I wouldn't be too hopeful about the PHI being kind to you unfortunately.
My DD 2 had been in top PHI since biirth but hadn't added obstetrics to hers as she was not planning a baby.
She got pregnant and as soon as she found out she went to them and asked if she could back pay the 2 months at the higher rate and then pay the full year in advance would they let her take Obstetrics and they said NO. She even went to 2 other insurers asking the same thing and they all had the same answer.
Good luck OP but to go private in private without PHI will potentially cost you many thousands of dollars.


There are exceptions to this. I called my insurer before we started TTC and 'confirmed' that we were covered for obstetrics with our plan (because it had several levels of cover all called the same thing, some which incuded obs and some which didn’t' and it was all pretty confusing). And then found out at 20 weeks that that plan didn't include obstetrics.

They had a computer log of a call being made to them around the time I thought I had checked, but they had not recorded the content of that call. I ultimately got put through to a lovely manager who agreed to escalate it on the basis that there was a call logged, and that I had in fact booked my Ob and private hospital on the basis that I believed I was adequately covered.

It took two weeks, but they agreed to upgrade my cover from the time of the logged mystery phone call (in which I would have upgraded anyway) and I paid the $150 difference between the premiums. We'd also been with them for a decade at that stage.

In your case, though, OP, I suspect that given you voluntarily gave up your cover, you have no choice.

And no, I would not risk paying for private.

#16 Soontobegran

Posted 04 December 2012 - 07:05 PM

QUOTE (MsN @ 04/12/2012, 07:58 PM) <{POST_SNAPBACK}>
There are exceptions to this. I called my insurer before we started TTC and 'confirmed' that we were covered for obstetrics with our plan (because it had several levels of cover all called the same thing, some which incuded obs and some which didn’t' and it was all pretty confusing). And then found out at 20 weeks that that plan didn't include obstetrics.

They had a computer log of a call being made to them around the time I thought I had checked, but they had not recorded the content of that call. I ultimately got put through to a lovely manager who agreed to escalate it on the basis that there was a call logged, and that I had in fact booked my Ob and private hospital on the basis that I believed I was adequately covered.



I'd hope they'd make exceptions when you've proven you made a call to check your status but DD2 dropped it just like the OP and they wouldn't entertain the thought even with lengthy enquiries to head office etc sad.gif
She eventually went to the MWC and was happy with the care anyway.

#17 premmie_29weeks

Posted 05 December 2012 - 12:18 PM

If you don't have phi covering obstetrics I wouldn't deliver at a private hospital. The accommodation costs alone would be $500 a night, not to mention the costs of a csotentially or god forbid a child needing special care.

My ob delivered at either e private or public hospital in randwick (I'm in Sydney) the costs were about the same and we had phi so chose to go private for the private room. Maybe check if your ob will deliver in a public hospital. That way the scans, and accommodation plus any special care is covered.

#18 Gembac8019

Posted 05 December 2012 - 03:41 PM

Same happened to me. Thought we were done having kids and dropped obstetrics out of our PHI. The minute I found out I had fallen pregnant (and yes, we have been with them for a long time too) I asked if we can backpay like the op wants to. Not a chance. Nowhere else will either. You must have obstetrics for 12 months before I was told.




1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

The myths and truths of gender swaying

Here are a few popular methods hopeful parents-to-be use to try to get a baby of their preferred gender – and what an expert says about whether they really work.

10 easy DIY Christmas decoration ideas

It's officially time to get into the Christmas spirit. Why not branch out when you put up your tree this year and add a personal touch with a few DIY decorations? We've found the perfect easy-to-make ways to put more festive fever into your home.

The dangerous new trend of glucose challenge test refusal

A dangerous trend is seeing more mothers-to-be declining a relatively simple and painless test to check for gestational diabetes.

Office of Fair Trading reveals naughty toys ahead of Christmas

The Office of Fair Trading has pulled seven toys from shelves ahead of Christmas after they fail safety tests.

Video: Baby boy's trouble with twins

These twin girls will no doubt have fun fooling people in years to come, but nobody will be as confused as baby Landon.

Long-term reversible male contraceptive on its way

Men could soon have access to an injectable long-term contraceptive which works in a similar way to a vasectomy but promises to be easily reversed.

'I tried to kill my baby': one mum's story

After bathing and dressing her three-month-old son, Amanda had a rare moment alone with her baby.

Attack of the 'mummy brain'

I feel that almost every day, someone in my life - be they a friend, family member or complete stranger - feels the need to excuse my behaviour as I have other things on my mind.

Mum of baby who fell ill after drinking raw milk speaks out

A Melbourne mother has described how her son turned grey when he became seriously ill after drinking raw milk.

Australian divorce rate lowest since 1976

Modern newlyweds are now well into their 30s and marriage still offers something powerful a new book argues.

The aftermath of a traumatic birth experience

In Australia, 30 per cent of women find their birth experience traumatic, with 6 per cent going on to develop post traumatic stress disorder (PTSD).

Young mum burns 'from inside-out'

A young mum is in intensive care after she took a friend's antibiotic and wound up with an ailment that is burning her body 'from the inside-out'.

The disagreement that can break a relationship

If he doesn't change his mind, all I can hope is that I will. It would be a waste to spend the rest of my marriage mourning a baby that never was.

Co-sleeping or no-sleeping? Mum videos worst nap ever

One mother's futile attempt to sleep in caught on camera in a hilarious - and very cute - video.

Why children misbehave during the festive season

While we all like to imagine the holiday season as being a fun, loving and bonding experience; often our reality is quiet different.

I was fat-shamed by my doctor

The fear of being weighed is the most significant factor in women cancelling medical appointments - and now weight-shaming has happened to me.

End of an era: no more childcare

As we reach the end of 2014, we're closing the book on many things for another year, most notably childcare. Our last child has attended childcare for the very last time.

The 7-year itch is more like the 10-year itch: study

Contrary to popular belief, making it past the seven-year mark doesn't mean your marriage will be smooth sailing from there on.

Stop telling us that parenting gets harder

I’m sure that parenting will get harder. But life isn’t exactly smooth sailing for many of us right now, either.

Should children be forced to sit on Santa's lap?

We teach kids it’s okay to say no if they don’t feel safe, so why do some parents force their children to climb in to Santa's lap?

Download now: Essential Kids Activity Finder app

Got bored kids? Quickly find the best activities for kids wherever you are in Australia with the Essential Kids app.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

Baby born weighing almost 14 pounds

Yes, the bouncing baby girl was born by caesarean section. And mum says no more kids.

The dummy debate

I'm the first to admit that when I used to see tiny babies with dummies in their mouths, I thought "Hmm, lazy parenting." And now I apologise.

'I thought I was an only child'

Imagine meeting your double at a school sports event, or regularly being mistaken for someone you haven't met. Separated twins Margaret and Joy tell their story.

Mums reveal their nappy bag essentials

Ever wondered what other mums carry in their nappy bags? We have, so we asked mums to tell us their must-have nappy bag items.

Toddler died because he wasn't given antibiotics soon enough

A 15-month-old boy would almost certainly be alive today if doctors had given him antibiotics sooner, a coroner has ruled.

VIDEO: moment a toddler falls on to train tracks in Melbourne

Shocking footage has emerged capturing the moment a pram carrying a toddler rolled off a platform and onto train tracks in suburban Melbourne.

Sold on natural birth? Read the fine print

In the excitement and anticipation of a first pregnancy, I ignored the fine print: some women, some of the time.

Child with alcoholic mum who drank while pregnant won't win pay-out

A young child is not entitled to criminal injuries compensation after her mother drank excessively while pregnant.

Superbugs killing India's babies, posing wider threat

A deadly epidemic that could have global implications is quietly sweeping India, tens of thousands of newborns dying because antibiotics no longer work.

Can you teach a toddler to sleep in?

Parents share their tips on getting their early risers to sleep in, even for just a little bit longer.

Keeping your relationship on track as new parents

About 70 per cent of couples experience a slump in their relationship within three years of having a baby. Here's how we tried to get back on track.

America's favourite baby names of 2014

Americans are turning to television, Netflix and sports for ideas for what to name their wee ones.

Carers admit to force-feeding children

As Sydney grieves the loss of Sydney siege victims Katrina Dawson and Tori Johnson, reports have suggested that both died as heroes.

 

How many weeks til Christmas?

On your To-Do list

Get the "Santa" shopping done without the kids in tow.

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.