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Out of pocket private hospital costs
While in the hospital

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#1 ausbokkie

Posted 06 January 2013 - 08:39 AM

I am booked into Jessie Mac. At this stage I am very confused by what I will be up for upon checking out from hospital after the birth. My private health fund don't do no-gap but will pay 125% of any specialist costs but I'm just wondering in real terms what I might end up paying. Are we talking hundreds or thousands? I just feel I need to be a bit more prepared!

At the moment I know about the excess and ob fees. Can anyone help me with an idea of:

- out of pocket for pain relief such as epidural
- out of pocket if I need a caesar/emergency caesar
- out of pocket if baby needs to be admitted to special care nursery
- pediatrician
- anything else I haven't thought of

Thank you for your help!

#2 MuminMtEliza

Posted 06 January 2013 - 09:10 AM

Hi OP, I had my DS and DD at Jessie Mac. For my DD which was just over a year ago, I had out of pocket charges for blood tests and some scans. I was in hospital for a fortnight before she was born. She was delivered by caesar, although planned was classified as emergency as they performed the op on a Saturday (decision was made late Friday night due to my medical condition). I never had a bill for the operating theater, epidural, second Dr required for the theater etc. Am assuming they were covered entirely by the health insurance company. There were charges for a pediatrician (who attended the Caesar then looked after DD for 7 days as she was in Special Care Nursery). There were no additional charges for the SCN stay and they provide nappies and formula if required. The paed charges were covered by the health insurance. Good luck.

#3 Soontobegran

Posted 06 January 2013 - 09:18 AM

Your hospital stay will be 100% covered, this is what PHI pays for, what they don't pay is the doctor's bills, medicare will rebate you for these but for most there will be out of pocket expenses as most charge way over the scheduled fee.
You will not pay out money as you leave the hospital unless there is perhaps a pharmacy fee but once you are home you will start getting bills from your anaesthetist , assistant surgeon and paediatrician if you need them.
Your Obstetrician's fees may well be all paid up depending on his/hers particular management plan but it's best to ask his rooms for this information.

If you have a straightforward vaginal delivery you will not get any of these 'extras' and you should only be paying your management fee.
If you have a baby who needs to go to SCN and you are private in a public facility your baby can be admitted as a public patient if you wish and there will be no cost.

Most people find the costly bill aside from the Obstetrician is the anaesthetist with there often being an out of pocket of well over $1k. sad.gif I think on average my girls have been out of pocket for their recent pregnancies about $4k (some less, some more) One had a C/S, one had an epidural.

#4 Melanie_81

Posted 06 January 2013 - 06:30 PM

It's all very confusing as it depends on what PHI you have and what arrangements your ob has! We paid an excess of $500 for the hospital stay, paid around $1000 for the anaesthetist as I had an epidural. Medicare and our PHI provider covered some of this (not much!). No bills for painkillers like pethideine etc. Our ob had previously charged a pregnancy management fee, so that covered all his charges that would have accumulated during the birth. My private hospital has no SCN Bubs in danger are transferred to nearest public one, so cost of transport is not included but is covered under ambulance insurance. Hope that helps! Do chat to the person in your Obs rooms which does the billing they should be able to give you an estimate. Ours send out an info sheet detailing the costs. Good luck!

#5 FizzlingFireboxes

Posted 06 January 2013 - 06:37 PM

I wasn't at your hospital but at another private hospital.

I paid my excess for the hospital stay, OB's management fee, in our hospital babies are seen by a paed I received a bill for this which was a couple of hundred, bills for babies blood tests which was probably just over $100, no pain relief cost but I did speak to ladies who had epidurals which paid around $1500, I also had an allergic reaction to antibiotics given to me and was charged for medicine to take home all $14 lol

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