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No medicare or PHI cover and pregnant?

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13 replies to this topic

#1 umma

Posted 25 January 2006 - 02:16 PM


I was hoping someone here might know the answer to this - I have a new colleague who is Hungarian and his wife is Japanese and they are not elligible for Medicare and there is a 12 month waiting period for PHI and so they are not covered either way so what do they do?

#2 nowsinglewith1

Posted 25 January 2006 - 07:03 PM

I believe they would have to pay for all services from memory-as if going private.


#3 LisaMaree82

Posted 26 January 2006 - 08:44 PM

Have they moved here, or are they travelling.  I think travellers insurance my cover some costs, otherwise they will have to pay for everything.

#4 Coffeegirl

Posted 26 January 2006 - 08:50 PM

Travellers insurance usually only covers emergencies (not pre-natal care such as checkups etc) and then only up until 32 weeks or so (from memory of my last trip O/S whilst pregnant)  If they are here on work visas legally I think they can be covered for some medicare things and they should check with Medicare to confirm this.
If not they should maybe look at shared care with a GP and the local hospital to keep costs down.  My Gp did most of my last pregnancy and his visits were only $40 as opposed to OBs who charge $200!

#5 **Tiger*Filly**

Posted 26 January 2006 - 11:39 PM

I'm sure I saw an ad on TV for one of the Private Health Funds saying they were waiving waiting periods until end of Feb?? Could have been medibank private, but not sure if it was for everything. It might be worth ringing around the private health funds if they  haven't already. Even playing one off against the other - a friend of mine much reduced her premiums by going backwards and forwards telling various funds how much others were willing to give her - they are all desparate for members.

#6 umma

Posted 30 January 2006 - 09:07 AM

Yes, they are working here and just having a work permit does not give you access to Medicare - you have to be a resident.  I checked with Medicare's eligibility office.  

Travel insurance won't cover pregnancy - except if some emmergency thing happens.

And the public hospitals are not cheaper if you don't have access to Medicare (but the shared care model might be a good way around the private OB fees for routine care).

Yes, it could be very expensive for them - even just a standard uncomplicated birth can cost $10,000 for the self insured.

As for the PHI - they have to have special PHI (call overseas visitor cover) because they are not resident or eligible for Medicare.  To cover obstetrics it costs about $4,500 per year minimum (my PHI costs about $2000) and even then they still have the 12 month waiting period.

I think that it is terribly harsh but the cheapest way to do things would be to go back to Japan for the birth and that would mean travelling before 7 months and sitting it out.  And hoping that all goes well - ie no prem baby and no other complications in the mean time!  What a terrible position to be in.

#7 fona25

Posted 30 January 2006 - 07:51 PM

Just checking quickly - are they just here on a work visa or waiting to get residency etc?  My dh came over on a spouse visa (he is South African), and was able to claim medicare before he got his residency....

#8 belindam

Posted 30 January 2006 - 08:17 PM

What state are you in?

I work in this area and if its SA can give you a specific answer.

#9 umma

Posted 31 January 2006 - 10:48 AM

Belindam - Victoria, why is it different in South Australia?

Fona - just a work visa - they will probably try and get a residency visa but other colleagues here who have done that say it takes many months.

#10 belindam

Posted 31 January 2006 - 05:12 PM

Hi Umma,

Not sure of Victorias arrangements - in SA what happens is that we bill non medicare's for an 'episodic'payment.  This is based on what is called casemix and its how public hopsitals in SA get funded.  Short story is that there are about 8 delivery DRG's - without having it in front of me - 4 caesareans and 4 vaginal delivery DRG's.  Within each 4 they range in complexity from simple to complex.  Which one a person would fall into cannot be determined until the patient is discharged as it depends on the complexity of the admission (eg a ventouse delivery with an epidural and a 2nd degree tear may fall into the most simple DRG but if a patient has a straightforward delivery with no intervention but has pre-eclampsia or gestational diabetes it will push it into a more complex one).  In SA we bill about $3500 for the most simple vaginal delivery up to about $10800 for the most complex caesarean.  That gives the patient a minimum of about 8 days stay for a simple delivery and 26 (from memory) for the most complex caesarean. Staying a shorter period of time does not reduce the cost. This is an all inclusive cost (ie dr, midwife, anaesthetist, any radiology, pathology, post natal care including in the home - in short everything).  Each antenatal visit on top of that is $115 - although if you can find a GP that will do shared care then you can save money.  

My advice is to ring various hospitals in Vic and ask if they can do a quote (thats what we do in SA for obstetric non-medicares so they know exactly what they will be charged and we stick to it).

#11 grmc1

Posted 21 November 2012 - 09:39 PM

I was wondering if you were in a position to update it to 2012. I am in a similar situation and need to know the costs so I can decide whether I can actually afford to return to Australia to have our child or whether I should stay overseas for the birth, where I know I can afford it. I understand if you are unable to answer but thanks anyway. Kindest regards, Gavin.

#12 Bombom

Posted 27 November 2012 - 02:44 PM

unfortunately it will be cheaper for them to go to Japan or other country as hospitalization without medicare would be very expensive. That's also a holiday!

#13 Phascogale

Posted 30 November 2012 - 02:46 PM

This thread is only 6 years old.  The baby is well and truly born.

PP who started a new question - it might be better to start a new thread.

#14 EllenD

Posted 30 November 2012 - 02:55 PM

Are you planning on applying for a permanent residency visa soon grmc1 by any chance?

Once you have applied for a permanent residency visa (the visa doesn't have to be assessed yet) then you are eligible to apply for and hold a medicare card until your PR visa is processed.

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