Jump to content

Private Health Waiting Periods


  • Please log in to reply
14 replies to this topic

#1 baileybunny

Posted 08 January 2012 - 12:58 PM

I was just curious, as most private health funds have a 12 month waiting period for pregnancy/obstetric benefits-

what happens say if I signed up for private health now, then in 3 months time got pregnant, meaning the due date would be somewhere around mid-Jan 2013 (meaning I would have served the 12 month waiting period based on the due date).

Lets say bub did not go 40/41 weeks but instead decided it was time to come at 30 or even 35 weeks.

Would this mean I would not get private health cover, because I would not have reached the waiting period when bubs was born, or because the 40 week due date was past the 12 month waiting period I would be covered?

I hope that all makes sense...just something I was thinking about. Ideally I suppose people would generally line up their private health cover that includes pregnancy maybe 18 months before they expected their baby to be born just to be on the safe side??

#2 mez70

Posted 08 January 2012 - 01:07 PM

To be blunt YOU would not be covered until the 12 waiting period has been served even if bubs was due after that date but came early... Some funds may pay a benefit if bubs was born prem but I certainly would not be relying on that occuring as the 12 mth is a Govt legislated rule that health funds need to stick to. If the bubs was admitted in it's own right and you had family coverage the BABY and babys costs alone would be covered.

The other thing to remember is any hosp during pregnancy will not be covered so if you have really bad morning sickness and need to be admitted, or complications requiring hosp bed rest that will not be covered either..

Edited by mez70, 08 January 2012 - 01:08 PM.


#3 geishagirl

Posted 08 January 2012 - 01:16 PM

La trobe have a 9 month wait period. Not true that 12 months is government legislated.

#4 mez70

Posted 08 January 2012 - 03:18 PM

Unless there have been changes to the National Health act or what ever it was called in the past few years it used to be 9 months and there were way to many borderline cases. It then got changed out to 12 mths to avoid this scenario. From memory Funds were able to pay Private Patient Public Hosp benefits between 9 and 12 mths so there could be fine print in Latrobe's coverage or if they are paying after 9 mths they are walking a fine line. Basically when I was in the PHI field we always said 12 mths ... Two years is often a benefit limitation on lower dollar coverages. If you are thinking of having kids and using PHI you need to get you covered ASAP to start serving your wait times, you can always add dH once you get the BFP or in the first few mths of pregnancy as most funds require membership to be a family one Prior to bubs birth for bub to be covered.


#5 pinkelephant

Posted 08 January 2012 - 04:41 PM

Hi OP

I'm with HCF and when I was asked this question they told me that they go by the due date of the baby, so if you do have bubs early you are still covered.  Best to ring around a few PHI's and ask them.

#6 Futureself

Posted 08 January 2012 - 04:46 PM

Perhaps it depends on your fund - mine goes by the due date and if early, an authorising letter from the OB was needed stating the due date in order to be covered. If Private is important to you then I would get it ASAP to ensure you're covered, not just for the birth but other benefits like fertility treatments if needed, acupuncture, pregnancy massage etc which are a great benefit of PHI too.


#7 StudyMum

Posted 08 January 2012 - 05:19 PM

I'd say that it must be ok after 9 months as I am with one of the major health funds that has a 12 month obstetric waiting period and I fell pregnant (a surprise baby!) about a month after we got new insurance. When I rang up to cancel my insurance (as I was contemplating a change to Latrobe as they honor any waiting period already served and have a 9 month waiting period) my current insurer changed my waiting period to 9 months. I'd say it is at the discretion of the insurer if they insure you after 9 months.

Edited by StudyMum, 08 January 2012 - 05:19 PM.


#8 Dylan's Mummy

Posted 12 January 2012 - 01:22 PM

I work for a health fund.  With us, as long as the baby is due on or after the date that the 12 month waiting period ends, we will cover it.  We do request an EDC (estimated date of confinement) certificate and make a determination about it and this can be done before the baby is born.  You'll need to contact your fund to see what their policy is.

#9 Bluenomi

Posted 12 January 2012 - 01:28 PM

Also check the fine print. Some funds have a 12 month waiting period but that is for a private patient in a public hospital. A private hospital sometimes has a 24 months waiting period.

#10 SeaPrincess

Posted 12 January 2012 - 01:35 PM

QUOTE (mez70 @ 08/01/2012, 11:07 AM) <{POST_SNAPBACK}>
The other thing to remember is any hosp during pregnancy will not be covered so if you have really bad morning sickness and need to be admitted, or complications requiring hosp bed rest that will not be covered either..


This is a really good point. I spent a total of nearly a month in hospital with 3 separate admissions while pg with DS2, all of it well before his due date - PHI paid out $500/day just in accommodation, and where we were living at the time, I definitely wouldn't have wanted to be in a shared room in the public system.  While you hope nothing will go wrong, you can't rely on that.

R

#11 Roselet

Posted 13 January 2012 - 08:34 PM

Definitely a read the fine print issue. I did loads of research when I was looking at changing funds and some definitely allowed the 12 months to be due date and still covered you if you were prem. But I'm pretty sure that wasn't true of all funds.
Good luck wtih your research.

#12 baileybunny

Posted 14 January 2012 - 08:07 AM

QUOTE (mez70 @ 08/01/2012, 01:07 PM) <{POST_SNAPBACK}>
The other thing to remember is any hosp during pregnancy will not be covered so if you have really bad morning sickness and need to be admitted, or complications requiring hosp bed rest that will not be covered either..


I never thought of this,,thanks for bringing it to mind. I wonder then if you could get admitted at a public hospital for things like premature labour, morning sickness etc, even if you weren't registered/booked in with the public hospital...and then only use your private hospital/ob or go there if you know you are definitely covered and had now exceeded the waiting period...?

#13 chookymonster

Posted 17 January 2012 - 09:35 PM

QUOTE (baileybunny @ 14/01/2012, 09:07 AM) <{POST_SNAPBACK}>
I never thought of this,,thanks for bringing it to mind. I wonder then if you could get admitted at a public hospital for things like premature labour, morning sickness etc, even if you weren't registered/booked in with the public hospital...and then only use your private hospital/ob or go there if you know you are definitely covered and had now exceeded the waiting period...?


I don't know if that would work but if you do that, you will not be seeing your private OB, and they might not have a full history of your pregnancy so, if you have early complications, not sure if you want to risk that?

#14 stella777

Posted 19 January 2012 - 01:56 PM

Hi OP
as PP's have said it is best to check with the fund you are with. I was initially with MBF and they only covered from the day the baby was actually born (not the expected due date). I ended up switching to Medibank Private as they would cover me from the expected due date as long as the doctor could provide proof that the baby arrived before it's due date. I was in your hypothetical situation, with twins due only a few weeks after I had served my waiting period, and as I knew there was a high probability they may arrive early I switched. As long as you have held equal obstetric cover in the fund you are with and the fund you are moving to, all waiting period times carry over to the next fund if you know what I mean

#15 brizvegas

Posted 20 February 2012 - 11:15 PM

QUOTE (StudyMum @ 08/01/2012, 05:19 PM) <{POST_SNAPBACK}>
I'd say that it must be ok after 9 months as I am with one of the major health funds that has a 12 month obstetric waiting period and I fell pregnant (a surprise baby!) about a month after we got new insurance. When I rang up to cancel my insurance (as I was contemplating a change to Latrobe as they honor any waiting period already served and have a 9 month waiting period) my current insurer changed my waiting period to 9 months. I'd say it is at the discretion of the insurer if they insure you after 9 months.


Can I ask StudyMum which major fund you were with? I'm with MedibankP and am only 2 wks short and they won't cover me. Latrobe will cover me but I'm finding no many OBs have arrangements with them and there is a big gap that I'll need to pay.  Thanks for any info you can provide.




1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

Win $1000 with Sea-Band

Three lucky fans can win a Sea-Band prize pack valued at over $1000 each, which includes two Sea-Bands plus a $1000 Eftpos gift card!

Misery loves Facebook

Facebook users are often criticised for only showing the positive, fun parts of their lives. But what about when it swings the other way, when someone uses it for the purposes of ranting about their children all the time, never posting anything positive?

Toddler's adorable impersonation of pregnant mum

Little Ellis has noticed his mum is walking differently lately, and his impersonation of her is hilarious.

'Forgotten baby syndrome' can happen to any one of us

When my third child was two months old, I strapped her into her car seat, then promptly forgot all about her. But she survived, unharmed, because it was winter, and I was lucky.

Join the Real Mums Test Drive Team

Five mums or mums-to-be will join the EB Test Drive Team and discover great items at an exclusive Big W event. (Sydney only.)

Ten things I've learned about motherhood

Never take a good night's sleep for granted. There is no logic like toddler logic. Standing on Lego hurts every time. These are the truths of parenthood.

Parenting past the toddler years: what's next?

Your baby has grown into a toddler, and now your toddler is fast approaching the preschooler stage. What can you expect as a parent?

Tips on what to pack in your hospital bag

Before giving birth I read countless lists, ended up overpacking just a little, and now know what I'll actually want to pack next time.

New app keeps tabs on your kids at childcare

Popular new technology lets parents know what their children are up to at childcare - but not everyone is a fan.

21 things I love about newborns

There?s an irresistible magic about newborns. Of course they're not all smiles and rainbows, but they are undeniably cute and remarkable in so, so many ways.

Kid-friendly hairdressers: who says haircuts can?t be fun?

I?ve found some salons who boast setups ideal for children ? you name it, they?ve thought of it. All are designed to make haircuts fun rather than stressful.

Labour pain relief may reduce risk of postnatal depression: study

Postnatal depression is a complex condition, but researchers say pain relief during labour may help some women.

Why we need better support for men after miscarriage

In a recent study, 85 per cent of men admitted feeling sadness after their partner miscarried, but almost half said they didn't share their feelings at all. What can be done to help them?

Mum in business: Kristy Chong

Kristy Chong is the managing director of Australian-made Modibodi underwear and a mum to Lucas, 6, Jason, 4, and Isaac, 6 months. She shares her advice for other mums thinking about starting their own businesses.

From toddler to preschooler: a developmental roadmap

So your toddler is growing up and will soon be entering the preschooler years. Here are a few ways to frame their development that will help you understand what?s going in those beautiful, funny, clever little heads of theirs.

Mum sacrifices an eye for her unborn baby

Motherhood is full of sacrifices, but this woman has made a life-altering one - and her baby hasn't even been born.

A grandparent by any other name

A growing number of grandparents are shunning tradition and going against conventional names - but a grandparent by any other name still gives the same awesome cuddles and kisses.

Photographer captures the beauty of adoption

The love of a family is usually tough to capture on camera. This is an exception.

When labour just doesn't happen

After three healthy kids, I can?t help feeling I?ve been a little ripped off. I missed out on something I had always wanted to experience, and now I?ll never get the chance.

Be careful what you say, your baby is listening

The importance of speaking to your baby even if they are not old enough to answer back has been highlighted by new research.

Share the little things that make you smile

We're giving away a Mountain Buggy nano, the ultimate travel stroller - and here are some of the great entries so far.

Win a Mountain Buggy nano

We?re giving away the new Mountain Buggy Nano - the lightweight travel buggy! So show us the little things that make you smile for your chance to win.

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

Win a Mountain Buggy nano

We?re giving away the new Mountain Buggy Nano - the lightweight travel buggy! So show us the little things that make you smile for your chance to win.

Be careful what you say, your baby is listening

The importance of speaking to your baby even if they are not old enough to answer back has been highlighted by new research.

Win $1000 with Sea-Band

Three lucky fans can win a Sea-Band prize pack valued at over $1000 each, which includes two Sea-Bands plus a $1000 Eftpos gift card!

The beautiful moment a baby was born at the side of a road

It's not where she expected to give birth, but mum Corrine Cinatl is delighted that her daughter's roadside arrival was captured in a series of beautiful photos.

Doctor sings first Happy Birthday to newborns

His job is to deliver babies, but this US obstetrician also has a unique way of celebrating the miracle of life.

Join the Real Mums Test Drive Team

Five mums or mums-to-be will join the EB Test Drive Team and discover great items at an exclusive Big W event. (Sydney only.)

The Nappy Collective starts new drive

It's that time of year when the dedicated volunteers at The Nappy Collective do their bit to help out mums and children in need - and they need your help.

Baby shower cake wrecks

From misshapen cake babies to questionable text, from odd colour choices to internal organ recreation, these are the baby shower cakes that taste forgot.

Photographer captures the beauty of adoption

The love of a family is usually tough to capture on camera. This is an exception.

Pregnancy progression photo ideas

Want to record your pregnancy as your belly grows? Here are some creative, fun ideas for photo shoots along the way.

The myths and facts about "normal" breastfeeding

When it comes to successful breastfeeding, there is a wide variety to what is "normal", according to new research.

Tin can craft and DIY ideas

Got a few old formula, Milo or coffee cans around the house? Use these fantastic upcycling ideas to create items for around the house and yard.

Dads meet their newborn for the first time

Emotional photos of two fathers meeting their newborn son have resonated with viewers worldwide, attracting thousands of Facebook likes and shares.

Skin safety isn't just a summer worry

Lax about the slip slop slap with your kids as weather turns cooler? Here's a reminder as to why we have to remain vigilant for our children?s future health.

Personalised baby gifts

We've scoured the internet to find gorgeous personalised keepsakes and nursery decor to record baby name and dates. They make great gifts for christenings, name days and birthdays! (All prices in AU.)

Creative sleeping baby photoshoots

See how some parents and photographers have captured sleeping babies in unusual positions and using different props.

DIY kitchen and food hacks

DIY your way to a better kitchen and make cooking easier with our clever hacks. (Some content reproduced with permission from mashable.com.)

Winter warmers for babies and toddlers

Your baby or toddler will be nice and snug in these beautiful and fun winter pieces. Most are hand-made or knitted, and they're all designed to keep your little one toastie - and adorable!

 

Mind, body, beauty, life

Making time for me

We look at your wellbeing, covering health, relationships, beauty and fashion, mind and body.

 
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.