Over the past week, I have spoken to a few newly-pregnant women who have expressed some confusion with what exactly private health insurance covers. So I thought I'd run through it here. Private Health insurance is available in two forms: hospital cover and extras cover.
Hospital cover covers the cost of your treatment while you are actually in hospital. It does not cover the cost of your out-of-hospital care such as your appointments, scans, tests and so on. These are claimed through Medicare.
You need to also check the level and type of hospital cover that you have. Some cover you to be a private patient in a public hospital; others cover you to be a private patient in a private hospital, and others do not cover pregnancy at all.
The other thing to consider is your extras cover. Extras cover may cover some services provided by private midwives that are not claimed through Medicare such as childbirth education and homebirth. There is generally only a two month waiting period for extras cover, whereas there is usually a 12 month waiting period for hospital cover, with the exception of one or two funds who require 24 months of cover for pregnancy.
To re-cap, your appointments in pregnancy and after baby is born are claimed through Medicare as these are out-of-hospital services. When you have your baby in hospital, your health fund covers the cost for your hospital accommodation and treatment in hospital.