Pregnant? No private health insurance? Your options explained.

Many women believe they need to have private health insurance to be treated as a private patient.

For many, the terms "public" and "private" are discussed in relation to birth, and "public" tends to mean giving birth in a public hospital, while "private" means giving birth in a private hospital. 

However, being treated as a public / private patient really has very little to do with the location of the birth.

Public patient

Being a public patient means you do not pay for your care (we pay indirectly through our taxes), your care providers are employed by a hospital to provide your care, and you generally cannot choose where and with whom you give birth.

Private patient

Being a private patient is the opposite of this: it means that you pay for your care, your care provider is not employed by the hospital (they are in private practice); and you can choose who cares for you and where you give birth.

So where does private health insurance come into it?

Private health insurance is a way of funding your in-hospital care, ie, the birth.  It pays for the cost of accomodation in the hospital, pathology attended in hospital, and for your care provider's services.  It does not cover the cost of out-of-hospital services such as consultations with your care provider leading up to your birth and for postnatal consultations, although you can generally claim a part of the cost of your care provider through Medicare.

So do you need to have private health insurance to be a private patient?

The short answer is no.  Private health insurance does not cover the cost of any consultations during pregnancy, it does not cover the management / care plan fee of the midwife or obstetrician, and it does not cover the cost of the postnatal consultations.  All that a private health fund will cover is the cost of in-hospital care.

Provided that you are able to fund the cost of your in-hospital care, you can choose to give birth within the private system.

If you are choosing to birth in a public hospital as a private patient, the fees for in-hospital care are generally very affordable: you're only looking at paying a few hundred dollars extra, in most cases.  Of course, if you choose to give birth as a private patient in a private hospital without health insurance, this can be very costly, extending into the thousands of dollars.  But to be a private patient n a public hospital without health insurance is actually do-able for most families.

There are other options, too, with some women choosing to be private for their pregnancy care and postnatal care, while giving birth as a public patient under the care of hospital staff; this model of care is shared care.

Melissa Maimann is an endorsed eligible midwife in private practice in Sydney.  One of the first eligible midwives in Australia, Melissa now offers a range of care options for women including private midwifery care, antenatal shared care and birth support.  Visit Melissa's website to learn more about her services.