health insurance/pregnancy

[jameskristie]

Hi

 

My 457 has been applied for and i need to get health insurance, i'm thinking of getting bupa cover, is this a good cover? Also not that we have any immediate plans but was thinking of upping the coverage to include pregnancy & childbirth as i've heard a few nightmare stories, what sort of assistance do you get with medicare for this?

 

Thanks in advance, james & kristie

[Laugan]

Hi, we are on a 457 and took cover with Bupa, thou not the pregnancy cover. We've been with them for almost two years, we have up-ed our cover with them twice as we initially only took the basic bronze cover but since moving out we now have gold cover with hospital for expenses like dentist and my kids also now get free dental check ups. I have to say when applying for refunds with Bupa we've always got ours pretty quick.

but I don't know how Bupa compares to other providers.

[Guest littlesarah]

Assuming that 457 visa holders are entitled to the same from Medicare as residents under the reciprocal arrangement (apologies if I'm wrong), I'd say to make sure you know exactly what is covered. If I'd opted for private care with my current pregnancy, I would be looking at bills running into the thousands already. It's fine if all goes well, but if you end up like me with unexpected complications that require multiple specialists & allied health professionals you could end up with some pretty high gap payments. Check also what they cover should your baby need to be admitted to NICU as that would have the potential to add to your final bill.

 

I'm not meaning to sound negative or pessimistic, & I know that I'm in the minority (8% of pregnancies), but so far I've developed a medical complication that has required additional specialised scans, medication, & 2 consultants, plus one procedure & 5 visits with AHPs. I'm looking at obstetrician led delivery, post-birth paediatrics assessment & treatment, possible C-section & likely special care nursery for baby. I estimate that if I'd gone with our insurance we would be facing a bill of several thousand dollars; & I have one of the most common pregnancy complications which has been well-managed. As well as the money, I wouldn't have received seamless care in the way I have if I'd been seeing each provider separately. So far I'm very impressed with the care I've received.

[fourcorners]

I am approaching 8 months pregnancy and am fully covered under private healthcare (we're with GU Health which is a corporate provider - I don't think you can get it independently). So far I have been able to claim all the gap amounts for scans and obstetrics appointments. I am on a 457. I have seen the same healthcare providers that I would have seen through the public system anyway, so there is no difference in the service I get and I've been very happy so far. It's a similar situation with the hospital, there is only one in town so that's where I'll be to have my baby, the only difference is private patients get their own rooms, public share rooms (4 beds to a room in maternity), but if it's quiet they'll put the public patients in the private rooms.

 

The amount you get charged at appointments seems to vary somewhat. For example I had an obstetrics appointment on Tuesday for which the total cost was $70.00 as is normal for a routine appointment. They then immediately claimed back $40 from medicare of this so I ended up paying $30. I can now put in a claim for this gap with my private health insurer. A few months ago my appointment was $130, and they claimed the whole lot back on medicare (bulk bill). I couldn't tell you what the difference was in my appointments, both had a normal check up and ultrasound. The whole medical system here is still quite mysterious to me!

 

Just a note, if I wasn't private I would be looking at out of pocket medical expenses so far of about $500 as the providers here rarely bulk bill. But I have had a very normal pregnancy with no complications (touch wood!).

 

Another thing to think about is maternity pay. As a 457 visa holder I get no paid parental leave as I do not meet the residency requirements. My employer does not have any kind of maternity pay either, so in a week or so's time I'm going to be earning $0. Friends of mine have more generous employers and they get 4 months full pay. It is not something I asked about at interview stage, and when I looked through my contract I wrongly assumed I would get paid parental leave. Worth considering when looking at jobs etc.

[Petals]

Different funds do things differently so you would need to check excactly what you were entitled to with the fund you chose. Some do gap and some do minimum gap and sometimes it depends on which private hospital you go to and what arrangements that hospital has with the fund. I think myself you have to be prepared to pay gap fees and as has been said anything out of the ordinary they can be high. Need to take out the insurance before you get pregnant as they will require you to be in the fund for a full 12 months before they will pay out on maternity.

 

I have health insurance, top cover and have paid a lot of gap fees but that has been because I used doctors who were not affiliated with the fund, but that is the idea of health insurance, doctor of one's choice.

[Naomi from Manchester]

Am I right in thinking if you're private and choose an epidural, it costs around $800? That's what I heard... I went public and have mixed feelings about the service.

[fourcorners]

My obstetrician is affiliated with my fund, so there is no gap in the fees and all my costs in hospital, no matter what happens, will be covered by my insurance. So it really depends on your cover, and what the arrangement is between your fund and your service provider.

 

So from a financial point of view I have piece of mind about any costs associated with my labour. Which is a really nice thing to have, one less thing to worry about!