What Is a Good Health Fund for Low Income Earners Planing Family and Do Any Waive 12mth Pregnancy Period?

Low Punt on 22/07/2018 - 19:22
Last edited 22/07/2018 - 20:42

Hi

My wife and I both have private health with Bupa as individuals. We are trying for kids and assume a family cover will be necessary. Im quite confused as to how to choose a cover and what it actually covers with children. We don't want to be on any long wait lists or be thumped with a huge specialists bill!

Can anyone recommend a provider and do any waive the 12 month period as we would like to start trying straight away for children. We are in SA.

Thank you

Edit:
- Income ~40k but have paid off house and returned to study as adults.
- I dont have a preference for private over public; from what I've heard the women's and children's hospital (30-40min drive with no traffik) and local public are great. They also deal with many emergency births etc.
- My SO does have some medical conditions that may hamper a natural birth or cause some complications, because we are low income we are concerned about post-birth complications for mom/child
- I have had a few op's (hernia) and was seen straight away and done a week later. My uncle had to wait a 2 years on public so some level of cover seems ideal.
- One we have a child I imagine family cover would be important?

Health & Beauty

Comments

  • Laurenlauren on 22/07/2018 - 19:31
    +4

    Is there a reason that you'd prefer private hospital for pregnancy over public? Depending on the hospital, most public hospitals provide excellent care. Even after private insurance fees, you're still out of pocket about $5k-ish having a baby through the private system.

    I haven't found a cover which waives the 12mth waiting period but have been very happy with health.com.au

    • Low Punt on 22/07/2018 - 20:46

      I assume we would have the baby in a public hospital. My concern was how obstetrics are managed, my SO has some existing medical conditions which need to be managed and may hamper a natural birth, post-birth care and complications. For example, if child/mum has medical complications requiring extended stay and ongoing care?
      I have edited original post. Although I read i would need to change to family cover a few days before birth also so I assume this covers after birth health?

      • Laurenlauren on 22/07/2018 - 20:55
        +3

        I've had two babies through the public system and had post birth complications requiring surgeries in the weeks after birth.

        This is just anecdotal, but from my experience there wouldn't have been any difference with my care if I was private (except for the bill). I was seen straight away, had extensive testing, great aftercare and extended stays in hospital.

        Both births were c-section (emergency and elective) and I was very well cared for.

        It may help to visit the local hospital and have a chat with the birthing suite about what sort of care they provide through the public system. There isn't a lot of difference between public and private with pre and post natal care like there is with other departments.

      • Quantumcat on 22/07/2018 - 21:32

        If the mother or baby has any complications you'll get moved to the public hospital whether or not you are using private. Private is only for the routine things.

  • tsunamisurfer on 22/07/2018 - 19:50

    What is your combined income?

    • Low Punt on 22/07/2018 - 20:47

      ATM ~50k however <40k from maternity on wards. Single income only. Have updated my original post.

  • thatonethere on 22/07/2018 - 19:59
    +2

    Just go public. You will be fine (source: spent thousands on private births and you mostly got public health system which was fine).

  • salmon123 on 22/07/2018 - 20:10
    +2

    I had employer provided private health insurance … still went with the public system.

    • JetBombat on 22/07/2018 - 20:12

      How's the end result?

      • SBOB on 22/07/2018 - 20:36
        +9

        Still end up with a baby ;)

  • devpress on 22/07/2018 - 20:58
    +4

    @OP:

    First key decision you need to make is whether you want family cover WITH or WITHOUT pregnancy. The former will be significantly more expensive than the latter.

    Some notes if you decide to go with the former:

    None of the health funds will waive the 12 month waiting period as it is forbidden under law.

    If you decide to go private, keep in mind that at time of birth you need have held the policy for at least 12 months for any claims that have a 12 month waiting period.

    Of course, waiting periods for any conditions that you've satisfied under your current Bupa policy will carry over to any other PHI policy you take out.

    Note no PHI policy (as far as I'm aware) will cover you for costs related to private obstetrics. Part of the costs are covered under Medicare.

    A pro tip — as soon as your wife falls pregnant, call the local hospitals in your area to see if they can book you in for the scheduled ultrasound scans (there's about 3 scans up to week 20, from memory). There's no out of pocket costs for you if you can do these at a public hospital (as opposed to having them done at a private clinic), but note that there's much more demand than available spots. Ultrasound scans at private clinics are fully out of pocket (not covered under PHI nor medicare as far as i'm aware).

    Also, depending on the medical condition of your SO, she may actually end up delivering at a public hospital as they are generally better equipped to deal with various medical issues than private hospitals. In fact, in some instances delivering at a public hospital may be the only choice as your nominated private hospital does not have the facility or ability to deal with certain issues (e.g. severe premature births). You'll still get some benefit from your private cover at a public hospital - such as your own room, tv in the room - but whether it is worth it is worth considering.

  • SBOB on 22/07/2018 - 21:07
    +2

    Why are you paying for private cover when you have a combined income of sub 50k?

    seems like other expenses/saving goals would rank higher when our public system is pretty good (especially for child birth)

    • Low Punt on 22/07/2018 - 21:22

      We have both had to use it for non-pregnancy related surgery (which I haven't listed) and various extras. Private health covered those costs and ongoing costs requiring specialists. We were told without it there would have been a substantial delay if in public system and there wasn't a specialist available other than private. Even having to see an endodontic specialist broke even for 2 years nearly; just ridiculous.
      I was about to cancel it until the above occurred!

      Agree, there seems to be no obvious advantage if using a public hospital for pregnancy.

  • [Deactivated] on 22/07/2018 - 22:08
    +1

    Agree private cover very useful in getting some conditions looked at faster than in the public system.

    With private system there is a lot of reaching into pocket for things normally covered for free in the public system. Pathology, hearing test, paediatrician all have to be paid with only a small Medicare subsidy. Even with the private cover out of pocket expenses were around 5-6K factoring in what the obs cost this was a few years back though.

    I haven’t heard of a single bad experience in the public system - it’s one of those things where the standard of care has to be high. Also if you think there could be additional care requirements due to complications that’s another reason to go public - last thing you need is to be worrying about large out of pocket expenses.

  • AusGP on 22/07/2018 - 22:19
    +4

    There are multiple factors at play in the public vs private debate. I think a large part will be dependent on your local area maternity service. You can run the gamut from local services which have had the coroner investigate and find preventable foetal deaths (4 from memory over couple of years), to Australia leading if not world renowned institutions. Obviously the difference can be night and day depending on where you are.

    I was a resident at a leading Australian maternity unit and my impression is (If you are lucky to be in area for these types of hospitals):

    Low risk pregnancies - public absolutely fine. You basically get midwife care from some of the very best midwives even if supervising trainees.

    High risk care - public also absolutely fine. Because you are a high risk pregnancy, all the trainees take their time, run things by the consultants and there is plenty of communication with specialty support (e.g. endocrine, psychiatry, pediatrics etc). If anything, where I trained at, the private wing was reliant on the public hospitals neonatal resuscitation team (obviously a paid arrangement - but it actually meant if things went wrong arguably the public side had BETTER neonatal resus support - Damn there were some stressed out paediatric trainees running between codes between public and private…)

    Low risk that requires intervention- this is where Private probably adds value. You get an experienced obstetrician pulling your baby out if required, and doing the C- section. Better suturing, better technique etc. (Having said that the public senior registrars can be amazing and have a baby out in what seems one minute flat for an emergency C-section).

    In public if you require some non-emergency suturing you can get a non surgically inclined resident like me whom although can suture decently, I wouldn't recommend it above an experienced obstetrician. (I was never going into obstetrics btw).
    Also it is the responsibility of less experienced staff like myself to monitor foetal monitor traces and bring it up with senior staff. Although I felt quite safe (maybe overly cautious and annoying of senior staff), you can imagine some dangers with this system.
    —> Most stressful 6 months of my life as a doctor

  • onevstheworld on 22/07/2018 - 22:31
    +2

    The main advantage of private is that you get to choose your obstetrician and are more likely to have continuity of care (unless your specialist goes on holiday). In the public, you're treated by the team you are admitted on the day, no choice… you may have met them previously, or you may not. These will include junior doctors in specialty training (supervised by a specialist).

    For pregnancy and post-natal, you and your baby will not be denied life-saving treatment, whether in public or private.

    In terms of cost, the main ones are obstetrician and hospital (and anaesthetist, if you end up having an epidural or surgery)… you may need to pay a gap for 1 or more of them depending how much they charge. In your situation, I'd suggest going public, since your income is limited and costs can add up in private. You can always use your PHI later on if there are ongoing problems that have a long waiting list.

  • try2bhelpful on 23/07/2018 - 12:08

    Having a good GP, who is in the know with a number of good specialists, is a much better way to get good health care than being a private vs public patient. We have been warned, in the past, about delays with getting treatments by going public but we have yet to experience any significant delays in going public when we were dealing with, potentially, serious medical issues. Some specialists will only work in the private sector hospitals but a good GP knows several to recommend.

    The thing to also consider is if you opt to get a test, or procedure, done in a private hospital and something goes wrong then they will admit you to the hospital and you will be up for the additional charges. You may be OK for the procedure costs but the admittance costs will soon add up.

    Best of luck with the baby.

  • savage bargain on 23/07/2018 - 12:13
    +1

    I've put a more detailed answer in this tread: https://www.ozbargain.com.au/node/384143

    We have private health insurance and have decided to go public instead, and when I had complications, the public system was excellent. We're going public again this time as we can't fault it.

    Also had friends and my own Mum had planned to go private, spent the thousands out of pocket on the appointments, then had to go public anyhow because of complications that could only be dealt with in public (premature birth, dangerously bad pre-eclampsia that was an emergency, etc.). So sometimes, as is sometimes the case with pregnancy ans birth, it's also out of your control.

  • [Deactivated] on 23/07/2018 - 18:00

    If you go private you will have to pay for a lot of extra little things along the way. We recently had our second baby in WA and it came to about $5000 in out of pocket.

    You mention your partners has compications. If a birth is too high risk you will automatically go the specialist public birthing hospital (King Edward in WA) and all patients (public or private) will be treated the same. You should find out if that is where you will end first.

    I doubt there is any health fund that will waive the 12 month wait period.

  • HeWhoKnows on 23/07/2018 - 21:18

    This is not the forum for this question
    Go to a health fund comparison site instead and plug in your parameters and priorities

    Here are the best sites

    https://www.comparethemarket.com.au/health-insurance/

    https://www.iselect.com.au/health-insurance/

    https://www.privatehealth.gov.au/dynamic/search

  • deanspn on 21/08/2018 - 13:15

    Did you recently get a letter or email from Bupa saying they’re going to discontinue coverage of some previously covered things? They sent these to their lower end plans (I got one). Their “sweetener” for taking away coverage was to offer a waiver of waiting periods if I upgraded to any of their higher plans by 1 September. You could see if this applies for you and you could sign up to a higher plan that includes pregnancy without the waiting periods that way? And I think (don’t quote me) you can then transfer to another fund without having to serve waiting periods for something you’re already covered for.

Login or Join to leave a comment
Login Join