Thoughts on Private Health Care for Pregnancy BUPA VS HCF

Laqu on 04/07/2020 - 09:55

I am currently with Qantas Assure which is under NIB mostly as it was low premium and I only kept basic hospital cover. As I am planning to start a family I have increased to Gold cover and currently paying $212 a month with basic extras, $500 excess. I know NIB doesn't have the best GAP cover performance so I am looking to switch to a health fund that will pay more when the time comes.

My friend recently had a baby and was with Bupa and was happy with the cover. She went to Mater private and apparently BUPA have a good relationship with this hospital and she didn't have to pay any gap.

but when doing comparisons the insurance brokers have been recommending HCF as having better gap cover performance than BUPA. I don't know any one who has used HCF before so wondering if its a good health insurance to switch to. On paper all the numbers look slightly better than what BUPA offers. Price is also similar bupa $220 vs HCF $219 per month for gold cover to cover pregnancy with $500 excess.

I have graves disease (autoimmune regarding thyroid) which means i would be considered more "high risk" and planning to go through private system because of this.

Any advice would be greatly appreciated.

Poll Options expired

  • 1
    BUPA
  • 2
    OTHER
  • 5
    HCF
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Comments

  • Diji1 on 04/07/2020 - 10:13
    +2

    the insurance brokers have been recommending

    So you haven't worked out that the insurance broker only cares about getting paid a commission yet?

    Just another inefficient cost that the customer pays that a nationalised sector doesn't have.

    • aqu on 04/07/2020 - 10:22

      yeh which is why I am hesitant to just take their word and sign up through them. trying to get a few more opinions before I decide. i just don't know other people who went through private a few others went public but they all had very straight forward pregnancies.

  • Hellfire on 04/07/2020 - 10:19
    +2

    Regardless of the health insurance you have it will still cost thousands of dollars by having your baby in a private hospital. High risk patients are often better going through the public system because of the greater resources available.

    • drose1 on 04/07/2020 - 10:41
      +1

      "greater resources available"? care to elaborate?

      • whooah1979 on 04/07/2020 - 11:21

        State operated hospital will always have more funding than private ones.

      • Hellfire on 04/07/2020 - 12:37

        More equipment and range of specialist doctors to deal with issues. My partner was refused access to a private hospital for her second birth because they couldn't deal with possible complications.

  • Amaris on 04/07/2020 - 10:33
    +2

    If I was a high-risk pregnancy, I wouldn't want to have my baby in a private hospital unless the hospital had a proper neonatal ICU and an adult ICU. Private hospitals are usually poorly staffed and I wouldn't want to risk it.

    Below are the payments received by doctors under gap cover from some funds for item numbers 132,133,116 respectively which are the most common for inpatient consultations in private hospitals. Charges for surgeries will differ but I expect the percentages would be similar.

    Medibank $353,$177,$100
    Bupa 325,163,93
    HCF 332,166,95
    NIB 317, 157, 90

    Gap cover is for payments to doctors and you need to check with the fund if that particular hospital has an agreement with the hospital you want to go to so that they won't charge you an out of pocket for hospital services (other than doctors' charges).

  • ihbh on 04/07/2020 - 10:34
    +1

    Are you engaging a ~$5+k obstetrician? If so their suites are next to private hospitals and recommend them.

    Wife had kids at the Mater and RNSP with BUPA and experience was good but unnecessary.

    With what we know now, we'd choose a public system such as Ryde with a mid-wifery group. If spending an extra $6k on an OBG and a couple thousand for maternity cover gives you more peace of mind, then try to achieve it by making time to be more informed.

    • sahh on 04/07/2020 - 10:39

      Trying to make the decision between private vs public atm and the cost is still confusing me. The OB cost - how much of this is covered by PHI? I know it’ll depend on how much the OB is charging above the standard but is the $6k you mention the final out of pocket amount?

      • ihbh on 04/07/2020 - 10:42

        The OB cost - how much of this is covered by PHI

        0; Medicare maybe a consultation or parts of.

        $6k you mention the final out of pocket amount

        $5-6k City/Eastern Suburbs/lower North Shore for an experienced one - but do your research, and look at reviews, as it's been a couple of years. Not sure about starting out ones and so on.

        • Amaris on 04/07/2020 - 10:50

          Lots of OBs participate in gap cover schemes of health funds and will charge the patient a lesser fee (or no fee).

          • ihbh on 04/07/2020 - 11:01

            @Amaris: I see, e.g. the BUPA Hatch arrangement. This is not much different to the public system.

            • Amaris on 04/07/2020 - 14:56

              @ihbh: Not just with group practices. There are plenty of independent OBs who would 'bulk' bill the actual delivery and the hospital wouldn't charge out of pockets. Of course, the really popular Obs will not do this because they can charge for their service. Those starting out will often not charge a gap.
              The Australian OBGyn training system is very good and one Ob should be very similar to another, especially for a process that happens normally without anyway.

  • whooah1979 on 04/07/2020 - 11:19
    -1

    Giving birth in the public system is free for low income while some may have to pay a small fee depending on their income.

  • YesPleaseThankYou on 04/07/2020 - 11:32

    HCF = Member-owned.

    HCF pays a bigger benefits as % contributions than Bupa.

    Bupa has 2nd highest complaints in the industry.

    Refer https://www.ombudsman.gov.au/publications/reports/state-of-t…

  • brendanm on 04/07/2020 - 14:43

    You are bonkers to want to go private full stop, even more so if you are high risk.

    • Amaris on 04/07/2020 - 14:57

      Could consider a public hospital as a private patient. Can get a single room and of course a TV!

      • brendanm on 04/07/2020 - 15:16
        +1

        We went public, had fantastic support the whole time, lots of burning options, and the knowledge that if something went wrong, you have a lot of extremely experienced people and operating rooms ready to go. Also had a single room. Not sure what sort of hospital has shared rooms in the maternity ward?

        • brendanm on 04/07/2020 - 16:57

          Birthing not burning, stupid phone.

  • Gazpacho on 18/04/2021 - 21:27

    Anyone have experience with which PHI to get with RNSP, and recommendations for OB that deliver out of there?

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