Pregnancy - Can You Switch from Public to Private Later?

archieduh on 16/04/2023 - 22:10
Last edited 17/04/2023 - 09:47

I have a cousin who is seeking advice and going to talk to a GP tomorrow for her situatioin, but I just couldn't stop but ask OzB for advice.

The couple had taken private health insurance and intended to go private for birth of their first child.
But they are pregnant before the 12 month waiting time is completed (poor planning imho).
They had assumed because they had private cover for long that they will be eligible but switched to a higher cover including pregnancy only 9 months ago, so still have 3 months of wait.

Can they start getting care in the public health system and then change to private health care when the wait is over?
I thought its a non-issue, but they showed me a blog which said "It's important to note that once you have received care in the public system, you may not be able to transfer to the private system for the remainder of your pregnancy" which really surprised me.

Anyone has any inputs or experience regarding this?

UPDATE: There was confusion that the 12 month waiting period before falling pregnant, turns out it is not the case and the expected hospitalisation has to be after 12 months.
So they should be able to go ahead with private.

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Comments

  • oscargamer on 16/04/2023 - 22:15
    +2

    Wait until tomorrow

    • archieduh on 17/04/2023 - 09:16

      LOL. just hope they care to contact me soon they get clarity.

  • sumyungguy on 16/04/2023 - 22:30
    +2

    What's the origin of the blog post? I can't find that wording via a verbatim search

    • archieduh on 17/04/2023 - 09:27

      It doesn't matter what you think.. rock bottom.. rock bottom..
      ps: will ask for the link, thanks

  • morse on 16/04/2023 - 23:04
    +1

    GP would be 100% fine as it’s private with a public subsidy like all private. You don’t really need to see a midwife or obstetrician until 12-14 weeks or so, so they should be fine with GP until then. GP can organise 9-12 week scan and NIPT test if that’s what they want to do. I only saw my private obstetrician late in the piece at around 14 weeks pretty much as I’m disorganised.

    The things that might come up are miscarriage, which a GP can handle, or some kind of finding on ultrasound or nipt, in which case GP can advise whether specialist is needed - I hope none of this happens for your cousin.

    • archieduh on 17/04/2023 - 09:36

      Thanks, what I was told was that you need to book your Obstetrician by the 8th week, so they need to decide private v public asap.

  • FoxJump on 17/04/2023 - 00:00
    +4

    if you're having twins, stay in public. they treat her like a queen and you get a whole big room and free fortnightly checkups

    • archieduh on 17/04/2023 - 09:37

      Good tip.

    • bargaino on 17/04/2023 - 11:06
      +1

      Good advice. I know somebody with twins born prem, ended up with massive out-of-pocket costs. Insurance limits were designed for one baby.

      And depending where you live, public may be a lot better than private if anything goes wrong, regardless of cost. But that's huge other topic.

      Usually, the biggest problem with public hospitals is the waitlist. They don't do that for pregnancies :-)

      • FoxJump on 17/04/2023 - 11:59
        +1

        also, we skipped all queues for scans and stuff, as we were priority at the northshore public.
        was amazing. I definitely recommmend twins to everyone - just in case you have some magic to make it 100% certain you'll get twins.

        for me, it was a lucky two-birds-with-one-stone kinda thing.

  • screensaver on 17/04/2023 - 04:16
    +1

    private health insurance is for hospital use, so they need to seek an obstetrician who uses their funds preferred private hospitals and gap cover.

    • archieduh on 17/04/2023 - 09:38

      Concise and clear comment, thanks.
      I went down a rabbit hole last night looking up the costs and articles.
      Posts around 2017 saying it can cost around 3k for private birth but when I did the math it is clearly 10k+

  • aoeueoa on 17/04/2023 - 05:56
    +5

    In Sydney we went private, but not via health insurance we just paid out of pocket. We went later in the pregnancy. We had a private ob who saw us in his private clinic. On delivery day he was on leave, but sent his next best partner to the hospital. We delivered in St George public hospital, in the public birthing clinic, with public midwives. Only the ob was private and he was using the public facilities and nurses. Even the anetheaetsestesetetitisteeeeaeeeaeaestist was a public dude.

    I don't know if other people get the full private hospital treatment or what but that's what we did.

    • archieduh on 17/04/2023 - 09:40

      Interesting approach. Didn't find such an approach come up in my discussion.

      Can you share how much out of pocket you paid?
      Would having private insurance helped - guess not, as it only covers the hospitalisation process? which you went "public"

    • bargaino on 17/04/2023 - 11:12
      +1

      That's not really "going private". You can do similar in WA. We consulted a private Ob who had admission rights to our chosen public hospital.
      Was ready to go back to him if any complications, but fortunately none, so we stayed with the midwives.

    • FoxJump on 17/04/2023 - 12:00
      +2

      +1 for "anetheaetsestesetetitisteeeeaeeeaeaestist "

    • Peeceexd on 01/05/2023 - 23:06

      I am planning to do exactly the same as we didnt get private insurance for pregnancy and going to use private pb in RPA. Do you mind sharing how much it cost you? how much out of pocket for anetheaetsestesetetitisteeeeaeeeaeaestist? Cheers.

  • archieduh on 17/04/2023 - 09:47

    UPDATE: There was confusion that the 12 month waiting period before falling pregnant, turns out it is not the case and the expected hospitalisation has to be after 12 months.
    So they should be able to go ahead with private.

  • archieduh on 17/04/2023 - 09:47

    Would be great to hear private v public cost debate. With the rising costs, I am sure now there must be a significant "gap fees" to be paid that public is no longer "Free" either.
    For e.g. the 3 ultrasound scans are for around $200 each and medicare only covers $50. So regardless you deliver private or public, you have to bear that cost out of pocket, correct?

  • jaxlikesgrog on 17/04/2023 - 10:18
    +2

    We have had 4 kids (yay) 2015-2021, all public. I think a couple of scans and some prescriptions after two emergency cut opens, we are probably out of pocket 400-500 going through the public system.
    Not one large expense was incurred.

    Had great experiences in a tough hospital (Northern at Epping), only one bad nurse one one shift in 4 kids is pretty good.

    I’m all for public, cost, ease and outcome were all A+

    • archieduh on 17/04/2023 - 17:40

      Thanks for sharing

  • brendanm on 17/04/2023 - 10:23

    We chose to go public, I've always had better experiences public vs private. Paid for the extra and fancy scans out of pocket. This would obviously depend on the quality of your local hospital to some extent.

    • archieduh on 17/04/2023 - 17:50

      Thanks for sharing

  • deme on 17/04/2023 - 11:35

    So they should be able to go ahead with private.

    Why? Public hospitals are designed for emergencies that's where the kid is going if any problems.

    • archieduh on 17/04/2023 - 17:51
      +1

      To clarify, I meant the couple'e first choice was to go private and there was some confusion they can't due to waiting period.
      So now that insurance provider have confirmed they should be able to go ahead with private.

  • donbot on 17/04/2023 - 12:34
    +2

    She chose to go private. At first, I questioned whats the difference, but she insisted and given she's the one carrying, who am I to object?

    Then, given complications that arose at 35 weeks, I've never been happier to have had private as the private OB made the right call to deliver early, and the follow up to my wife and co-ordinating and delivering the specialists needed to get my wife through the complication meant that she has no ongoing health issues, whereas the only other person I know who had the condition has been left with liver issues and inability to have another child, whereas we just had our 2nd last year, without the same complication arising.

    IMO, public is fine unless shit hits the fan. My wife presented to emergency at 35 weeks pregnant with back pain for her first pregnancy. The OB was the only doctor that didnt brush my wifes call off saying this pain isnt normal and something is wrong, and she pushed and pushed and pushed for an urgent blood test in the emergency - which immediately identified the condition which caused things to happen very quickly. Had we been in public system, its very likely that she would have been brushed off for the condition to severely worsen rapidly - find me a 35 week pregnant person who isnt in some form of pain, and the condition she'd developed is rare - so you can understand doctors being reluctant to think its not just normal pregnancy pain. Until this, it was a straight forward pregnancy - but things turned very quickly and without any rhyme/reason - so nothing could be done to prevent it.

    Out of pocket was maybe a total of $6k, including all OB appointments/scans/medical/tests/hospital excess/anaethestist, and we didnt see a single bill arising from the complication as it was all treated in private hospital, including ~2 weeks admission + newborn into special care nursery.

    • archieduh on 17/04/2023 - 19:43

      Thanks for sharing such a detailed response.

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