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Private Health Insurance - a few questions


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#26 bide

Posted 28 October 2015 - 09:07 AM

View Postroses99, on 28 October 2015 - 09:03 AM, said:

Be aware that you will need to have private cover before you become pregnancy. Well before, to be safe.

I've heard this as well. My understanding is there's a 12 month waiting period that they don't waive. Based on conversations with different PHI sales, I'd need to get it at least 4 months before TTC, if not earlier.

#27 just roses

Posted 28 October 2015 - 09:09 AM

View PostCallMeFeral, on 28 October 2015 - 08:48 AM, said:

I stayed for 3 days at my public. DH stayed overnight (albeit on a fold out couch, not a bed). I could call the midwife team at any time and be listened to. I saw the same midwife throughout both my births, who was the most lovely person, and knew my history. I had LC and midwifery follow up care. All free :)
This is an important point. In my experience, private gave me continuity of care with my OB. But not with a midwife.

When you're in labour (private or public) you'll spend far more time with a midwife than with your OB (who will drop in an out and - in some cases - may be busy delivering another patient's baby at the same time!)

I did not connect at all with the midwives who cared for me. With DS, she was perfectly nice. But I didn't know her, she didn't know me and there was no connection. With DD, I barely saw the midwife. Again, no connection.

If you go midwife led care in my town, you'll have the same midwife (they work in a team of two, so you have a main midwife but - if yours isn't available on the day - you'll have the other) right through the pregnancy, in labour, and for six weeks after you've given birth. That's pretty impressive continuity of care, I think.

Also, having the same midwife (again, this applies to my town. You'll need to check your own options) means you have an advocate in case you have concerns. A friend of mine suffered terrible carpal tunnel syndrome during the later stages of her pregnancy. Her midwife advocated on her behalf and convinced the public OBs to induce her early.

#28 Lady Sybil Vimes

Posted 28 October 2015 - 09:10 AM

Keep in mind that public hospitals often have better nurse-patient ratios as part of their enterprise bargaining agreements. You will not necessarily find staff have more time for you in a private hospital.

I've had one baby public and one private and had a private room each time, DH stayed overnight both times and I had good care each time.

#29 RockyV

Posted 28 October 2015 - 09:11 AM

View Postbide, on 28 October 2015 - 09:00 AM, said:


I have some general questions from comments made in this thread:

For those who went public, how much were you out of pocket for?

Is it that difficult to learn to breastfeed? A few people have mentioned the longer stay helps with breastfeeding. Can someone please explain that a bit more? Why does a longer stay help with breastfeeding?
:)

I paid nothing for public. Not even scans or ultrasounds.

Breastfeeding is an ongoing skill that needs practice and patience. Some babies take to it easily, others take more time, some don't adapt at all. You won't know in 4 days.

I'd save my money and get a private lactation consultant once you're home if you feel the breastfeeding isn't working for you. PM if you want the name of a great one (who works 1 day a week in our local public hospital and then privately consults outside of that shift).

Continuity of care seems to be practise based. Ask at the hospitals if there is a midwife led program. I had one where it was same midwife one on one but funding was cut by the time I had my second. There may still  be programs available in the areas you've mentioned.

jem_cat is right. Narrow down what is most important to you. Speak to your local public hospital first, tour it and get a feel for it. If it doesn't serve your needs, explore private options.

#30 Lady Sybil Vimes

Posted 28 October 2015 - 09:21 AM

I will just add the my private obstetrician, although lovely and highly skilled, remembered nothing about me between visits and I had to remind him every single time I saw him that I was having a caesarean and the reasons why because he didn't look at my file before I came in to see him. So if that kind of personal touch is something you're interested is then private care won't guarantee it. I have no complaints at all about the care I had when it really mattered but sometimes it galled me to be paying so much money to someone who didn't glance at my file. Towards the end I told DH I'd be taping a "Wrong Way Go Back" sign on my vulva, just in case.

As far as breastfeeding I would take up the offers of home visits after discharge by the midwives if you're offered it. I found that so helpful to have someone come to my home who had time to sit with me and watch me go through a feed.

I don't remember paying anything when I went public.

#31 CallMeFeral

Posted 28 October 2015 - 09:25 AM

View Postbide, on 28 October 2015 - 09:00 AM, said:

For those who went public, how much were you out of pocket for?
Is it that difficult to learn to breastfeed? A few people have mentioned the longer stay helps with breastfeeding. Can someone please explain that a bit more?
Finally, can you choose which public hospital to go to or is it location based?

Out of pocket - only for my nuchal translucency, as this was external and not bulk billed. My Dr referred me to somewhere quite expensive - next time I shopped around and got it much more cheaply from equally competent staff who also burned the images on a CD.
Also see if your GP will refer you to somewhere that does the bloods bulk billed.

Breastfeeding - yes it CAN be difficult (sometimes), especially first time, as your milk takes a while to come in and your nipples will be tender and your bubs mouth is so small. But a longer stay wouldn't have helped me with that - I got plenty of advice in my 2-3 days, and free access to the lactation consultant after that was worth a lot more than an extra day in hospital when my milk hadn't even come in by then.

I think public is location based. So as Roses said, check out your location based public, and your private options, and compare them. Ask about what choices of program you will have to go through. As a PP said, a midwife program may be able to give you continuity of midwife, whereas private will give you continuity of ob.

#32 Fossy

Posted 28 October 2015 - 09:36 AM

My friends in croydon who went public went to the angliss, further north you'd probably be zoned for the mercy or box hill. The latter two are great public hospitals, the first I'd avoid like the plague!
Private around there there's Knox private or Mitcham private out east or northpark more north. Or the CBD maternity hospitals Freemasons, St Vincent's and Frances Perry.
Do some tours and see what you think. Work out what is important to you and decide which hospital is best equipped to meet your needs.  Good luck!


#33 ScarfaceClaw

Posted 28 October 2015 - 10:15 AM

I wanted access to tertiary services 24/7 for both me and my baby (especially if it was to be born prematurely). Therefore private hospitals didn't even enter my mind when planning a pregnancy.
It's all about what you think is important to you, and often you won't know until you are in it.
Generally more midwife driven care and lower interventions, and more exposure to complications (so more skilled staff) in the public setting, but longer times sitting in waiting rooms, and all the food is rubbish everywhere.

I had excellent support publicly, but you do need to ask for it some of the time.

#34 PrincessPeach

Posted 28 October 2015 - 10:21 AM

I went private with my first, simply because I wanted my own room and I wanted to be able to stay longer than 24 hours after delivery. Plus our nearest public hospital is crazy busy and at that time was 4 share to a room. It also had the same level SCN as the private hospital I delivered at, so if we had complications I would have been sent to the nearest tertiary hospital no matter what happened.

I did do a lot of looking around and research into ons prior to getting pregnant. Contact a few of them and find out what their appointment costs are and management fees. Some will also do shared care with your GP if costs are a factor.

Also as a pp said, get advice from other people who have delivered at your hospitals of choice (public and private), if you are unsure, this might help you make your decision.

There is also another option of going public as a private patient. Not done it myself, or known anyone who has, but I think this will give you your continuity of care by seeing the same Ob, but delivering in the public hospital, so it will reduce your costs.

But I have to disagree with the pp who said all of your tests will be done privately.

My dating scan and all blood tests (I ended up needing quite a few) were all bulk billed. Yes I had to pay for my 12 and 20 week scan, but I would have had to pay for these even if I went public.

#35 SenatorPrissypants

Posted 28 October 2015 - 01:28 PM

I went public with my first and am happily doing the same with my second. I wanted to do shared care but am high risk so have to see OBs instead. I've had one I didn't like and the rest were great. Whoever said they went private so they could call at any time, you can do that in the public system too. After 20 weeks, you just call maternity and they advise you and tell you wether to come in or not. I don't remember the food in the hospital, I had a new baby, they could have fed me gruel for all I cared. I had a shared room, it was fine, the other mums were just as enraptured with their babies as I was, nobody was throwing parties. Great lactation support. I had a c section and was given the choice of three or four days stay, I chose four when they asked on the third day then realised that I didn't need it because I was just sitting around doing nothing but it was too late by then because they'd moved on. You may not actually want such a long stay, I thought I would but I was wrong.

Reality is, both options are incredibly safe and you'll be seen to by skilled professionals either way so it really comes down to personal preference.

#36 Hollycoddle

Posted 28 October 2015 - 01:38 PM

Only advice is that if you want to go private to have a baby (or with any other health procedure or condition, I guess) make sure you use a private hospital, not public.  In a public hospital you aren't necessarily likely to get better care, ie. c-section patients can trump natural birth for private rooms in the public hospital regardless of your cover and if they are short-staffed with midwives it affects everyone equally.  May as well go Medicare if you're going with a public hospital.

Edited by Mollycoddle, 28 October 2015 - 01:39 PM.


#37 wombats

Posted 28 October 2015 - 01:59 PM

My public pregnancy/birth cost around $80 I think, that was for a nuchal scan at 12 weeks. I did shared care with my GP who bulk billed all antenatal appointments. I went home from hospital later than they first suggested on a lactation consultant's advice. I had multiple home visits by midwives after, plus I was able to go back to see the lactation consultant as needed.

#38 FuzzyChocolateToes

Posted 28 October 2015 - 02:18 PM

View PostLady Sybil Vimes, on 28 October 2015 - 09:10 AM, said:

Keep in mind that public hospitals often have better nurse-patient ratios as part of their enterprise bargaining agreements. You will not necessarily find staff have more time for you in a private hospital.


This is what I was going to say. I've had 4 babies in 3 different public hospitals in your area op (including the Angliss) and I had no complaints about any of them. I stayed 1 - 2 nights max and was happy to go home. I found breastfeeding pretty straight forward. I had no need for a longer stay.

Edited by ednaboo, 28 October 2015 - 02:20 PM.


#39 MerryMadrigalMadge

Posted 28 October 2015 - 02:30 PM

Had DD at the Mercy Heidelberg.

Saw the same team of midwifes all the way through, only saw an OB when DD was getting over a 1 week late.

Great team of midwives, remembered my name, never had any problems calling etc.

Started in the birth centre, but had meconium - whisked down the corridor to the standard suites - DD came out to a room of senior OB, trainee OB, midwife, trainee midwife, paediatric nurse and paediatrician (who took one look at my screaming 4.1kg baby (41+5days) and gave me a thumbs up and left).

Birthed at 6pm, DH stayed overnight with me, made informed decision to leave at 4pm next day, with daily and then weekly home visits from midwife.

Cost of entire process $0  (paid for a CVS but that's separate)

Spent my thousands saved on support services at home where I got far more value.

My SIL birthed at Freemason's and did the whole recovery at the Hilton thing - I visited her there, and so did not see the point of the thousands it would have cost, just to stay in a hotel room.

Edited by MarigoldMadge, 28 October 2015 - 02:55 PM.


#40 MrsLexiK

Posted 28 October 2015 - 02:49 PM

View Postnup, on 28 October 2015 - 08:40 AM, said:

And no one mentions the upsell that happens in private hospitals.
Can you explain this to me? I never had any up sell seriously what are you on.

View PostCallMeFeral, on 28 October 2015 - 08:48 AM, said:

.

My PUBLIC hospital had all single rooms except one (and I haven't heard of the shared room being used). It was new and had wonderful facilities. Yes you don't get to stay as long (some people like that). And I expect the food is not as nice - I don't really like hospital food anyway so it's kind of moot for me.
Meanwhile people have had shared rooms in PRIVATE hospitals in our area, after paying all that money.
The nurses and midwives in our public hospital were absolutely wonderful apart from one or two duds - which is the same as I've heard from private hospitals. Probably because they are people, and there are always going to be some good some bad. I never felt like my midwives were rushed. Anaesthetists yes (but this is often because they are shared with private/public hospital), but not the midwives where I was.
And the care will be better if the public hospital you are at is a tertiary one, not all privates are, and they would then transfer you to the public anyway if there were an emergency.
And the lactation consultant at our public? Legend. And as a public patient I could come back and see her whenever I wanted (and I did) without paying - unlike private.

What you DO ALWAYS get with private is your choice of obstetrician, choice of a c section that's not medically required, and a lot of extra costs. You need to decide whether the ones offset the other.


I stayed for 3 days at my public. DH stayed overnight (albeit on a fold out couch, not a bed). I could call the midwife team at any time and be listened to. I saw the same midwife throughout both my births, who was the most lovely person, and knew my history. I had LC and midwifery follow up care. All free :)
Clearly not zoned to my public hospital. 6 hours for a normal vb birth. They start trying to push you out after a csection at 24 hours I kid you not. There is no LC specialist. They have plenty of shared rooms and it's usually those that have had csections that get the privilege for shared rooms due to where they are located. They don't like dad's staying so tend to put those that are going to be discharged within 6 hours into the double rooms. The midwife case load isn't 1 on 1 it's more like 5 on one. My OB doesn't offer csections for non medical reasons. My private hospital is a baby friendly hospital, with a fantastic LC, a midwife who offers follow up appts, all the OB's use midwives from the mat ward. The midwives remembered me and my DS1 when I went in the second time. Also no parking charge at the private hospital but it costs a pretty penny at the public.

View Postnup, on 28 October 2015 - 08:59 AM, said:

Is private hospital food really worth it? I think all mass catering is pretty rank. People are talking as though it's worth paying for. The tertiary hospital closest to us has one of the best hospital cafetarias I know of. Would much rather have proper coffee, decent pastries and a selection of fresh made salads. None of the private hospitals I've been to have had food worth even mentioning. Where are all these well catered hospitals???
My food was better at the private then the public I have been too but the location of the private is in our Main Street opposite plenty of redundant a and take away places and a woolies and aldi. I recently had DS1 at te hospital for tonsils and adnoid removal, he had dietary requirements and they sent a cook down to speak to me. At the public when he has gone he has not had that his been given whatever even if that wasn't something he could eat.

I wouldn't have spent $4k between both births let alone one so it's all relative to where you are and what the OB's charge. If my public had been a better fit for me my choice may have been different.

#41 Burro

Posted 28 October 2015 - 04:04 PM

View PostMrsLexiK, on 28 October 2015 - 02:49 PM, said:


Clearly not zoned to my public hospital. 6 hours for a normal vb birth. They start trying to push you out after a csection at 24 hours I kid you not. There is no LC specialist. They have plenty of shared rooms and it's usually those that have had csections that get the privilege for shared rooms due to where they are located. They don't like dad's staying so tend to put those that are going to be discharged within 6 hours into the double rooms. The midwife case load isn't 1 on 1 it's more like 5 on one. My OB doesn't offer csections for non medical reasons. My private hospital is a baby friendly hospital, with a fantastic LC, a midwife who offers follow up appts, all the OB's use midwives from the mat ward. The midwives remembered me and my DS1 when I went in the second time. Also no parking charge at the private hospital but it costs a pretty penny at the public.


Wow. Which hospital is this?

#42 Soontobegran

Posted 28 October 2015 - 04:21 PM

View Postnup, on 28 October 2015 - 08:38 AM, said:

When these threads happen I'm always astonished that people willingly fork out these outrageous fees. I know why they're so high, but don't understand how they're deemed necessary for so many women. I've had friends who've paid the outrageous fees and they feel perfectly justified, when there are far more affordable options available. It seems to be about status amongst the people I know. I've even had one friend tell me she didn't want a horridly disfigured vagina. Midwives for births unless you're in a high risk category. And that's a very small percentage of women. But apparently I only know high risk women.

I think you are out of line here. I don't think anyone has a right to criticise the decision made by other women with regard to their obstetric care.
What does it matter to you ? You did  what you wanted to do and that is all that matters.


FTR a low risk birth can only be established after the event.

#43 Teds

Posted 28 October 2015 - 05:14 PM

Public and out of pocket? $0-. I think I paid for an extra scan. I could go into the lactation classes, which I did as dd was bottle feeding she we came out of hospital but with the free public sessions through the hospital and our local centre,  she was back to fully breastfed at two weeks. I did, however see a different ob each time I turned up at the cattle call appointments for pregnant mums with gestational diabeties. Would have liked continuity of care here. I worked for a private health insurer and so many ladies I worked with said go public, private isn't worth it. They too shared rooms and had rude hurried nurses.  And if you have issues at private, they send you to public or charge over $800- a day for nicu, if they have the facilities. SIL was out $8000- as her son was in for over a week. Public, this would have been free and better resourced.

Edited by Teds, 28 October 2015 - 05:16 PM.


#44 Soontobegran

Posted 28 October 2015 - 05:29 PM

There are terrible public hospitals and there are terrible private hospitals.

The hospital I worked in for afforded a level of care that I did not experience for any of my births in the private system nor for the births of my children who had their babies in the private system.
This is certainly not the case for many people in some public hospitals.

As I said upthread I chose private because at the time most public hospitals had multiple beds in a room and I very much like my privacy.

I was more than happy and still am happy to pay a fortune to PHI ...it is what we choose and we have got far more out of it than we've ever paid in subscriptions.

#45 Stoked

Posted 28 October 2015 - 05:35 PM

I like how people bag private hospitals while only having public hospital experience! I'm not bagging public hospitals - I simply don't know enough about them. What I have seen of public hospitals (not as a maternity ward patient, I must say) have not impressed me.

Being able to pay extra for a private hospital opens up extra options. For me convenience was a very important factor of choosing which hospital to go to. Nearest public hospital was 30 mins drive away while a private hospital was literally on my doorstep. DH being able to stay was critical for me with the first baby (we both were so lost at trying to work out why all the screaming, but it was less daunting when we shared the load during nightime), so was him being able to go home and fetch a yet another forgotten thing within half an hour.

Breastfeeding? Only got the hang of it by the evening of Day 4 of my stay. Forever grateful to the midwives and have no idea if I would have received better support in the public system. Follow up? Yep, had home visits, opportunity to phone and ask any silly baby-related question, opportunity to go to twice weekly breastfeeding support sessions, of course a bazillion of (sadly, needed) follow up appointments with the OB as well.

Now we moved away so it's unlikely that I will go back there - easily a 30 min drive, more in peak hour. The nearest hospital with a maternity ward now is a public one, so I don't know, maybe private over public next time? I'm keeping my PHI with obstetric cover even though the premiums are insane just to continue having options for as long as I am of childbearing age and can afford it.

And the food? Best food in the private system, I had heard about my hospital. Gourmet meals. I remember being brought a chicken dish for dinner, contemplating that it was impossible to determine how this piece of chicken was cooked and wondering just how horrible food at other hospitals must be to consider that a gourmet meal.

#46 Veritas Vinum Arte

Posted 28 October 2015 - 05:46 PM

Have only given birth in private system, but private hospital was only 800m away from home.

I have eaten in both public and private.... Let's just say private is the only one where I haven't sent a loved one out for emergency McDonalds.

Extra costs I have been $200 out of pocket for anaesthetist and $850 out of pocket. Ironically the scheduled CS anaesthetist within normal business hours was the expensive one and the Saturday afternoon or late Monday night ones were only $200.

My OB was reasonable PG mgmt fees of $1,200-,$2,000 (went up over three pregnancies). My OB was lovely. I would bump into him at the shops (and still do) as he lives locally. Have not visited him in nearly 6yrs but he still knows me.

Like in anything depends on what is on offer for you locally.



#47 Stoked

Posted 28 October 2015 - 05:51 PM

Isolabella, we delivered our babies at the same hospital :)). You would have delivered yours before the scheduled Medicare fee for the pregnancy management was capped at ~$500? So OOP amounts were not as high as they are now for a private OB.

#48 Soontobegran

Posted 28 October 2015 - 05:59 PM

View PostStoked, on 28 October 2015 - 05:51 PM, said:

Isolabella, we delivered our babies at the same hospital :)). You would have delivered yours before the scheduled Medicare fee for the pregnancy management was capped at ~$500? So OOP amounts were not as high as they are now for a private OB.

My DD's management fee was under $2k 3 years ago.
There are fortunately still obstetricians who keep their management fee affordable around these parts.

Inner city you tend to pay more as you are helping to pay their outrageous room rental prices. :(

#49 Renovators delight

Posted 28 October 2015 - 06:22 PM

I have had a $2,000 management fee and two $2,500 fees since 2012.

Private allows me to choose a hospital where I don't feel overwhelmed.

It pretty much guarantees me access to a private bathroom. I can state that if id had to share a bathroom after my second child arrived by emergency c section id have had to be sedated, I could not have coped. My zoned public hospital has many shared rooms.

I have several pre existing conditions which need management ( eg high blood pressure), and I admit I was afraid my weight would see me treated poorly in the public system, while in private there was less chance I would encounter such issues (and haven't, it's just been dealt with matter of factly)

In terms of food, I was in a public hospital for 6 weeks, and the food was a niggling source of discontent, but it is rather nice to be in a small hospital with onsite kitchen rather than in a public hospital serving thousands of meals per day from an off site kitchen.

Edited by Tarantara, 28 October 2015 - 06:23 PM.


#50 Lady Sybil Vimes

Posted 28 October 2015 - 06:52 PM

View PostStoked, on 28 October 2015 - 05:35 PM, said:

I like how people bag private hospitals while only having public hospital experience! I'm not bagging public hospitals - I simply don't know enough about them. What I have seen of public hospitals (not as a maternity ward patient, I must say) have not impressed me.

It's interesting how different care can be between wards in the same hospital. I had DS1 public and had great care in maternity. A few weeks later my appendix burst and was admitted to a surgical ward in the same hospital and the care was so bad that I was traumatised by it for a long time.

Second pregnancy I went private and again, excellent care in maternity. Not long after DH was admitted to a surgical ward at the same private hospital and the care was so poor that I had to bring food from home because there was nothing for him. It was beyond difficult getting him adequate pain relief because the nurses were so short-staffed. I also had to see to him mobilising after surgery because there was no one else to do it. For a while it looked like he wouldn't even have a bed post-surgery because they'd overbooked.

Maybe there's an element of luck of the draw, there?




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