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Elective C and out of pocket costs


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#1 kimba501

Posted 17 May 2017 - 05:21 PM

Hi all,

DF and I are on our journey to start TTC. I'm starting the folate tablets today and had my check up, so very very early on in our journey.

Due to some personal reasons, I'm thinking of having an elective CS (not due to any medical reasons of my own) but I'm interested in knowing what your experience was with out of pockets costs.

I have private health insurance and obviously not everything's covered, though I'm just wanting to see if this is a realistic option for us. I'm in Melbourne's west if that helps at all.

#2 -Belinda-

Posted 17 May 2017 - 05:35 PM

Your OB won't charge any more or any less due to the way you deliver. Start looking at your local OBs and what each has as a management fee is, as this is not part of private health insurance and will be your only major out of pocket cost (couple of thousand). You may be up for a charge for an anaesthetist.
Hospital stay covered by PHI, depending on its rules regarding excess etc, as long as you have completed obstetrics waiting period.
There will be other costs for ultrasounds and tests, but these aren't C-section specific either.

#3 kimba501

Posted 17 May 2017 - 06:01 PM

 -Belinda-, on 17 May 2017 - 05:35 PM, said:

Your OB won't charge any more or any less due to the way you deliver.

This is amazing advice and exactly what I was looking for. I've found some management fees at $3500-$3900 which was my expectation though your response has put my mind at ease :) thank you!

#4 Veritas Vinum Arte

Posted 17 May 2017 - 06:05 PM

As PP mentioned delivery type doesn't change your OB costs.

Anaesthetic costs will be a definite, but even then it depends who you get on the day. Ironically my worst anaesthetic experience was with a daytime scheduled cs and left me $800 out of pocket. My best and cheapest was a late night emergency cs which only left me $200 out of pocket.

Expect to be out of pocket quite a few thousand dollars. Even with my last my PG mgmt Fee was $2.5k and that was with locally one of the cheaper OBs 7 years ago. These days expect $6k minimum out of pocket.

Also note PHI only covers you for the hospital side of things (and only pays the 25% of the scheduled fee Medicare doesn't) and if you Drs charge more you will be out of pocket.

Other OB visits scans, blood tests etc are additional and only partially covered by Medicare and not covered PHI.

Don't also forget you will have Paed costs at the hospital too as for cs births you need a paed to check the baby.



#5 rosie28

Posted 17 May 2017 - 06:44 PM

$500 for the excess for me, otherwise PHI covered everything regardless of delivery method.

#6 MrsCee

Posted 17 May 2017 - 06:57 PM

My first CS was technically classed as an elective (even though OB had insisted at the last minute due to breech, cord around neck and slowed growth) and my out of pocket was about $5k.

Number 2 was an emergency CS and out of pocket cost was about $4k. Because it was classed as emergency I didn't pay for the anaesthetist (but still perplexed as to why).

Edited by MrsCee, 17 May 2017 - 06:58 PM.


#7 Nrsnat

Posted 17 May 2017 - 07:15 PM

For my first, including all appointments (all of which were bulk billed after 20 weeks), ultrasounds, hospital excess, blood tests, anaesthetist,management fee etc, we were out of pocket $8500, only $2500 of which was the 20 week management fee. He was an emergency Caesar, but was born at 3.30 in the afternoon.

#8 MrsPuddleduck

Posted 17 May 2017 - 07:19 PM

OB pregnancy management fee: $2k (got some back from Medicare)
Hospital excess: $250
Paediatrician (not negotiable): $500ish (got some back from Medicare)
Anaesthetist: $400ish (got some back from Medicare)

Plus all the pre-natal visits but you'll pay for those if you go private regardless of birth method.

#9 Veritas Vinum Arte

Posted 17 May 2017 - 08:03 PM

You were lucky MrsC 2/3 of mine were Emergency cs but I still got billed for anaesthetic.


#10 Sara.xoxo

Posted 17 May 2017 - 09:35 PM

I had my DS in 2015 via elective CS. We paid $1200 out of pocket total. But I know my OB so was not charged (yay!) so I only had to pay for 3 days in hospital, plus the anaesthetist and paediatrician.
Good luck with ttc

#11 MrsCee

Posted 18 May 2017 - 03:10 PM

 Veritas Vinum Arte, on 17 May 2017 - 08:03 PM, said:

You were lucky MrsC 2/3 of mine were Emergency cs but I still got billed for anaesthetic.

Yeah, I never quite understood why I wasn't charged anaesthetist fee for the emergency.

Same OB, Hosp etc and only 12 months apart (hence the 2nd CS) and the second was going to be "elective" too except my water broke a week earlier and so it became an "emergency" CS and no charge for anaesthetic????

Was always odd to me and I did ask and that was the explanation... and I wasn't going to argue with them lol

#12 Veritas Vinum Arte

Posted 19 May 2017 - 11:31 AM

Yeah my 2/3 were scheduled which came earlier, waters breaking with one (footling breech - my first) and labour started with the other (my 3rd - luckily I chose cs as OB said my scar should not have lasted another 6hrs of labour - told not to have any more kids).






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