|Antenatal Care and Delivery Fees|
Having your pregnancy care with a private Obstetrician incurs some out of pocket costs, Dr O’Neill’s staff will ensure you are fully aware of Dr O’Neill’s fees prior to your first appointment. Fee information will be sent to you upon booking for pregnancy care, however if you wish to know any information before receiving this please ask the friendly staff.
The first thing to do is make sure you are covered for maternity services with your health fund. Most people do not realise there is a waiting period of at least one year before your health fund will cover you. Other considerations include;
Does my health fund cover my appointments with Dr O’Neill?
Appointments in the office are not covered by health funds and are partially covered by Medicare. Medicare has a scheduled fee towards each of your first appointment, subsequent appointments, pregnancy management, delivery and postnatal care.
What about the Planning & Management Fee?
This fee is charged by all Obstetricians and can range from $2500-$3500, in WA. Medicare defines it as a fee for planning and managing a pregnancy, with a private Obstetrician. It reimburses the Obstetrician for providing 24/7 cover (by Dr O’Neill or by a specialist colleague in her absence), and recognises the implications of on-call obstetric practice being unpredictable. It also helps cover escalating costs in medical practice (particularly insurance/indemnity).
I have also heard about the Medicare Safety Net?
The Medicare Safety Net is an initiative which allows you to claim some of your out of pocket expenses after you have met a particular threshold of expenses. You are automatically registered for the Safety Net as an individual, however, if you register as a family you and your partner, and children, can get the benefits of the Safety Net. If you would like some more information regarding the Medicare Safety Net please visit the Medicare website.
Is Dr O’Neill with my health fund?
Dr O’Neill has an agreement with all major Australian health funds, excluding NIB and Frank Health. This means the fee for in-hospital care will be sent to your health fund on your behalf with no cost to yourself.
Dr O’Neill DOES NOT have an agreement with NIB, Frank Health, or expat or overseas insurance companies. This means you will need to pay the delivery fee upfront and claim from your health fund yourself.
We are unable to offer services to patients who do not have private health insurance.
Please be aware some health fund policies do not cover admission of babies to Neonatal Intensive Care for cardiac or respiratory care. It may not be known until your baby is delivered whether this will be necessary. ALL expecting parents should check with their health fund to make sure you have no unexpected costs at this difficult time.
What is a ‘gap’ payment?
A ‘gap’ is any out of pocket expense incurred by a patient for their medical treatment during their stay in hospital. It reflects the difference between the total fee charged by the doctor and any health fund benefit, plus Medicare rebate. Unless your health fund has an agreement in place with your doctor which will cover all of your doctor’s charge, you will have to contribute towards the doctor’s bill out of your own pocket.
Some health funds do not allow doctor’s to charge ‘gaps’, so if an agreement cannot be reached the doctor may choose not to be affiliated with the fund.
Will there be other costs to consider for my pregnancy care and delivery?
There will be other costs related to blood tests, specialist ultrasounds, anaesthetists, paediatricians and the hospital.
There are two types of costs associated with private treatment while you are an inpatient – hospital costs and medical cost.