How health insurance can cover your costs when you’re having a baby  

Baby names, schools and nursery furniture… there’s a lot to consider when you’re getting ready to be a parent. One of the things you’ll need to think about – sooner, rather than later – is what medical care you (or your partner) will want during pregnancy, where you’ll give birth and what healthcare professionals you’ll want supporting you.  

In Australia, Medicare covers most, or all, of the costs of pregnancy care and giving birth in a public hospital or birth facility, but if you want private obstetric care (whether it’s in a public or private hospital), that can get very expensive without health insurance.  

Private Health Insurance will cover a lot of your birth care costs, but there’s a 12-month waiting period before you can claim, so you need to take out cover (or upgrade your existing cover) well before getting pregnant. Taking out a family or single parent policy before pregnancy will help you get your baby covered from birth, including the costs of care if they are unwell or premature. Check your policy conditions because some insurers require you to notify them of your baby’s birth within a certain time period. 

What health insurance do I need to give birth? 

If you want to give birth with a private obstetrician or in a private hospital, you’ll need Hospital Cover. Pregnancy and Birth services are covered under Gold tier (top level) policies, so if you have Basic, Bronze or Silver cover, you’ll need to upgrade ahead of time. With that said, some Silver+ policies may include Pregnancy and Birth cover, so check the policy carefully for inclusions and wait periods. 

Under Pregnancy and Birth cover, you may be covered for: 

• Giving birth in a private hospital 
• Having your own room and space for your partner to stay (if available) 
• Fees for an obstetrician of your choice  
• Fees for any anaesthetist or other doctors required for the birth 
• Midwife fees for a home birth (check the policy conditions for this) 
• Fees for a paediatrician, if your baby needs extra care. 

It may also be helpful to have Extras Cover, which (depending on your policy) may include these pregnancy care costs: 

• Birthing courses and post-natal classes 

• Lactation consultants 
• Midwife services 
• Sleep consultants 
• Physiotherapy for pregnancy complications  
• Remedial massage.

What does Pregnancy and Birth cover include?

What are the different tiers of health insurance?

Are there out-of-pocket costs for giving birth in a private hospital? 

There may be out-of-pocket costs associated with giving birth in a private hospital or with a private obstetrician, such as Medical Gaps or Hospital Gaps. Check your policy carefully and ask your healthcare professional, hospital or clinic for a full breakdown of costs in advance. Some insurers may have arrangements with certain hospitals, which could reduce your out-of-pocket costs, so contact your insurer to check well ahead of your due date.  

Why do I have to pay a Gap?

Does health insurance cover fertility treatment?

How to find health insurance for pregnancy 

To get the best value on Hospital Cover or Extras Cover for pregnancy, try the healthslips.com.au Calculator, which will search every policy, leaving no stone unturned, to find you the best option for your needs. Other comparison calculators only search a small selection of the market, but at healthslips.com.au, we proudly check every insurer in Australia. Our Calculator is fast, free and you don’t have to enter your contact details. 

Try the healthslips.com.au Comparison Calculator.

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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