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If you’re considering starting a family, you might be thinking about health insurance – especially if you want to give birth in a private hospital. You need to think ahead, since waiting periods for childbirth claims are 12 months, which means you need to start your policy before getting pregnant. Here’s everything you need to know about health insurance for childbirth and cover for your children as they grow up.
Do I need health insurance when starting a family?
In Australia, treatment in public hospitals is free under Medicare – including for childbirth. But if you want the option of going to a private hospital for childbirth, choosing your own doctors and getting a private room (if available), you’ll need Hospital Cover. If you or your kids needs a non-urgent procedure such as tonsillectomy in the future, you can skip public hospital wait times and have the surgery done faster. And if you earn over the Medicare Levy Surcharge threshold, getting Hospital Cover can also lower your taxes.
If you want to lower non-hospital healthcare costs associated with having a family, such as dental check-ups and physiotherapy, an Extras Cover policy might suit your needs.
Mia, becoming a single parent Mia, 36, is single and has decided to have a baby. Before beginning fertility treatment, she upgrades her Hospital Cover from Silver tier to Gold tier, so that she will be covered for private childbirth – giving her time to serve the 12-month waiting period before she needs to claim. She also takes out Extras Cover to cover pre-natal classes and acupuncture. If the fertility treatment is successful, she will upgrade her Hospital Cover policy from a Single to a Single Parent policy during her pregnancy, to make sure her child will be covered from birth.
Image credit: Shuttestock
How much does private childbirth cover cost?
Private childbirth is covered by Gold tier Hospital Cover and some Silver Plus policies. Using the healthslips.com.au calculator, premiums for Gold tier Hospital Cover for a couple in NSW as at April 2026 were:
Remember, you may have to pay a high out-of-pocket costs for private obstetrician care. Find out more here. And if you want your baby to be covered from birth, you’ll need to upgrade to a Family or Single Parent policy before they’re born.
The easiest way to choose health insurance is to get clear on why you need cover.
Hospital Cover – choose if you want cover for childbirth and elective surgeries in a private hospital, or to reduce taxes by avoiding the Medicare Levy Surcharge (MLS). Remember you will need a Gold tier policy for childbirth cover.
Extras Cover – choose if you want cover for out-of-hospital costs such as dental, optical and physio, not covered by Medicare. Extras Cover doesn’t cover all of your treatment costs and there are annual limits. Extras Cover does not affect the MLS.
Combined Hospital and Extras Cover – choose if you want both Hospital Cover and Extras Cover. Combined Cover may not make the premiums cheaper, but for some people it’s more convenient than separate policies.
Ambulance Only Cover – choose if you want cover just for ambulance treatment. (Note: not required for QLD or TAS residents because your state governments fund ambulance costs.)
Couple – for 2 adults in a relationship, living together (you don’t have to be married).
Single Parent – for one adult and one or more children.
Family – covers 2 adults in a relationship, living together, with one or more children (you don’t have to be married).
Find out how much it costs to include children in your health insurance by using the healthslips.com.au calculator. It’s fast, easy and free.
Jessica and Kelly, choosing a public hospital birth Jessica and Kelly are expecting a baby. They check their Bronze tier Hospital Cover and find it doesn’t include childbirth cover. They consider upgrading to a Gold tier policy but realise they won’t eligible for childbirth cover due to the 12-month waiting period, so they decide to give birth in a public hospital instead. They use the healthslips.com.au calculator and buy a Family policy that only costs a little more than their Couples policy, so that their baby will be covered from birth.
Image Credit: Shutterstock
Incentives and penalties that affect families
If you’re starting a family, these government incentives and penalties may affect how much you pay for health insurance:
Government Rebate – reduces your premium based on your income and number of children. Check your eligibility.
Age-based Discount – reduces your Hospital Cover premium if you start cover before 30 and maintain it (not all insurers offer this). On Couple and Family policies, the Discount will be averaged between the 2 adults, depending on their age. Check the details.
Lifetime Health Cover Loading – increases your Hospital Cover premium if you or your partner are starting cover after the age of 31. On Couple and Family policies, the Loading is averaged between the 2 adults, depending on their age and when they started cover. Learn more here.
Sunita and Dan, want to reduce tax Sunita and Dan are a couple who don’t have children, but hope to in the near future. They both earn over the Medicare Levy Surcharge so they look for Hospital Cover to lower their taxes. They find a Bronze tier Couples policy on the healthslips.com.au calculator that fits their budget and meets their healthcare needs. It does not cover childbirth but Sunita and Dan decide that when they start a family, they will go to a public hospital for the birth.
Image credit: Shutterstock
How do I choose health insurance when starting a family?
Choose your policy type
Choose between Hospital Cover and Extras Cover, or both, for your budget and healthcare needs (and your future children’s). If you want cover for childbirth in a private hospital, you’ll need Gold tier Hospital Cover. If you want cover for kids’ out-of-hospital healthcare, you’ll need Extras Cover.
Choose your cover
Do you want cover for childbirth? What healthcare needs do you have? Think about the future, including any family history of illnesses.
Find the best policy
With the free healthslips.com.au calculator, you can search every policy in Australia without commercial bias, and we guarantee you the cheapest policy. It’s fast, free and you can search anonymously (no need to enter your contact details).
Buy your chosen policy
Double-check details like the excess and waiting periods then buy the policy that’s right for you and your family.
Ed and Erin, wanting childbirth cover Ed and Erin are a couple planning to have children in the next few years. Erin wants to give birth in a private hospital and choose an obstetrician she feels comfortable with. Because there’s a 12-month waiting period for Pregnancy and Birth cover, the couple use the healthslips.com.au calculator and find a Gold tier Hospital Cover policy that covers childbirth and fits their budget. They start cover early so they can claim on it by the time Erin will be pregnant.
