Your maternity cover A helpful guide for parents to be.
Your guide to HBF maternity cover Getting ready to have a baby is an incredibly exciting time. But before you start your family, there are lots of things you’ll need to consider. We’ve put together some useful information about HBF maternity cover to make the process easier and to help you plan ahead, so you can make this the best experience it can possibly be.
Planning for your pregnancy..............................................................................................................4 Now that you’re pregnant...................................................................................................................5
Choosing your obstetrician......................................................................................................5 Choosing your hospital.............................................................................................................5 Understanding the costs.....................................................................................................................7
Private hospital benefits...........................................................................................................7 IVF benefits.................................................................................................................................8 Additional costs for your baby................................................................................................8 After your baby arrives........................................................................................................................9 Understanding your bills.....................................................................................................................9
Hospital bills................................................................................................................................9 Specialist bills..............................................................................................................................9 Easy ways to claim............................................................................................................................. 10
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Planning for your pregnancy When it comes to having a baby it’s important to plan ahead. Not all policies include maternity or IVF, so the first thing you need to do is check your cover. We recommend you give us a call or visit a branch so we can give you advice on the best cover to suit your needs. You’ll also need to check that you’re eligible for the 12-month maternity waiting period. If you’d like to have your baby privately, you’ll need to take out hospital cover that includes maternity at least 12 months before your due date.
It can also be useful to check if your policy covers services you can use to optimise your health and wellbeing before and after you’re pregnant, such as physio, exercise physiology, yoga and pilates programs, Friendlies health checks, flu vaccinations, nutritionist consultations, quit smoking aids and psychologists.
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Now that you’re pregnant Once you reach this stage you have some important decisions to make, including choosing your obstetrician and choosing your hospital. If you choose your obstetrician first, you don’t always get to choose your hospital and vice versa.
Choosing your hospital
Choosing your obstetrician
To help you get the best value, HBF has special arrangements with a large network of hospitals across Australia. We call these Member Plus hospitals. You can avoid or limit your costs by having your baby at a Member Plus hospital.
We recommend choosing your obstetrician as soon as your pregnancy is confirmed, so you can get consistent care throughout your pregnancy and birth. You may need to contact a few to find someone who is available around your due date.
If you’ve chosen your obstetrician first, they’ll tell you which private hospital they will deliver your baby in. However if you want to choose your hospital first, we recommend choosing a Member Plus hospital to keep your costs down.
Questions to ask: Are they taking new patients? At which hospitals do they deliver? Can they provide a cost estimate?
What are the benefits of choosing a Member Plus hospital? • Access to a private room so you can enjoy your baby’s first days in your own space to help you bond.
Do they charge an admin fee?
• Generally more time in hospital with your baby.
HBF has a range of fully covered obstetricians to choose from. To find a local obstetrician in your area, call us on 133 423.
• Meals and a bed for your partner (usually a double bed if one is available) so you can spend as much time together as possible and have the benefit of their support.
Of course, you can also choose an obstetrician your family or friends recommend. If you choose to do this, please give us a call for a benefit quote, which will explain what HBF will cover and any out-of-pocket expenses you may have.
• Having as much control over the experience as possible. For example, public hospitals may not allow you to choose flexible meal times. • Access to nice-to-have optional extras, such as a daily newspaper, local phone calls and free-to-air TV. • In some hospitals you may receive a visit from an HBF Hospital Liaison Officer. They can add your baby to your policy and answer questions about making a claim, or tell you if you’re covered for unexpected things like prolonged stays or extra treatment.
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We recommend you research a few potential hospitals and arrange a visit so you can check their services and facilities before you make your decision. For a full list of Member Plus hospitals, call us or go to hbf.com.au/ health-insurance/find-a-provider We recommend you call us for a benefit quote before booking a hospital. We’ll help you understand how your cover works and if you’ll have any out-of-pocket expenses.
You’re legally entitled to know what your costs might be before going to hospital. If your hospital stay involves any out-ofpocket charges, the hospital and your obstetrician must disclose your costs and obtain your agreement in writing before your admission. The only time informed consent is not required is an emergency where you are unconscious or otherwise unable to give consent. In these circumstances consent is deemed to be given.
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Understanding the costs Before you have your baby, we want you to have a clear expectation of what your out-of-pocket costs might be so there are no surprises along the way.
Private hospital benefits
HBF will pay a benefit towards the following inpatient services (when you are admitted to hospital to have your baby):
Every pregnancy is different but we want to give you an idea of how much it costs to have a baby today. So we’ve analysed 2015 HBF claims data to figure out the average cost of having a baby as a private patient at a private hospital.
• Private hospital accommodation, nursing and food.
Average costs based on an uncomplicated pregnancy:
• Labour ward and theatre fees. • Intensive care. • Your obstetrician and anaesthetists fees while you’re in hospital. Some obstetricians and anaesthetists may choose to charge more than the Medicare Benefit Schedule (MBS) fee. If this happens and you haven’t selected a HBF fully covered specialist, then you may have significant out-ofpocket expenses to pay. HBF can’t pay benefits towards: • Any excess. • Any outpatient services (when you are not admitted to a hospital), such as antenatal appointments with your obstetrician, blood tests and screenings and ultrasounds during your pregnancy. Just like a normal GP visit, you can claim a benefit from Medicare for these services. • Obstetrician admin or planning fees. • Midwife classes or visits.
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• The total cost of having a baby in a private hospital is $10,500 (this includes hospital accommodation and obstetrics). • If you choose a Member Plus hospital and a fully covered obstetrician, HBF will cover 100% of this inpatient cost. • For members who don’t choose a Member Plus hospital and a fully covered obstetrician, the average out-of-pocket expense for childbirth is $1,200. As you can see, by choosing a Member Plus hospital and a fully covered obstetrician you can save yourself significant out of pocket expenses.
IVF benefits
Additional costs for your baby
IVF is a type of assisted reproductive technology used to help couples have a baby. HBF covers fertility treatments that are performed in a hospital, such as egg harvesting. However treatments performed in a clinic are classified as outpatient services and are not covered by private health insurance. You may claim a benefit for these treatments from Medicare.
After your baby is born, he or she is considered an outpatient. You won’t have to pay for their hospital stay but will have an out-of-pocket cost for the paediatrician who comes to check your newborn. You may also have costs associated with hospital tests or services, such as hearing tests or a whooping cough injection. If eligible, these services can be claimed through Medicare.
We recommend you discuss treatments and costs with your fertility specialist and check with us to see if your policy covers services that can be beneficial to supporting your IVF treatment such as remedial massage and acupuncture.
If your baby needs to have an operation or go to the special care nursery, he or she will be admitted to the hospital as an inpatient. In this case, you’ll need to add your baby to your membership and then HBF will cover the costs for hospital accommodation, intensive care and theatre fees in private hospitals in line with your level of cover.
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After your baby arrives Once your little one arrives you’ll need to give us a call to add him or her to your policy. In some hospitals, you may receive a visit from an HBF Hospital Liaison Officer who will add your baby to your policy right there.
If you have a Singles or Couples policy, you’ll need to switch to a Family policy. If you do this within 2 months of your baby’s birth, your child will be fully protected by your policy and won’t have to serve any waiting periods. Once your baby is added to your policy we’ll mail you a new member card.
Understanding your bills When you have your baby in hospital you can expect at least two types of bills – one from the hospital and the other from your specialist(s).
Hospital bills Hospitals usually send their bills directly to HBF. However you may receive a hospital bill if you have to pay an excess, the procedure is excluded on your policy or if the hospital doesn’t have an agreement with HBF. Please call us if you’re not sure why you have been billed.
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Specialist bills These bills may come from the obstetrician and anaesthetist involved in your hospital stay. You’ll only receive bills if your specialist charges above the Medicare Benefit Scheme (MBS) fee or if they don’t have an agreement with HBF. To cover some of these out-of-pocket expenses, please lodge any bills with Medicare first. Then submit the Medicare Statement of Benefits and your provider’s receipts/ invoices to HBF for benefit consideration.
Easy ways to claim Claim online
Straight to your bank account
Just log in to hbf.com.au/myHBF then click on ‘Make a health claim’ and upload your original account and receipts.
Don’t forget to enter or confirm your bank account details on all claims so we can credit your benefits directly to your nominated account. If we don’t have your bank details, we’ll issue a cheque. To set up or confirm your bank details go to hbf.com.au/myHBF
Manual claim form Download a claim form from hbf.com.au and post it to HBF, GPO Box 1440, Perth WA 6839.
Ni hao!
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GPO Box C101 Perth 6839
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Even the healthiest bodies need looking after. HBF is the Official Health Partner of WA’s favourite teams, the Fremantle Dockers and the West Coast Eagles. HBF Health Limited ABN 11 126 884 786. The information in this brochure is correct at time of print. Minor changes may have occurred since that date. If major changes occur, the brochure will be replaced. Details of any minor changes can be obtained from HBF on request. C105418
HI-1258 16/02/16
