FEES AND COSTS
I understand that the financial aspect to accessing private obstetric care can be confusing as well as challenging. It is therefore very important to me that any fee structure associated with your care is clearly explained and understood by you, so you can make informed decisions.
The following table outlines our obstetric fees and as a practice we have structured them to be all inclusive and as simple as possible. This means that no matter which way you deliver your baby, these fees will not change.
There is a $400 fee for our initial 45 minute consultation. The fee for our routine consultations is $150 and as your pregnancy progresses and you reach your Medicare Safety Net, you will get increasingly larger rebates. You will also have scheduled visits with Polly both during and after your pregnancy, for which there is no charge. The planning and management fee is paid at 28 weeks. This is to reflect the 24 hour service provided by our practice during your entire pregnancy, as well as the delivery of your baby and review in hospital. The planning and management fee is independent of the consultation fees that continue to apply throughout the pregnancy.
Below I have outlined the item numbers that will typically be invoiced during your pregnancy along with the minimum Medicare rebates. The quoted delivery fee assumes coverage by private health insurance#.
| ITEM NUMBER | DESCRIPTION | TIME OF INVOICE | AMOUNT | REBATE |
|---|---|---|---|---|
| 16401 | First consultation fee | After initial consultation | $400 | $75.65* |
| 16500 | Routine medical consultation | After each subsequent consultation | $150 | $41.70* |
| 16590 | Planning and management Fee | 28-week appointment | $5,900 | $384.50* |
| 16519/16522 | Delivery Fee | - | No out of pocket # | |
| 16407 | Postnatal medical review | - | No out of pocket | |
| 82100 | First midwifery consultation | - | No out of pocket | |
| 82105 | Subsequent midwifery consultation | - | No out of pocket | |
| 82115 | Preparation of midwifery care and birth plan | - | No out of pocket | |
*Please keep in mind that the rebates quoted above are the minimum amounts that you will receive from Medicare. Once you have passed the safety net in a calendar year, you’ll receive more back from Medicare than the amounts I’ve quoted. The Medicare Safety Net is based on a yearly threshold that is different for each individual/couple/family. It is highly likely that you will receive larger rebates than those quoted above.
The number of consultations you will have during your pregnancy can sometimes vary but in general it’s outlined here in the appointment schedule. If you ever need to be monitored overnight in hospital during your pregnancy, there will be no charge to you.
Other costs that may be incurred during your pregnancy include ultrasound scans and blood tests, but we will explain ways of minimising these expenses as we come across them. You may also receive invoices from the following specialists in association with your delivery:
| PROFESSIONAL | SERVICE | ESTIMATED AMOUNT |
|---|---|---|
| Anaesthetist | Epidural | $700-$1,500 |
| Surgical Assistant | Caesarean | $300-$500 |
| Paediatrician | Check up for the baby at delivery | $250-$400 |
As these services will have been given to you in hospital as an in-patient, you will be able to claim with both Medicare and your private health fund for these services. If you need help submitting these claims, we can provide this to you.
As you financially prepare for your obstetric journey, we encourage you to use the following checklist to make sure you are being as financially savvy as possible.
OBSTETRIC FINANCES CHECKLIST:
• To learn more about the Medicare Safety Nets, click here
• Check that your health fund will cover your obstetric care in a private hospital. This means your policy will need to cover you for item numbers 16519 and 16522. I deliver at The Mater Hospital and Prince of Wales Private Hospitals only. If your private health insurance covers you for obstetric care, you will not receive an invoice from my practice for your delivery. This is because I provide a ‘no-gap’ service for deliveries for all health funds irrespective of whether I appear on their ‘no-gap’ list or not.
• Once you have chosen the hospital in which you would like to have your baby, you may wish to contact them to check whether any out-of-pocket expense will be associated with your admission. You can contact the hospitals on their numbers below.
The Mater Hospital
(02) 9900 7300
The Mater Hospital
(02) 9900 7300
Prince of Wales Private Hospital
(02) 9650 4693
Prince of Wales Private Hospital
(02) 9650 4693
#What if I don’t have private health insurance?
If you are not covered for obstetric care by a private health fund, the great news is that you can still pair up with our team for your pregnancy journey and delivery at the Prince of Wales Private or the Mater. You can discuss this with my team, who will be then able to help you obtain an estimate of the increased costs associated with your delivery and hospital admission.
