by Bessie Hassan

Deciding to have a baby is obviously an exciting time. However what probably doesn’t cross many future parents’ minds is the process of taking out the best value health insurance policy with pregnancy cover. But having this security in place is an important part of the process, and can assist with many of the costs along the way. So how do you find the best policy to suit your needs? Here are a couple of things you may want to consider.

The benefits you want/need

The private health system does provide some benefits that aren’t accessible if you decide to go public. For example, some policies allow you to choose your preferred doctor and even your hospital of choice– a benefit for many. If you’re in the later stages of pregnancy it might bring comfort to know that you’re in the hands of a medical professional you know and trust.

The level of cover obviously dictates the benefits you receive and this can vary. Some levels of cover let you choose to have a private birthing room and access certain extras on top of the basics, such as prenatal classes. The higher levels of cover can also provide benefits for things such as accommodation costs, theatre fees, anaesthetists, pharmaceuticals, obstetrician and paediatrician fees, and various other medical costs that may arise.

Whether you’re eligible for cover

In Australia, you’ll only be covered for pregnancy-related complications under a health insurance policy with pregnancy cover if you took the policy out well in advance. Most policies even have a waiting period for obstetrics of around 12 months, meaning you’ll need to find insurance a few months before you even conceive. Post-birth treatments may also be excluded so it’s important to know the ins and outs of the fine print before you spend money on things you think you may be reimbursed for.

Other exclusions

Typical pregnancy policies won’t provide cover for appointments that occur outside of a hospital (if you have a hospital-only policy). This means that regular checkups at your GP, certain ultrasounds, blood tests, or any other appointments may not be included in your policy.

It’s also important to be aware that you may end up paying gap fees, so don’t go to the hospital expecting your insurer to cover 100% of your costs. Gap fees are the difference between the Medicare rebate you receive and the fees charged by the medical professional – and these sometimes can be high.

Cover for IVF

It can be difficult to find good policies that provide cover for assisted reproductive technology services but it’s possible. If you undergo treatments in the hospital, certain hospital policies will provide cover even if your pregnancy is the result of IVF. Just bear in mind that this varies across different insurers and everyone has a differing rule, so do your research first. However, you should be aware that there is typically a 12-month waiting period before you can claim.

When you’re planning to have a baby, private health insurance can be a very daunting thought. To those unfamiliar with the jargon and unsure of the process it can definitely be tricky but having a level of cover in place for your pregnancy is important. If you’re confused, make sure you jump online, do your research and compare policies so that you can find the best value for your money.


Bessie HassanBessie Hassan is a mother of two and an Insurance Expert at, Australia’s most visited comparison website.

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