Private health insurance for pregnancy

GMHBA’s waiting period for pregnancy and birth related services is 12 months. This means that if you are preparing to start or extend your family and want to have your baby in a private hospital, you need to be covered by hospital cover that includes pregnancy at least 12 months before your baby is born. This means that as long as you upgrade your cover at least 3-4 months prior to falling pregnant, you will have served your waiting periods before your baby is born.

If all goes well, a newborn baby is not admitted as a patient in hospital, but if you have complications and your baby requires any accommodation or medical attention, your newborn baby will be covered for accommodation or medical services provided you have served all relevant waiting periods.

Contact us following the birth of your child to have them added to your cover.

In vitro Fertilisations (IVF and assisted reproductive services) is covered under some of GMHBA’s hospital covers. Like all hospital cover, it will only cover you for services provided whilst admitted as an inpatient in hospital. This would usually mean the actual day stay procedures for embryo collection and embryo transfer.

Often the IVF and assisted reproductive services process involves a number of consultations, tests, and services received outside of hospital. Many of these costs are covered by Medicare, however if considering IVF and assisted reproductive services, you should discuss the potential costs with your IVF and assisted reproductive services provider.

Your obstetrician
Your GP will refer you to a local obstetrician as soon as they confirm that you’re pregnant. You can select your own obstetrician if you prefer, but a referral is still required from your GP. We recommend that you discuss with your GP if you have a hospital preference to ensure that the obstetrician you are referred to practices there.

Your obstetrician will be with you throughout your pregnancy and in most cases will deliver your baby. You’ll have regular appointments during your pregnancy with your obstetrician (or midwife).

The fees charged by your obstetrician for consultations in their rooms are outpatient services which are not covered by hospital or extras cover but are partially covered by Medicare. Your hospital cover provides coverage for inpatient services that your obstetrician or their staff perform, provided that your cover includes pregnancy and you’ve served your waiting periods.

Other pre-birth consultations and appointments
You may encounter other consultation and appointment fees before the birth of your child, such as GP visits, ultrasounds, blood tests and so on. These are not covered by hospital or extras cover, however, may be partially covered by Medicare.

Your obstetrician may recommend you tour the maternity ward of your chosen private hospital before the birth to help you become familiar with where you’ll be having your baby. Hospitals do not usually charge for this tour.

Traditional Antenatal Classes
GMHBA Top Extras 75% and Top Extras Set Benefits provide you with the ability to claim benefits for sessions and courses provided by registered midwives or physiotherapists in a private practice, such as Preparing for labour and birth (antenatal) and Sleep Settling or Breastfeeding consultations or classes (postnatal).

To qualify for cover, the classes must be billed separately from a hospital account and benefits are not payable for courses or sessions that are paid for by Medicare Australia. This benefit has a 2 month waiting period and the annual limit is $350 per person.