a smiling mother after breastfeeding her newborn

Visa holders may face high fees if they become pregnant without health insurance coverage

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Key points
  • Giving birth in Australia without Medicare can cost between $10,000 and $18,000.
  • The cooling off period for private health insurance to cover pregnancy is generally around 12 months.
  • The pregnancy management process is different for international students or temporary visa holders.
Sadia Khan was pregnant when she arrived in Australia in 2012 on a student visa with her husband.
While their consultant had taken out health insurance for them, the couple say they did not know there was a 12-month waiting period before being covered for pregnancy-related expenses.

Now working as a professional banking consultant, Ms Khan said it had been very difficult for them to pay all the medical bills – totaling around $18,000 – at that time.

Since I wasn’t covered by my insurance, I had to pay all my expenses out of pocket, which was a lot of money.

Sadia Khan

“If you have a student visa, they refer you to a private hospital and you have to choose a private gynecologist,” she told SBS Urdu.

Even though visits to a GP were covered by her insurance, she had to pay the full costs incurred by her gynecologist, including his fees, all exams and other costs, she said.

What is the waiting period/cooling off period?

According to the insurance comparison site, “the waiting period to benefit from benefits linked to pregnancy and childbirth is generally 12 months”.
This means that an insured person must have held a health insurance policy for at least 12 months before being eligible for pregnancy-related benefits, including antenatal care, childbirth and postnatal care.
The 12-month waiting period is often set as the maximum waiting period by the federal government.

This regulation aims to ensure that individuals do not purchase health insurance only when they need pregnancy-related services, which could potentially lead to adverse selection and increased costs for insurers.

The reflection/waiting period for reimbursement of pregnancy costs is normally 12 months. Source: RF Moment / d3sign/Getty Images

As a solution, Melbourne-based GP Dr Afshan Mian suggested “shared care” for students or temporary visa holders who did not have private health insurance or were in a waiting/delay period. reflection.

“When you don’t have Medicare and you have private insurance, it’s important to know what level of insurance you have,” Dr. Mian said.

Dr. Mian said most hospitals and even insurance agencies cooperate to provide patients with information about their medical costs, coverage and out-of-pocket expenses.

What is shared care?

In a GP shared care arrangement, the individual’s GP plays a central role in providing antenatal care. Most routine antenatal check-ups and appointments take place at the GP clinic.
These appointments may include initial confirmation of the pregnancy, general health assessments, and discussions about the pregnancy.
Dr Mian said that due to busy schedules, hospitals often encouraged patients to see a GP for at least the first 15 weeks of pregnancy.

After that, if there were no complications and patients opted for shared care, they only had to go to the hospital at 20 weeks, 32 weeks, 36 weeks and 38 weeks, she explained.

If you have no complications, you can see a GP under shared care for most of your antenatal services.

Dr Afshan Mian

Dr Mian said a patient’s GP was also able to arrange any pregnancy-related examinations and tests for the patient.
According to , “GP shared care is an arrangement between a GP and a maternity or other place of birth. You see your GP for most pregnancy appointments, and you also have hospital appointments at the start and end of pregnancy.
Dr. Mian mentioned that the cost of this arrangement could be between $10,000 and $18,000 depending on the level of insurance, paperwork and options. It was therefore very important for women to choose wisely and complete all the necessary documents.
Dr Mian also indicated that expenses could vary on a case-by-case basis and depending on the fees of treating GPs.

The cost of prenatal care, delivery, and postnatal care can vary widely depending on several factors, including the level of insurance coverage, the specific health services received, and choices made by the patient.

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Image Source : www.sbs.com.au

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