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Insurance tip: Upgrade your cover well in advance of pregnancy

18 August 2016 - 11:35am

Planning to have a baby? Make sure your private health cover is up to scratch at least 12 months in advance of the expected delivery date.

Raising a child is often considered a matter of planning more than anything else. Where are they going to sleep, when are you going to take time off work, are you in the right financial place to be able to support them adequately - these are only a few of the questions that many potential parents are going to be asking themselves.

It is understandable, then, that in the excitement of making such an important decision, your insurance can fall by the wayside. However, this could be a costly mistake, as failing to have the pregnancy covered could result in you needing to pay for your hospital costs out-of-pocket.


Are your obstetrics covered?Are your obstetrics covered?

Timing is everything

Having a baby is all about timing, and the same is true when it comes to covering the costs of pregnancy.

Having a baby is all about timing, and the same is true when it comes to covering the costs of pregnancy. Your health fund may impose a 12 month waiting period before allowing for a claim for pregnancy; meaning that you have to be covered in this regard for at least a year before you would be able to claim back your health costs of delivering a baby in a private hospital.

Considering the average pregnancy lasts about nine months, prospective parents should have their cover sorted at least three months before they expect to fall pregnant.

However, getting this cover even earlier is advised, particularly in light of the complaints that the Private Health Insurance Ombudsman has received around claiming for premature births. In previous years, the Ombudsman explains, some funds were flexible in their pay-outs for babies born a week or so early.

This has resulted in some parents being surprised when they are refused a claim for a premature birth, even though the expected delivery date was at least 12 months after taking out cover - the funds have become more stringent in this regard, likely in order to prevent confusion and provide consistency across the industry.

Compare and prepare

What does this mean for prospective parents? It means that if you are planning to have children, it pays to ensure that your insurance is up-to-date well in advance to prevent unexpected denial of your claim.

Not sure if you are covered for obstetrics? Get in touch with us here at HICA on 1300 44 22 01 to compare your private health insurance and find the right cover for your needs.