Your maternity cover A helpful guide for parents to be.
Your guide to HBF maternity cover Getting ready to have a baby is an incredibly exciting time. But before you start your family, there are lots of things you ll need to consider. We ve put together some useful information about HBF maternity cover to make the process easier and to help you plan ahead, so you can make this the best experience it can possibly be. Planning for your pregnancy...4 Now that you re pregnant...5 Choosing your obstetrician...5 Choosing your hospital...5 Understanding the costs...7 Private hospital benefits...7 IVF benefits...8 Additional costs for your baby...8 After your baby arrives...9 Understanding your bills...9 Hospital bills...9 Specialist bills...9 Easy ways to claim... 10 2
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Planning for your pregnancy When it comes to having a baby it s important to plan ahead. Not all policies include maternity or IVF, so the first thing you need to do is check your cover. We recommend you give us a call or visit a branch so we can give you advice on the best cover to suit your needs. You ll also need to check that you re eligible for the 12-month maternity waiting period. If you d like to have your baby privately, you ll need to take out hospital cover that includes maternity at least 12 months before your due date. It can also be useful to check if your policy covers services you can use to optimise your health and wellbeing before and after you re pregnant, such as physio, exercise physiology, yoga and pilates programs, Friendlies health checks, flu vaccinations, nutritionist consultations, quit smoking aids and psychologists. 54
Now that you re pregnant Once you reach this stage you have some important decisions to make, including choosing your obstetrician and choosing your hospital. If you choose your obstetrician first, you don t always get to choose your hospital and vice versa. Choosing your obstetrician We recommend choosing your obstetrician as soon as your pregnancy is confirmed, so you can get consistent care throughout your pregnancy and birth. You may need to contact a few to find someone who is available around your due date. Questions to ask: Are they taking new patients? At which hospitals do they deliver? Can they provide a cost estimate? Do they charge an admin fee? HBF has a range of fully covered obstetricians to choose from. To find a local obstetrician in your area, call us on 133 423. Of course, you can also choose an obstetrician your family or friends recommend. If you choose to do this, please give us a call for a benefit quote, which will explain what HBF will cover and any out-of-pocket expenses you may have. Choosing your hospital To help you get the best value, HBF has special arrangements with a large network of hospitals across Australia. We call these Member Plus hospitals. You can avoid or limit your costs by having your baby at a Member Plus hospital. If you ve chosen your obstetrician first, they ll tell you which private hospital they will deliver your baby in. However if you want to choose your hospital first, we recommend choosing a Member Plus hospital to keep your costs down. What are the benefits of choosing a Member Plus hospital? Access to a private room so you can enjoy your baby s first days in your own space to help you bond. Generally more time in hospital with your baby. Meals and a bed for your partner (usually a double bed if one is available) so you can spend as much time together as possible and have the benefit of their support. Having as much control over the experience as possible. For example, public hospitals may not allow you to choose flexible meal times. Access to nice-to-have optional extras, such as a daily newspaper, local phone calls and free-to-air TV. 5
We recommend you research a few potential hospitals and arrange a visit so you can check their services and facilities before you make your decision. For a full list of Member Plus hospitals, call us or go to hbf.com.au/ health-insurance/find-a-provider We recommend you call us for a benefit quote before booking a hospital. We ll help you understand how your cover works and if you ll have any out-of-pocket expenses. You re legally entitled to know what your costs might be before going to hospital. If your hospital stay involves any out-ofpocket charges, the hospital and your obstetrician must disclose your costs and obtain your agreement in writing before your admission. The only time informed consent is not required is an emergency where you are unconscious or otherwise unable to give consent. In these circumstances consent is deemed to be given. 7
Understanding the costs Before you have your baby, we want you to have a clear expectation of what your out-of-pocket costs might be so there are no surprises along the way. HBF will pay a benefit towards the following inpatient services (when you are admitted to hospital to have your baby): Private hospital accommodation, nursing and food. Labour ward and theatre fees. Intensive care. Your obstetrician and anaesthetists fees while you re in hospital. Some obstetricians and anaesthetists may choose to charge more than the Medicare Benefit Schedule (MBS) fee. If this happens and you haven t selected a HBF fully covered specialist, then you may have significant out-ofpocket expenses to pay. HBF can t pay benefits towards: Any excess. Any outpatient services (when you are not admitted to a hospital), such as antenatal appointments with your obstetrician, blood tests and screenings and ultrasounds during your pregnancy. Just like a normal GP visit, you can claim a benefit from Medicare for these services. Obstetrician admin or planning fees. Midwife classes or visits. Private hospital benefits Every pregnancy is different but we want to give you an idea of how much it costs to have a baby today. So we ve analysed 2015 HBF claims data to figure out the average cost of having a baby as a private patient at a private hospital. Average costs based on an uncomplicated pregnancy: The total cost of having a baby in a private hospital is $10,500 (this includes hospital accommodation and obstetrics). If you choose a Member Plus hospital and a fully covered obstetrician, HBF will cover 100% of this inpatient cost. For members who don t choose a Member Plus hospital and a fully covered obstetrician, the average out-of-pocket expense for childbirth is $1,200. As you can see, by choosing a Member Plus hospital and a fully covered obstetrician you can save yourself significant out-ofpocket expenses. 7
IVF benefits IVF is a type of assisted reproductive technology used to help couples have a baby. HBF covers fertility treatments that are performed in a hospital, such as egg harvesting. However treatments performed in a clinic are classified as outpatient services and are not covered by private health insurance. You may claim a benefit for these treatments from Medicare. We recommend you discuss treatments and costs with your fertility specialist and check with us to see if your policy covers services that can be beneficial to supporting your IVF treatment such as remedial massage and acupuncture. Additional costs for your baby After your baby is born, he or she is considered an outpatient. You won t have to pay for their hospital stay but will have an out-of-pocket cost for the paediatrician who comes to check your newborn. You may also have costs associated with hospital tests or services, such as hearing tests or a whooping cough injection. If eligible, these services can be claimed through Medicare. If your baby needs to have an operation or go to the special care nursery, he or she will be admitted to the hospital as an inpatient. In this case, you ll need to add your baby to your membership and then HBF will cover the costs for hospital accommodation, intensive care and theatre fees in private hospitals in line with your level of cover. 9
After your baby arrives Once your little one arrives you ll need to give us a call to add him or her to your policy. If you have a Singles or Couples policy, you ll need to switch to a Family policy. If you do this within 2 months of your baby s birth, your child will be fully protected by your policy and won t have to serve any waiting periods. Once your baby is added to your policy we ll mail you a new member card. Understanding your bills When you have your baby in hospital you can expect at least two types of bills one from the hospital and the other from your specialist(s). Hospital bills Hospitals usually send their bills directly to HBF. However you may receive a hospital bill if you have to pay an excess, the procedure is excluded on your policy or if the hospital doesn t have an agreement with HBF. Please call us if you re not sure why you have been billed. Specialist bills These bills may come from the obstetrician and anaesthetist involved in your hospital stay. You ll only receive bills if your specialist charges above the Medicare Benefit Scheme (MBS) fee or if they don t have an agreement with HBF. To cover some of these out-of-pocket expenses, please lodge any bills with Medicare first. Then submit the Medicare Statement of Benefits and your provider s receipts/ invoices to HBF for benefit consideration. 9
Easy ways to claim Claim online Just log in to hbf.com.au/myhbf then click on Make a health claim and upload your original account and receipts. Manual claim form Download a claim form from hbf.com.au and post it to HBF, GPO Box 1440, Perth WA 6839. Straight to your bank account Don t forget to enter or confirm your bank account details on all claims so we can credit your benefits directly to your nominated account. To set up or confirm your bank details go to hbf.com.au/myhbf
Go to hbf.com.au Call us 133 423 Mon to Fri: 6am to 6pm (WST) Sat: 8am to 2pm (WST) Postal address GPO Box C101 Perth 6839 Stay in touch Find us at HBF Health Visit a branch For branch opening hours, please visit hbf.com.au Metropolitan branches Perth 96 William St Belmont Belmont Forum Shopping Centre Booragoon Garden City Shopping Centre Cannington Carousel Shopping Centre Innaloo Innaloo Shopping Centre Joondalup Lakeside Joondalup Shopping City Karrinyup Karrinyup Shopping Centre Mandurah 32 Pinjarra Rd Midland Midland Gate Shopping Centre Morley Galleria Shopping Centre Rockingham Rockingham Shopping Centre Subiaco 142 Rokeby Rd Success Cockburn Gateway Shopping Centre Regional branches Albany 21 Albany Hwy Bunbury 12 Arthur St Geraldton Northgate Shopping Centre HBF Health Limited ABN 11 126 884 786. The information in this brochure is correct at time of print. Minor changes may have occurred since that date. If major changes occur, the brochure will be replaced. Details of any minor changes can be obtained from HBF on request. HI-1258 16/08/17