On this page
- Emergency Services Health’s recommended cover
- Waiting periods
- Making sure your newborn is covered
- What to do if you're expecting twins or more
- Public hospitals and private hospitals
- Obstetrician fees
- Out of pocket costs
- Pregnancy support - Nourish Baby
What cover do I need?
We recommend our Gold Combined cover, which includes both Gold Hospital and Rolling Extras.
Choosing our combined cover means you can claim benefits on both Hospital and Rolling Extras services you utilise throughout your journey.
At a minimum we recommend you take out Hospital cover if you’d like to have your baby in the private hospital system.
Is there a waiting period for pregnancy?
There’s a 12 month waiting period for pregnancy cover. To be eligible for benefits, your baby’s delivery date (not ‘expected’ or ‘due’ date) must be after the 12 month period.
This means, if you want private hospital care during your pregnancy and labour, you’ll need to take out hospital cover before you're pregnant.
If you’re already pregnant but only joined or upgraded your hospital cover in the last 12 months, your benefits may be lower or you may not be entitled to any benefits.
Call us on 1300 703 703 to find out more.
Making sure your newborn is covered
You’ll need to officially register your newborn baby on your health insurance policy with Emergency Services Health.
If you’re already on a Family policy (including Couples) or Single Parent Family policy with us, you need to add your baby within six month of birth.
Assuming there are no other changes to the policy, this won’t change your premium.
However, if you’ve been on a Single policy, you’ll need to upgrade to either a Family or Single Parent family policy within two months of your baby’s birth and back pay the difference in premiums from the date of your baby’s birth.
Your baby will assume the same level of cover as you from birth, so if you’ve served all waiting periods, then so has your baby.
By serving your 12 month hospital waiting periods before giving birth, your newborn will be covered if they need to be admitted into hospital in their own right.
This normally only happens if there are complications. For straightforward, low risk births only the mother will be admitted as an inpatient in the hospital.
What if you're expecting twins or more?
In the case of a multiple birth, only one baby will be put under your admission (assuming there are no complications).
Other babies will be admitted to hospital as an inpatient with an account billed in their name, not the mother’s.
Can I choose to go to a public or private hospital?
Yes, but like most health-related decisions it’s best to way up the pros and cons of each option.
Thankfully there are an abundance of care options available to expecting mothers in Australia.
As a private patient you have a number of choices to make about where to give birth and who you would like to care for you during this exciting time.
Emergency Services Health gives you the freedom to choose who treats you and where. Our Hospital product covers you for treatment in any recognised hospital or day-surgery (public or private) anywhere in Australia
Some things that may influence your decisions include;
- Where you live
- Your health
- Culture and values
- Previous pregnancy experiences
When assessing hospitals you may like to consider things like:
- What birthing and nursery facilities are available?
- Is your pregnancy considered high or low risk and does the hospital cater adequately to you?
- How long will you stay in hospital after giving birth?
- If you’d like a specific obstetrician do they deliver at the hospital?
- Are you happy with the accommodation options?
- Can your partner or other children stay with you in hospital if you choose?
- What post-natal care does the hospital provide?
- Do the values of the hospital align with your own?
- Does the hospital provide pre-natal classes to help you prepare for birth?
- Would you like a tour of the hospital’s maternity area before you choose them?
- Is the hospital conveniently located for you?
Obstetrician Fees
While private health insurance can significantly reduce hospital costs associated with childbirth, it's important to understand that it typically does not directly cover the fees charged by your chosen obstetrician.
These fees are considered medical professional fees and fall outside the scope of standard hospital cover. However, there are still ways to manage your obstetrician's fees:
- Research and compare the fees charged by different obstetricians in your area
- Talk to your chosen obstetrician and discuss their fees upfront and inquire about payment options
Out of pocket costs
We strive to minimise treatment costs to members. While we have succeeded in covering most situations, there are some occasions when members will incur a charge from the service provider:
- Charges greater than the Medicare Schedule
- Fee that do not fall within the Access Gap Cover
- Charges greater than those recognised for Access Gap Cover
- Non in-patient medical services, including those medical services provided while treated in the emergency department of a hospital
- Visits by a paediatrician to a newborn who has not been admitted to hospital as a patient in their own right
Pregnancy Support - Nourish Baby
Emergency Services Health is proud to offer Nourish Baby, Australia's only accredited online antenatal and parenting courses, FREE to eligible members with Gold Hospital and Gold Combined.
*Nourish Baby brings you education on pregnancy, childbirth, and early parenting from qualified obstetric, midwifery, and child health professionals through a range of online courses.
*On registration, the member must be expecting, have given birth to a child, or have parental responsibility for a child under 12 months. Registration is limited to one unique registration code per membership per pregnancy/child and to one per calendar year per membership. New memberships or upgrades in cover may be subject to a 2-month waiting period before registration. Eligible members receive a 12-month subscription to this program. Note: The information provided by Nourish Baby is of a general nature only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. You should seek personalized advice from your doctor or midwife if you have questions about your or your baby's health. Other conditions may also apply.