Around 73 percent of women in Australia rely on Medicare alone once they fall pregnant, while the remaining 27 percent choose to be covered by private health insurance.
Which option should you choose?
Medicare only
When now-Sydneysider Natasha Ramirez first arrived in Australia, she and her partner Keith made sure they had put money aside just in case she fell pregnant. The couple wanted to be prepared, and they didn't know what to expect when it came to the Australian healthcare system. But what was truly unexpected was that she was seven months on the way and didn't know it.
“I didn't know,” she laughs, sharing in Filipino, “My period is irregular and my tummy didn't get big.”
Feeling ill, Ms Ramirez went to the doctor and was misdiagnosed as having a tumour due to abnormal hormone levels in her pituitary gland – that is, until a urine test confirmed that she was with child.
Once she found out she was pregnant, she relied on Medicare for prenatal checkups and examinations, as well as the birth of her first child, Jessica. She also utilised Medicare when she fell pregnant again - this time, with twins Zion and Zian.
Ms Ramirez shares that the general perception Filipinos have regarding public hospitals is far removed from how public healthcare is in Australia. She says that public hospitals in Australia are "first class" and even better than some of the private institutions in the Philippines.
Here are some things you need to know should you opt to rely solely on Medicare during your pregnancy:
Ate Jessica with Zion and Zian. Source: Natasha Ramirez
Two pregnancies. Three babies. Source: Natasha Ramirez
1. No out-of-pocket costs
Australian residents and citizens have access to Medicare. Should you decide to rely solely on Medicare, and consequently avail of care at a public hospital or birth centre, there will be no out-of-pocket costs except for examinations that aren't made mandatory such as screening for Down syndrome.
2. Hospital will be close to where you reside
A downside of using the public healthcare system for your pregnancy is that it works within zone catchment areas. This means that the hospital you go to will depend on where you live. But while this doesn't leave you with much of a choice on where to go, it also means that the hospital will be close to your home and will therefore, be more convenient to go to.
Speaking in Filipino, Ms Ramirez shares, "For my first pregnancy, I went to the Auburn Hospital which is five minutes from where we live. For my twins, all my prenatal exams were there."
She does share, however, that she had to give birth to the twins in the more-specialised Westmead Hospital due to her condition being classified as high-risk. Westmead is closely affiliated with Auburn.
3. No choice of doctor
You can rely solely on Medicare if you're not too fussy about having just one doctor attend to you during your entire pregnancy.
Ms Ramirez shares that she would get confused by who was actually going to examine her because sometimes the name on her referral letters would be different from the doctor she would actually see.
"I didn't really get to know any doctors," she laughs, relaying that during the time she gave birth to her twins, there were around eight doctors in the room with her - none of whom she knew.
4. Shared room
Those who have normal deliveries and who don't suffer from any complications from childbirth will typically share a room. If a lot of women give birth during the time you deliver, you may even end up sharing your room with three or four others.
Usually, family members can only stay during visiting hours.
However, due to the complications Ms Ramirez had during her pregnancies, she was given a private room. Her family was also allowed to stay in the room with her throughout her entire stay.
5. Longer waiting time
Because more expectant mums tend to rely on Medicare and give birth in public hospitals, waiting time for checkups and examinations tend to be longer.
Ms Ramirez shares that you need to book in an appointment, and your schedule will rely on the availability of the doctors and midwives. When you do manage to get an appointment, waiting to get checked or examined will be at least an hour over the time you were scheduled to see the doctor or midwife.
Private healthcare
In a span of three years, it seems that life happened all at once for Maita de Luna. She moved to Australia in 2015. In 2016, she married her now-husband Paulo and she fell pregnant. In 2017, she gave birth to their son, Mateo.
“[I had] a natural birth, without anaesthesia,” the mum-of-one laughs, “I had no birth plan...come what may...when I was asking for the epidural, the midwife said that it was the last option. As much as possible, they preferred a natural birth. So that's what I did.”
Maita de Luna holds her newborn son, Mateo, for the first time. Source: Maita de Luna
Opting for just laughing gas, this strong mum laughs saying, "I just had to endure it."
Ms de Luna prepared for the pain, and she prepared for her healthcare coverage. She is currently on a work visa and still awaiting for her permanent residency; but while she has no access to Medicare, she obtained private insurance which wasn't just for her basic healthcare needs, but also for her pregnancy and delivery as well.
Here are some things you need to know should you decide to be covered by private health insurance:
Two become three. Source: Maita de Luna
1. You can choose the hospital you go to (but there may be a limit)
Depending on your provider and coverage, you can go to whichever hospital you want. You can also opt to go to either a public or private hospital.
Although Ms de Luna could have gone to a private hospital, she chose to give birth in the Sandringham Hospital, a public hospital affiliated with the Alfred Hospital.
"People at work recommended Sandringham," she shares in Filipino, "What I know is in a private hospital, a doctor will deliver the baby. My doctor and workmates said, it's highly recommended to have midwives there because they really take care of you all throughout the birthing process."
2. You may still end up going to a public hospital even if you choose a private one
Private hospitals tend to be smaller and less-equipped than public hospitals.
Should you or your child need intensive, specialised care, you may end up being transferred to a public hospital anyway.
Also, unlike public hospitals which always have staff either on-site or on-call even after hours, anesthesiologists and doctors in private hospitals usually have to be called in.
3. You can choose your doctor
Under her policy, Ms de Luna was able to choose an obstetrician who would be there to assist her throughout her pregnancy.
This is a benefit that attracts a good number of women to private healthcare as they get to see only one doctor who will be familiar with their pregnancy, instead of having to see different health professionals who just go over their medical history and condition on file.
4. Access to a private room
If you stay at a hospital covered by your insurance and if your policy states it, you will have access to a private room.
This is particularly appealing if you want your own personal space to rest or, if it pains you to hear the quick Lamaze breathing of the other heavily pregnant woman on the next bed.
5. Eligibility and costs
When it comes to being covered for pregnancy, eligibility and costs are two of the most important issues to keep in mind.
To get coverage for pregnancy, private health insurance should be obtained at least 12 months before you conceive.
Costs will depend on your coverage. However, typically, basic coverage will not include consultations with specialists and checkups, some hospital fees, and visits to the paediatrician.
Fortunately, Ms de Luna was able to obtain insurance in 2015, therefore making her eligible for coverage when she fell pregnant.
She opted for basic coverage because it was the cheapest. Only her in-hospital fees were covered. Ms de Luna shares that she had to pay around $5,000 in total for her prenatal checkups and examinations.
Each mum-to-be is different. One pregnancy can run its course with no issue; while another can be plagued with complications. One delivery can go quickly, smoothly, and assisted by the welcomed numbness of an epidural; while another can be prolonged, painful and only made easier by the thought of the new baby she's about to meet.
Ultimately, choosing between private and public healthcare for pregnancy and childbirth is about each individual mum and bub, and whatever is best for the two.
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