How can health insurance support pregnancy?
Having a baby can be an exciting time in your life, but thinking about it can also lead to lots of unanswered questions. Knowing where to start and having a good plan can put your mind at ease when it comes to planning for pregnancy. Here's some explanation on how health insurance can support you through your pregnancy journey.
Which pregnancy services are covered by Frank?
Hospital cover
Gold Hospital covers you for pregnancy and birth, and assisted reproductive services.
You’ll be covered for:
- Medical procedures including specialists' fees, anaesthetists' fees and some other hospital charges (while you're an inpatient)
- Hospital charges such as accommodation & delivery suite
- Your choice of obstetrician for the labour and birth
There is a 12-month waiting period for pregnancy and birth, and assisted reproductive services.
Extras cover
Some closed Frank extras covers include benefits for antenatal and postnatal classes – if you’re an existing Frank member, check your fact sheet for an outline of your cover.
When included on your cover, benefits can be claimed for sessions and courses provided by registered midwives or physiotherapists in a private practice. Antenatal classes must be billed separately from the hospital account and benefits are not payable for courses or sessions that are paid for by Medicare. Antenatal and postnatal classes only have a two-month waiting period.
What isn't covered by Frank?
For pregnancy management and maternity cover, Frank Health Insurance does not cover:
- Medications for IVF and assisted reproductive services
- Visits to your GP
- Obstetrician's appointments before the birth
- Any procedures done in the doctor's rooms (unless performed while you're an inpatient in hospital)
- Ultrasounds, blood tests and other tests (unless performed while you're admitted to hospital)
- Any outpatient services received, like consultations with your doctors or any planning and management fees related to your pregnancy.
Read more about what’s covered and what's not in Frank’s Important Information Guide.
When should I upgrade my cover?
The waiting period for most pregnancy-related services is 12 months.
To make sure waits have been served before the birth and you will be covered, you’ll need to take out pregnancy cover or upgrade your cover to include pregnancy and birth as a clinical category, at least 3 months before you plan to fall pregnant.
Don’t fret – if your child is born early, waiting periods are calculated from the estimate due date.
How much will I be covered for?
If you have Frank’s Gold Hospital cover, contact us with your medical item numbers (provided by your doctors) to check how much we’ll pay for your hospital stay and birth-related services.
You will have to pay an excess upfront when admitted to hospital and will also have to pay for any out-of-pocket expenses from your doctors including the obstetrician, pathologist, anaesthetist etc. Make sure you check with them before your hospital visit and get a written estimate of their fees to confirm potential out-of-pocket amounts.
Adding your baby to your existing Frank policy
If you have an existing private health insurance policy through Frank and you want to add your newborn to your cover, it’s important to be aware that this may change the membership ‘class’ of your policy or require a new policy product altogether. This can come with additional cost and potential waiting periods depending on your current membership. It can be complicated, so we’d recommend giving us a call, prior to the birth of your baby to discuss your circumstance on 1300 437 265.
Once you have called and confirmed you have the right policy, you can follow the steps below to add your newborn to your cover.
1. Register your newborn with Medicare.
2. Call Frank on 1300 437 265 to add your newborn to your policy. If your baby needs to go into the Neonatal Intensive Care Unit (NICU) in a private hospital, we suggest calling and adding them as soon as you can. Please note, only the primary member (policyholder) can add new members or make changes to the cover, unless you have completed a Spouse Authority form for the second adult on the policy.
3. Pay an additional premium cost, if applicable.
Early motherhood
For extra support for you and baby during this time, some closed Frank extras covers pay a benefit for antenatal and postnatal classes such as lactation consultants. Services like physiotherapy are included on all open Frank extras covers.
