Pregnancy & health insurance: everything you need to know
Pregnancy health cover starts at around $61
per week. Comprehensive plans will be more expensive, particularly if you want extras like birthing classes and physio visits.
The average cost of hospital cover for childbirth is around $52 per week*.
You will need to hold cover for at least 12 months before your hospital admission date.
If you are already pregnant without private hospital cover, getting it today will not do you much good.
*Prices are based on a single person earning less than $97,000 living in Sydney.
Compare hospital cover for pregnancy and child birth
Here are some pregnancy health insurance policies from Finder partners that cover pregnancy. All have a 12-month waiting period before you can claim. Prices are based on a single individual with less than $97,000 income and living in Sydney.
This comes with lots of benefits you don't get with other insurers. In addition to pregnancy cover, continuity of care and IVF cover, you get access to its 24/7 Medibank Nurse service, an OptimalMe program for mums-to-be and a pregnancy health concierge. The Growing Family Extras cover includes antenatal and postnatal classes.
Pros
Extremely comprehensive pregnancy cover.
The extras option includes antenatal and postnatal classes, pregnancy compression garments and an Australian Breastfeeding Association membership.
It's efficient. Medibank has the lowest management expenses of all open health funds.
Cons
You may still have out-of-pocket expenses.
Only 83.80% of Medibank medical services have no gap (e.g. out-of-pocket expenses). Many including Bupa, HBF, NIB and Westfund are above 90%.
It's not the only good value option. Finder 2024 Gold Award winners included St. Lukes, HBF and Health Partners.
Medibank offers a lot of pregnancy-related benefits that you won't get with other insurers, including 24/7 Medibank Nurse service, an OptimalMe program for mums-to-be and a pregnancy health concierge.
Additionally, the extras portion of the policy goes further than others we researched including ahm, Bupa, St.Lukes and HBF.
Medibank is also above average for percentage of extras charges covered (52.60% vs 49% overall) according to the latest ombudsman report.
Average prices are updated monthly when we update Finder's database of health insurance policies. Prices are based on a single individual with less than $97,000 income, $750 excess and living in Sydney.
Limits and waiting periods will apply, be sure to read the PDS.
Hospital Treatments
Assisted reproductive services Back neck and spine Blood Bone joint and muscle Brain and nervous system Breast surgery Cataracts Cancer Dental surgery Diabetes management Dialysis for chronic kidney failure Digestive system Ear nose and throat Eye excluding cataracts Gastrointestinal endoscopy Gynaecology Heart and vascular system Hernia and appendix Hospital psychiatric services Implantation of hearing devices Insulin pumps Joint reconstructions Joint replacements Kidney and bladder Lung and chest Male reproductive system Miscarriage and termination of pregnancy Pain management Pain management with device Palliative care Medically necessary plastic surgery Podiatric surgery Pregnancy and birth Rehabilitation Skin Sleep studies Tonsils adenoids and grommets Weight loss surgery
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
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How much does health insurance for child birth cost?
To be covered for child birth in a private hospital, you'll need a Gold tier hospital policy, or a Silver Plus policy that happens to include it. These are the highest hospital tiers, and you'll need to have the policy for at least 12 months to cover the waiting period.
The cheapest hospital cover for child birth currently costs around $61
per week.
The average hospital cover for child birth currently costs around $82
per week.
These numbers are updated based on Finder's current health insurance database, which is pulled from the Commonwealth Ombudsman each month. The prices are based on a single person earning less than $97,000 living in Sydney.
We chose to go private for our first born. I appreciate that not everyone will be in the privileged position of being able to afford the high cost (we paid about $10K out-of-pocket), but for us it was worth it as the level of care overall was excellent. We stayed at the hospital until day 6 and there was no rush for us to leave. I felt a lot of support from the midwives, especially during days 3 and 4 which are obviously key days if you're breastfeeding. I really appreciated that my partner could stay by my side the whole week too. As well as having a private room with our own bathroom there were other nice touches, such as great food and it was easy to call for extra provisions at any time, day or night.
Erin Liu, Government worker.
For me, the pros of going private included a longer hospital stay – I felt very supported by the nursing staff after giving birth – and continuity of care. I was able to have the same obstetrician throughout the whole pregnancy. But that came at a big cost: Going private cost at least $5K in out-of-pocket expenses for each pregnancy. That's not including the added cost of insurance that will cover pregnancy and birth services. I've heard many public hospitals offer continuity of care now, so if your local hospital has a good maternity wing, it might be worth saving the money and spending it on parental leave instead.
I've no regrets about going public for my maternity care. I particularly liked the GP shared care that I did, rather than having to go to the hospital for all the midwife appointments. From my research, I'd learnt that if any serious complications occur with you or baby, you may well end up being transferred to a public hospital anyway. From a cost point of view, we only had to pay for antenatal classes and some medication. Everything else was free.
Katrina Hayes, Software engineer.
Who pays for childbirth in Australia?
Childbirth services on the public system in Australia are paid for by the government via Medicare. If you want private care – either in a private or public hospital – you will have to pay for it yourself. But you can meet some of these costs through a combination of Medicare rebates and private health insurance.
Anything that can't be claimed back on Medicare or on private health cover is known as an out-of-pocket cost.
Medicare
If you choose to give birth as a public patient at a public hospital, the government pays. Medicare will also cover other expenses throughout your pregnancy. These include midwife appointments, routine ultrasounds, blood tests and immunisations. Plus, you can get up to 3 free counselling sessions if you need emotional support.
Private health
With private health insurance in place, you can opt to give birth in a private hospital. In most cases, this will include your own room. You can also choose your own obstetrician, who you'll visit for appointments during your pregnancy and who will deliver your baby. A private plan also has cover for assisted reproductive treatments, such as IVF.
Did you know?
According to Finder's Parenting Report 2023, the top 3 reasons for going private were: better quality of treatment/care (16%), being able to choose an obstetrician (15%) and having a private room (15%). Our survey questioned 1,033 Aussie parents with children aged under 12. Respondents were a mixture of both public and private sector patients.
Do I need private health insurance for pregnancy?
Not everyone needs health insurance for pregnancy. It's important to weigh up your own circumstances before deciding if private health cover is the right choice for your needs. For more on this, read our guide on private versus public childbirth.
Pros
You can choose your obstetrician and get peace of mind that comes with continuity of care from them before, during and after your pregnancy.
Top-end policies offer a wide range of cover benefits such as first-aid classes and physiotherapy.
You can avoid some eye-wateringly high costs of private treatments if you have the right insurance in place – especially if you shop around for the best pregnancy health insurance for you.
Cons
You have to pay more for your health insurance premium for at least 12 months before you give birth.
Even with health insurance, private care can still set you back thousands of dollars in out-of-pocket costs.
You also need to factor into your budgeting your policy's excess, which can range from $250-$1,500. This usually needs to be paid when you're discharged from a private hospital.
What costs aren't fully covered by private health insurance?
Even with a health insurance policy that covers pregnancy and birth services, there will still be additional expenses* that won't be covered by all health funds**.
Here are the main types of out-of-pocket costs you'll need to consider:
Out-of-hospital medical services. Services including private GP visits, blood tests, ultrasounds, specialist consultations and obstetrician check-ups tend to not be covered. Aside from antenatal classes, most of these services can be partially claimed back on Medicare.
The gap. The gap refers to the difference between the Medicare Benefits Schedule (MBS) fee and what your health fund will pay for medical services. Usually this gap must be paid by you, but some private health policies can cover it.
Policy excesses and co-payments for hospital admissions. Excesses and co-pays are expenses that must be paid by you. These amounts mostly depend on factors such as if your baby requires additional postnatal care. Costs also vary from policy to policy.
Your baby's pre-release check-up. A paediatrician will come to the hospital and check on your baby. Check-ups – including any follow-up appointments – are usually not covered, but can be partially claimed back through Medicare.
Typical out-of-pocket costs
Service
Description
Approximate cost
In-hospital excess
You must pay this one-off fee on your admission to, or before you leave, the hospital when you give birth.
$500/$750
Obstetrician's management fee
The end-to-end care you receive from a private obstetrician. This covers hospital fees like delivery expenses and the doctor's insurance.
$2,500-$5,000
Ongoing appointments with your private obstetrician
This covers the regular appointments, including scans and check-ups, that you have with your obstetrician.
$100-150 per visit
Paediatrician
If you're a private patient, you have to pay for this specialist to come to the hospital for an appointment.
$150-$250 per visit
Private GP costs
The cost of going to a private doctor. In other words, an appointment that's not bulk-billed.
$50-$100 per visit
Lactation consultant
To get information and support around preparing for breastfeeding.
$150-$350 – costs vary between antenatal and postnatal. (Some health policies will pay benefits.)
Birthing classes
Privately-run antenatal or postnatal classes.
Costs vary a lot – anything from $100-$500. (Some health policies will pay benefits.)
*You'll be able to claim for some of these costs via Medicare. **Top policies may let you claim for some of the services listed above.
How much does health insurance cost?
We ask hundreds of Australians what they're paying for health insurance every month. Here's what their bill looked like in November 2024.
Extras only: $56
Basic: $105
Bronze: $141
Silver: $193
Gold: $223
Price based on 470+ responses for single hospital or extras insurance.
Frequently Asked Questions:
There's no single "best" policy. It's important you find enough cover for you at a price that's affordable. Bupa's Gold Hospital plan, a recent Finder Award winner for Best Health Insurance, may be a good place to start your search. In terms of pricing, we found HBF Gold Hospital and Medibank Gold Complete Hospital to be very competitive. Make sure you look into the finer detail of what's offered by each policy. Pay attention to any benefit exclusions or restrictions.
The typical waiting period for pregnancy health cover is 12 months. You'd need to take out a policy – or upgrade your current insurance – at least 3 months before trying to get pregnant. In general your waiting period must end either before, or on, your admission date to a private hospital.
It depends on whether you go private or public. Typically, private hospitals will let you and your partner be in your own room together and stay a certain number of nights. In the public system, many hospitals don't allow partners to stay overnight, particularly in shared rooms or wards.
Health insurance plans vary a lot, but if you take out a top level of hospital and extras cover your benefits can include:
Accommodation and care at a private hospital
Assisted reproductive services
Some hospital-administered medicines
Miscarriage and termination of pregnancy
Antenatal/postnatal classes
Remedial massages
Physiotherapy
maternity support clothing
Diet and nutrition appointments
TENS machines – purchase or hire
Australian Breastfeeding Association (ABA) membership
Whether you need private health insurance for pregnancy depends on your personal needs and circumstances. If you've weighed up your options and decided you'd like to go to a private hospital for your birth, it's likely you'll need private health cover. After all, a C-section alone can set you back over $10,000 without private insurance.
No, pregnancy is not considered a pre-existing condition for health insurance.
If you hold 2 single policies, you might be better off bolstering 1 of these to cover the pregnancy services for the child bearer. Otherwise, you may be paying unnecessarily for 2 people to be covered for pregnancy.
If you want to move to a family health insurance plan to cover your baby, you'll want to check that your baby is covered from birth. You don't always have to do this before you give birth. For example, Medibank confirmed to Finder that under its Gold Hospital Cover, you have 60 days after the baby is born to add the baby to a family policy. Each health insurance brand will have different rules, though. So be sure to check directly if you have any doubt about the time period you will or won't be covered for.
Finder research has found that 70% of first-time mothers chose the public hospital system for pregnancy and delivery. The reason most first-time mums go public comes down to cost – childbirth in a public hospital is free, whereas a standard private delivery can cost around $9,000-$10,000. When you're researching your options, you may want to start by looking into the quality of the public hospital system you're in the catchment for and where you'd birth. Speak to others who have been through the process, including friends, as well as discussions in online forums such as mothers' groups on Facebook.
A c-section may cost $11,476, according to Bupa's surgery cost calculator. Bupa estimates an average out of pocket cost of $339. These figures are for an elective (non-emergency) caesarean section.
If you have a C-section in a public hospital as a public patient, you'll be fully covered by Medicare and will not have to pay any fees.
Private health insurance can be worth it for pregnancy as you gain access to a number of benefits if you want to deliver in a private hospital. It means you can select your doctor and have continuity of care with the same medical team throughout your entire pregnancy, and you have access to private hospital rooms and a minimum 3-4 night stay in hospital. In a public hospital, you will usually share a room with other patients after delivery, and you will usually see a range of health care professionals throughout your pregnancy, rather than the same doctor each visit. Even with private hospital cover, you will usually be out of pocket several thousand dollars.
A Gold-level policy is recommended for pregnancy-related cover. You generally need to clear the waiting period (typically 12 months) to get access to pregnancy cover. Assuming pregnancy of 9 months, you'll need to take out this cover at least 3-4 months before you plan to get pregnant.
It is best to get health insurance at least 3-4 months before conceiving, as this allows for the 12-month waiting period to be met by the time you deliver the baby.
Most policies have a 12-month waiting period, which means you need to take out cover at least 3-4 months before conceiving to ensure the waiting period is met by the date of delivery. Once you are pregnant, it's usually too late to take out cover as you won't meet the waiting period.
Was this content helpful to you?
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To make sure you get accurate and helpful information, this guide has been edited by Angus Kidman as part of our fact-checking process.
James Martin was the insurance editor at Finder. He has written on a range of insurance and finance topics for over 7 years. James often shares his insurance expertise as a media spokesperson and has appeared on Prime 7 News, WIN News, Insurance News, 7NEWS and The Guardian. He holds a Tier 1 General Insurance (General Advice) certification and a Tier 1 Generic Knowledge certification, both of which meet the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
James's expertise
James has written 204 Finder guides across topics including:
Tim Bennett is a Finder insurance & utilities expert. For over 10 years he's reported on news, politics, finance and other topics as a journalist and radio presenter. Tim's roles have included radio news reader and breakfast at the ABC, news producer for SBS and producer for Fairfax Media. Tim regularly appears as a health insurance expert on programs like Sunrise and SBS news, as well as in the Australian, The Daily Telegraph, The Courier Mail and more. See full bio
Tim's expertise
Tim has written 122 Finder guides across topics including:
This guide looks at assisted reproductive services in general and IVF treatment in particular, including the procedures involved, what the costs are and who picks up the tab.
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Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
