Health insurance for couples planning a family

Pregnancy and birth-related services are included on Gold hospital policies, and some select ‘plus’ policies. These services will pay a benefit towards any medically necessary private hospital inpatient care associated with your pregnancy and childbirth and assisted reproductive treatments. For more information on what’s included on each level of cover, visit our health insurance categories page.

It’s important to note that pregnancy-related hospital benefits have 12-month waiting periods. So, if you’re looking to start a family, you should consider taking out hospital insurance before trying to conceive.

You might also want to consider including ambulance cover on your policy if you’re not already covered by your state ambulance service. Cover for emergency ambulances could save you from a significant out-of-pocket fee if there are complications and you need to go to hospital unexpectedly.

Yes, you can still get private health insurance while you’re pregnant. However, health insurance won’t pay a benefit towards pregnancy-related procedures until you serve the 12-month waiting period. Therefore, if you’re pregnant and want to give birth in a private hospital without insurance, you’ll have to pay for it out of pocket.

While you won’t be able to claim a benefit from your health fund for birth in a private hospital if you take out hospital cover while pregnant, there is another type of cover that can benefit you during and after your pregnancy. An extras policy can provide expecting or post-partum mothers with several useful out-of-hospital treatments and therapies, such as physio and chiropractic.

It might still be worth taking out a hospital insurance policy too, even if you can’t claim on pregnancy and birth-related services. You may want to take advantage of some pregnancy-related hospital services with shorter waiting periods, provided the condition is not classified as pre-existing (many pre-existing conditions will require you to serve a 12-month waiting period). This could include gynaecology, diabetes management for gestational diabetes and treatment for miscarriage or termination of pregnancy.

Every health fund has different rules on how they will go about including your newborn from birth. Some may not require your newborn to serve any waiting periods, while others may only require the newborn to serve waiting periods not already served by the principal member (provided the newborn is added within the allowable timeframe). In many cases, this will be shortly after the birth of the baby, while others may require you to upgrade to a family policy up to 12-months before the baby is born for them to be covered from birth.¹ It’s important to speak to your insurance provider to understand exactly what you need to do if you want peace of mind knowing your baby will be able to access the benefits of private hospital insurance if there are any complications after the birth.

Health insurance

Pregnancy and birth

Couples health insurance

Health insurance for kids

Health insurance tiers

Waiting periods