How to use your private health cover
If you’re considering an admission to private hospital, it’s also a great time to read our guide on going to hospital. That will help you understand the overall process including how to reduce or eliminate any out-of-pocket expenses, how to use your private health insurance, what to bring with you and how to claim afterwards.
One of the most exciting times in anyone’s life is the arrival of a new addition. If you’re a first-time parent or you’ve never given birth in the private health system before, you might be wondering what to expect.
How is birth in a private hospital different?
- You can choose your obstetrician and/or hospital based on the birth experience you’d like to have.
- Under private maternity care, your chosen obstetrician and/or midwife will usually provide care in their own clinics and will attend the birth. Continuity of care can be reassuring as you will have familiar faces with you on the big day.
- You’re more likely to get a private room, and ensuite. If privacy is important to you, this is a big one!
- Often your partner can also stay in the room with you and your new baby.
- You’ll have more flexibility with your antenatal clinic appointments and waiting times are usually shorter than a public clinic.
- Usually in a private setting, you can stay longer in hospital after having your baby. You won’t need to go home until you feel ready.
- There will be some level of out-of-pocket charges involved. Ask your doctor for a full breakdown of what costs you can expect both during pregnancy, for your birth and hospital stay and then for your postnatal care. It’s important to note thathealth funds can’t cover services as an outpatient, like antenatal appointments, bloodwork, scans and your obstetrician’s management fee. You’ll be able to claim some of these costs from Medicare. CBHS can cover your stay in hospital and the birth itself under Gold level Hospital cover.
- Your Extras cover also come in handy for services during and after pregnancy, like massage and physio – which a lot of pregnant women appreciate!
TOP TIP: Make sure you are registered for the Medicare Safety Net, as when you reach the annual threshold, your rebates become much larger. This can greatly reduce your out-of-pocket costs.
The big day
It’s almost impossible to know how your birth itself will play out. That’s the magic of babies − they don’t tend to follow our best laid plans. Your obstetrician will talk to you about a birth plan and your options closer to your due date, based on how everything is tracking with your pregnancy. Our best advice is to have a birth plan, but to be open-minded if you’re not able to follow this plan exactly. Trust that your medical team is doing the best thing for you and your baby’s health.
This resource from Raising Children Network explains the different birth options at private vs public hospitals very well, as well as what birth might look like at home or a birthing centre. Please be aware that CBHS doesn’t pay benefits for home births.
Education and support
Birth Beat is a 100% online childbirth education course. Delivered by a registered midwife and CBHS-recognised provider, it’s packed with tips to prepare you for birth and parenthood. For more information, visit the Birth Beat website.
An endoscopy is a day surgery procedure which will allow the specialist to examine the lining of your upper digestive tract.
You might need an endoscopy because you have abdominal pain, swallowing issues, vomiting, nausea, indigestion or suspected stomach or oesophageal cancer. The endoscopy can help determine what’s causing the issue through the specialist inserting a long flexible tube down your throat with a tiny camera onboard. While the endoscope − that’s the tube − is in your body, your doctor may take a biopsy or remove polyps if needed. Most endoscopies are done using conscious sedation, which means you will be awake but won’t feel any pain or remember the procedure.
However, because you will be sedated, you’ll need to arrange for someone to take you home afterwards as you will not be able to drive yourself. You will probably want to spend the rest of your day resting and not do anything strenuous as your coordination may be affected.
Your specialist and the hospital will provide you clear instructions to follow to help you prepare for your endoscopy, including when to start fasting. The procedure can only be performed with an empty stomach so it’s important to follow the advice very carefully.
An endoscopy isn’t typically painful, but some people report feeling a sore throat afterwards. If you experience serious side effects including severe abdominal pain, vomiting, pass blood or have black bowel movements, you’ll need to contact your doctor or go to hospital.
If you choose to have your endoscopy in the private system, you’ll have more flexibility over your procedure date, and you can choose your own doctor. Ask your GP to refer you to a specialist who participates in CBHS’ Access Gap Cover scheme or for a list of specialists who may be willing to participate. Your GP can make it an open referral if you’d like to choose one yourself. You’ll also need to check the specialist is using a hospital which has an agreement with CBHS.
Before you lock anything in, check with CBHS to see what you’re covered for to reduce any potential gaps.
There are two types of mental health admissions – voluntary and involuntary. If you think a voluntary hospital stay might be what you need, you and your mental health professional will be able to discuss different options available in your local area. Staying in hospital as an inpatient is a big decision, but many people find that it is what it takes to help them get back to a healthier and happier headspace.
Reasons you may need a hospital stay might include if you are at risk of harming yourself or others, if you’re experiencing psychosis, or if you are unable to physically take care of yourself at home.
Discuss the risks and benefits with your treating team or mental health professional. You will need to be prepared to be around others who might be acutely mentally unwell, which can be confronting.
It’s also best to contact the hospital, or have someone do this on your behalf, to find out more about what to bring with you. There will be some items that you won’t be able to have with you e.g. shoelaces, sharp objects, alcohol and illegal drugs. It’s best to leave them at home. At this point, we also encourage you to check with us about what you’re covered for. Our mental health guide has full information on how to access mental health hospital treatment with your cover.
On arrival, you will likely participate in a full assessment with mental health professionals. There may also be a period of time where you’re unable to leave the hospital or clinic voluntarily.
During your stay, the mental health team might prescribe you medications – or additional medications to those you already take. There may also be group or individual therapy sessions.
Care doesn’t stop when you’re ready to go home. Speak with your team as to what support is available for you ongoing and what your treatment plan looks like once you’ve been discharged. Through your CBHS Hospital cover, you may be able to access hospital-quality care at home, which might allow you to shorten your stay. Learn more.
A colonoscopy is a day procedure which allows a specialist to see inside your bowel (large intestine) and identify any issues which need treatment. Some of the symptoms which might lead to your GP offering a colonoscopy referral include gut pain, bloating, passing blood and changes to bowel habits. Your GP might also recommend a colonoscopy if he or she suspects bowel or colon cancer or if you have a family history of them.
Your GP will refer you to a gastroenterologist, which is a doctor who specialises in digestive system issues. The gastroenterologist will provide clear instructions on how to prepare for your procedure, as there are important things you’ll need to do in the lead-up to your colonoscopy so that the surgery can run smoothly. In the days immediately before the procedure you’ll have to eliminate some foods and also drink a quantity of ‘prep’ liquid to clean your bowel out.
During the procedure, your gastroenterologist and team will insert a long flexible tube called a ‘colonoscope’ into your anus. The scope takes images along the way, and your doctor may even remove polyps or take a biopsy if needed.
A colonoscopy is done under sedation, so you’ll be awake but not generally aware of what’s happening. It also ensures you won’t feel any pain.
Read full details in our guide to having a colonoscopy, which includes details on how to choose a doctor and hospital to reduce or eliminate any out-of-pocket costs.
Weight loss surgery, also called bariatric surgery, physically reduces the size of your stomach so you feel fuller after a smaller amount of food. It’s known to be an effective way of losing weight when a person has exhausted all other options such as diet, exercise and medication. It’s generally only considered for people with a body mass index (BMI) of 35 and above.
While weight loss surgery is available in the public health system, there are only a limited number of publicly funded surgeries available. The criteria to be accepted for surgery is strict to ensure the places go to those most in need and who also demonstrate the right readiness for surgery. In the private health system, as long as your specialist considers you a good candidate for the surgery than you will be able to begin the process.
Losing weight comes with health benefits, so having bariatric surgery can improve your chances of living a longer, healthy life.
This article expands on the different types of bariatric surgery in more detail. Most people will be advised by their doctor to follow a very low energy diet for 2–4 weeks immediately before surgery. This is to reduce the size of the liver and the risk of complications.
In the weeks immediately after the surgery, most people will follow a liquid diet, and slowly reintroduce food. Bariatric surgery might sound like an ‘easy option’, but it’s not − it requires significant lifestyle changes afterwards. You’ll need to eat much smaller meals and consider the nutritional quality of the food you eat for life. Your specialist will probably also prescribe you physical activity and a multivitamin once you have recovered from the surgery itself.
Bariatric surgery is more effective when combined with ongoing nutritional care. Your specialist will be able to refer you to a dietitian who specialises in bariatrics.
- Our article about weight loss surgery includes more information on the surgery itself and how to reduce your out-of-pocket costs.
- Our weight management health guide.
All information contained in this article is intended for general information purposes only. The information provided should not be relied upon as medical advice and does not supersede or replace a consultation with a suitably qualified healthcare professional.