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For a young couple, starting a family can be a very exciting time. However, as you might already know, there’s a lot of planning involved with starting a family. For one, you may want to consider purchasing or switching to a family health insurance policy.

While public hospitals in Australia offer high quality healthcare for pregnancy and birth-related services, there are still many benefits to giving birth in a private hospital with private health insurance. Being able to choose your own obstetrician and recover in a private room are just some of the reasons that expecting mothers choose to deliver their newborn as a private patient.

Which health insurance policies cover pregnancy?

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

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

Can I get private health insurance if I’m already pregnant?

Yes, you can still get private health insurance while you’re pregnant. However, health insurance won’t cover 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 covered 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, such as physio and chiropractic services.

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.

Does health insurance cover newborns?

Every health fund has different rules on how they cover your newborn from birth. Some will cover your newborn for non-pregnancy related procedures even if you haven’t served your waiting periods, while others will require you to upgrade to a family policy up to 12-months before the baby is born for them to be covered.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 covered for any complications after the birth.

new parents after using health insurance to plan a family

Top health insurance tips for couples planning a family from our health insurance expert, Lana Hambilton

  1. Consider taking out health insurance before trying to conceive. Not only might this ensure you serve your 12-month waiting period for pregnancy and birth before the baby arrives, you’ll also get coverage for some other, non-pregnancy related medical conditions.
  2. Hospital cover allows you to stay in a private hospital in a private room (if available). You can also choose your doctor (their fees and associated labour ward costs will be covered up to the Medicare Schedule of Fees). Through extras cover, you may be able to claim birthing classes, remedial massage, physiotherapy and other support services before the baby’s arrival.
  3. It’s important to familiarise yourself with your health funds rules on how they cover your newborn from birth. Even if you already have couples cover, you may want to consider taking out family health insurance before the baby is born. Your health insurance premiums for a family policy will often be similar to or the same as on a couples policy. If you’re on a singles policy, it will most likely cost you more to move to a family or single-parent policy. Depending on your insurance provider, if you have a family policy with extras cover, your family policy may carry higher group or annual limits on extras benefits and include items such as orthodontics and major dental.

How do I get health insurance for my baby?

If you want to ensure your child will be covered as you move into your next life stage, our free health insurance comparison service can help you find a family policy. You can compare a range of policies, including their benefits, premiums and more, in just a matter of minutes!

So why go to multiple sites when you can compare your options with us?


1 Commonwealth Ombudsman: obstetrics and pregnancy fact sheet. Accessed May 2022

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