ACT News

$2000 a day to have a baby? Couple warns of health insurance fine print

An overseas couple in Canberra is warning other parents-to-be about the fine print in insurance policies as they stare down the barrel of a $2000 a day hospital bill to have a baby in the ACT.

United Kingdom citizen Perparim Zagani and wife, Valbona who is from Albania, are due to have their baby in the first half of November.

As they arrived in Australia seven months ago they thought they had done everything correctly to look after themselves as they travelled here on a 457 visa. 

They had bought insurance with Medibank which included all the cover required by Australian legislation for temporary working visa holders. 

Plus Mr Zagani would be eligible for a Medicare card because of his UK status and the reciprocal arrangement between Australia and Britain. 

Their insurance brochure shows a tick next to "obstetrics related services" but at the bottom of the page, in much smaller print, was a note outlining a 12-month wait for these services. 

It means couples travelling here, not covered by Medicare, who have surprise conceptions can find themselves with a bouncing bundle of bills.

Now Mr Zagani, a chef who planned to work in Australia for 4 years, could be looking at a hospital bill of tens of thousands of dollars if something goes wrong during the birth of his baby at Calvary Hospital. 

"I don't know what I'm going to do," he said. 

He noted his wife was in her late 30s which increased the risk of complications.  

Because she is Albanian she is not covered by the same reciprocal arrangement as her husband who can receive Medicare. 

The $1926-a-day rate his wife will be charged drops to $1128 after 21 days and is in line with ACT legislation with the same charges applying to non-eligible patients at the territory's other public maternity ward at Canberra Hospital. 

A Medibank spokeswoman said all health funds had waiting periods.

"A waiting period is a period of time you need to wait after taking out your cover before you can receive benefits for services or items covered," she said. 

"At Medibank, waiting periods start at two months, which covers most services.

"For services such as obstetrics, pre-existing conditions, orthodontics and major dental work, there is a 12 month waiting period.

"This is standard for both residents and non-residents."

She said waiting periods protected members of the fund by ensuring that individuals were not able to make a large claim shortly after joining and then cancelling their membership.

"This would result in increased premiums for all members," she said. 

"We strongly advise members to read the fine print when taking out insurance and we encourage them to talk to us directly, either via our retail centres or over the phone, to ensure they fully understand what their insurance covers."