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What’s the best health insurance for pregnancy?
The best health insurance for pregnancy will be the one that offers cover for the procedures and services you want at the best price, with the lowest out-of-pocket costs.
There’s a bit to unpack there and ultimately private health insurance in Australia is a complicated product with lots of moving parts. For example, with pregnancy cover, some services are covered by Hospital cover, while others come under the umbrella of Extras cover. Within each of those options, there are also different levels of coverage and inclusions to consider.
Depending on the provider you choose, your pregnancy insurance may cover a higher percentage of your private health costs with certain providers versus others.
Choosing the right type and level of cover is important and fully understanding your options is the crucial first step.
In Australia, a mandatory 12-month waiting period applies to the pregnancy and birth coverage on private Hospital health insurance policies. This applies to hospital services like labour, birth, and obstetric care. You must complete this waiting period before your due date, or the insurer won’t pay benefits related to your pregnancy or birth. In practice, this means you'll need to have appropriate cover in place for at least three months before you fall pregnant.
What health insurance policies cover pregnancy in Australia?
Hospital policies that cover pregnancy and birth services
- Gold tier cover is the only level of Hospital cover with pregnancy and birth related services as a mandatory inclusion. It also must cover related services like assisted reproductive services.
- Silver Plus and Bronze Plus tier cover may cover pregnancy and birth services, depending on the specific policy. If it’s included, expect to pay higher premiums versus a base level Silver or Bronze policy.
Extras policies that cover pregnancy and birth services
- Some policies with higher levels of Extras will cover pregnancy-related services provided outside of the hospital.
- This includes the likes of antenatal classes, physiotherapy, chiropractic or acupuncture for pregnancy discomfort, lactation consultants, postnatal physiotherapy or pelvic floor support and mental health services.
Why do people choose the private system?
Dr Stephanie Miller, Obstetrician
“The things that push people towards the private system are usually continuity of care, having your choice of care provider and more control over the environment that you're birthing in. If you go private, you're going to see the obstetrician you know and trust every time and you're going to be able to choose where you give birth, with that same obstetrician present if they're available. It can also be valuable for patients who need flexibility, are time poor and who need their appointments to happen when they’re meant to happen.”
Dr Stephanie Miller, Obstetrician
How much does pregnancy health insurance cost?
Hospital cover that includes pregnancy and birth can cost between $178 - $295 per month, or $2,136 - $3,540 per year for singles cover, according to analysis by Money.com.au.
The cost of your cover will ultimately depend on a range of factors, including:
- The provider you choose
- Your age and location
- The level of cover (Silver Plus vs Gold)
- Your income (i.e. what level of government rebate you qualify for)
- Whether you will be impacted by the lifetime health cover (LHC) loading
- Whether you choose a policy to cover the mother or both partners (couples cover)
The table below shows the cost of pregnancy hospital cover from a range of providers in Australia, based on singles cover for a female aged 35 living in NSW.
Pregnancy and birth health insurance cost comparison
Provider | Mildura Health Fund |
|---|---|
Hospital cover with pregnancy and birth | Five Star Gold |
Monthly premiums starting from | $178.72 |
Provider | Peoplecare Health |
Hospital cover with pregnancy and birth | Silver Plus Grow Hospital |
Monthly premiums starting from | $221.30 |
Provider | HCF |
Hospital cover with pregnancy and birth | My Family Silver Plus Hospital |
Monthly premiums starting from | $222.41 |
Provider | Medibank |
Hospital cover with pregnancy and birth | Medibank Gold Protect |
Monthly premiums starting from | $267.60 |
Provider | Australian Unity |
Hospital cover with pregnancy and birth | Complete Hospital (Gold) |
Monthly premiums starting from | $275.44 |
Provider | Bupa |
Hospital cover with pregnancy and birth | Gold Comprehensive Hospital |
Monthly premiums starting from | $280.17 |
Provider | HIF |
Hospital cover with pregnancy and birth | Gold Top |
Monthly premiums starting from | $281.38 |
Provider | GMHBA |
Hospital cover with pregnancy and birth | Gold Optimum Hospital |
Monthly premiums starting from | $283.40 |
Provider | HBF |
Hospital cover with pregnancy and birth | Gold Hospital Elevate |
Monthly premiums starting from | $283.73 |
Provider | Health partners |
Hospital cover with pregnancy and birth | Gold Hospital Advantage |
Monthly premiums starting from | $288.68 |
Provider | Westfund |
Hospital cover with pregnancy and birth | Gold Ultimate Hospital |
Monthly premiums starting from | $295.54 |
| Provider | Hospital cover with pregnancy and birth | Monthly premiums starting from |
|---|---|---|
Mildura Health Fund | Five Star Gold | $178.72 |
Peoplecare Health | Silver Plus Grow Hospital | $221.30 |
HCF | My Family Silver Plus Hospital | $222.41 |
Medibank | Medibank Gold Protect | $267.60 |
Australian Unity | Complete Hospital (Gold) | $275.44 |
Bupa | Gold Comprehensive Hospital | $280.17 |
HIF | Gold Top | $281.38 |
GMHBA | Gold Optimum Hospital | $283.40 |
HBF | Gold Hospital Elevate | $283.73 |
Health partners | Gold Hospital Advantage | $288.68 |
Westfund | Gold Ultimate Hospital | $295.54 |
How to choose the best health insurance for pregnancy
Will the policy be just for the mother or both partners?
If only one partner needs pregnancy cover, it may be more cost-effective to take out separate singles policies. The birthing parent will need a Gold-tier hospital policy that includes pregnancy and birth, while the other partner might only need a lower level of cover or basic extras.
How much will the premiums cost?
Gold and Silver Plus tier hospital cover can be expensive, so it’s important to compare policies from a range of providers. Make sure you compare policies on an apples-to-apples basis (with the correct level of government rebate applied based on your situation) and consider any excess or co-payments.
What other services might you want during pregnancy?
Extras cover can help with useful pregnancy-related services like physiotherapy, lactation consultants, prenatal classes, and postnatal counselling. If these are important to you, check the inclusions and annual claim limits of extras policies — and confirm whether limits apply per person or per policy.
Are there special offers available?
Once you’ve shortlisted a few suitable policies, look out for health insurance sign-up offers like weeks free, waived waiting periods on extras, or cashback. These promotions can help offset the higher cost of higher-tier hospital cover. Some providers also offer additional benefits, like access to courses and phone/online support from health professionals as an extra incentive.
What does health insurance for pregnancy cover? (Hospital cover)
Labour and delivery
Contributes to the cost of giving birth in hospital, whether vaginal or via caesarean section. This includes delivery suite use, nursing care, and hospital-based support during labour.
Hospital accommodation
Includes your stay in a private or public hospital. You may be eligible for a private room (depending on availability), and your stay could range from 1–5 days depending on the type of birth and recovery needs.
Operating theatre fees
If you need a caesarean section or assisted delivery, your policy contributes towards the cost of the operating theatre and surgical staff.
Postnatal care in hospital
Covers the care you receive in hospital after giving birth, including medical checks, pain relief and support with your recovery.
Epidurals and anaesthesia (in hospital)
Anaesthetic services such as epidurals administered during your hospital stay are included in your cover.
Medications (while admitted)
Any medications required during your stay in hospital (e.g. antibiotics, pain relief) are typically covered under your policy.
Pathology and blood tests (in hospital)
If you need blood work or pathology during your inpatient stay, these are generally covered.
Miscarriage or termination of pregnancy
If you are admitted to hospital due to a miscarriage, health insurance with pregnancy cover will typically cover the inpatient care required, such as surgery (e.g. dilation and curettage/D&C), overnight stay or day surgery anaesthesia.
What does health insurance for pregnancy cover? (Extras)
Physiotherapy
This is arguably the most useful Extras benefit during and after pregnancy. Physiotherapy during pregnancy can help relieve back and pelvic pain, improve posture, and strengthen the pelvic floor. After birth, it’s useful for core recovery, C-section rehab, and managing incontinence or other postpartum issues.
Antenatal classes or childbirth education
Many extras policies help cover the cost of classes that prepare you for labour, birth and early parenting. These may include sessions on pain management, breastfeeding, and caring for your newborn — often taught by experienced midwives or educators.
Chiropractic and osteopathy
Some women find relief from pregnancy-related aches and pains through chiropractic or osteopathic care. These therapies can help with pelvic alignment, reduce lower back strain, and ease joint discomfort as your body changes.
Acupuncture
Often used to support pregnancy wellness, acupuncture may help with nausea, fatigue, and pain relief. Some women also turn to it late in pregnancy to prepare for labour or manage breech presentation.
Remedial massage
Pregnancy massage can relieve muscle tension, reduce swelling, and promote relaxation. If your extras cover includes remedial massage, and the provider is approved, you may be able to claim part of the cost.
Dietitian and nutrition consultations
A dietitian can support healthy eating during pregnancy, help manage gestational diabetes, and provide guidance for breastfeeding nutrition. Many extras policies offer a set number of sessions each year.
Lactation consultant services
Some higher-tier extras policies cover private lactation consultants, who can assist with common breastfeeding challenges like latching issues, low supply, or mastitis, which can be especially helpful in the early weeks after birth.
Psychology and counselling
Pregnancy and the postnatal period can come with emotional ups and downs. Extras cover may include counselling or psychologist sessions to support your mental wellbeing through anxiety, depression, or adjustment to parenthood.
Early intervention services (for baby)
Once your baby is on your family policy, extras cover may include services like physiotherapy or speech therapy if your child needs support with movement, feeding, or early development milestones.
What’s not covered under health insurance for pregnancy?
Obstetrician consultations
Private health insurance doesn’t cover your regular obstetrician appointments or the pregnancy 'management fee'. These are considered outpatient services, but you can usually claim part of the cost back through Medicare.
Scans and tests done outside hospital
Routine pregnancy ultrasounds, blood tests, and genetic screening are outpatient services. While Medicare may partially cover some of these, private Hospital insurance won’t contribute unless you’re admitted to hospital.
GP visits and shared care appointments
Appointments with your GP for pregnancy check-ups or shared care aren’t covered by hospital insurance. Medicare usually covers a portion, but you may still have out-of-pocket costs.
Antenatal classes through hospitals or clinics
Hospital-based antenatal or birth classes aren’t covered under hospital insurance. Some Extras policies may reimburse part of the cost, but it’s worth checking your individual cover.
Outpatient miscarriage or termination care
If a miscarriage or termination is managed outside of hospital (for example, at a GP clinic or early pregnancy unit) it won’t be covered by hospital insurance. Medicare may cover part of the costs.
Elective caesarean or birth preferences not medically required
Private insurance covers caesarean births, but it won’t fund non-medically necessary procedures that your doctor or hospital doesn’t support. You’ll need to discuss options with your obstetrician and hospital.
Newborn care outside hospital
Once your baby is born, any medical care they need outside the hospital, like GP visits, immunisations or check-ups, isn’t covered under your pregnancy hospital policy. You’ll need to add your baby to a family policy for future claims.
Does pregnancy cover also include IVF?
All Gold-tier hospital policies in Australia include assisted reproductive services, such as IVF-related procedures performed in hospital.
If you're undergoing IVF, private hospital cover can help with the in-hospital components of treatment, like egg collection or embryo transfer performed under anaesthetic. These procedures are typically done as day surgery and are classified as inpatient services, which means they’re eligible for cover under a Gold-tier policy (and some Silver Plus policies that specifically include assisted reproductive services).
However, it's important to understand that many IVF-related costs are outpatient services, and won’t be covered by hospital insurance, such as fertility specialist consultations, blood tests and ultrasounds done outside hospital.
Some of these outpatient expenses may attract a Medicare rebate, but out-of-pocket costs can still be significant.
A 12-month waiting period also generally applies to assisted reproductive services that relate to pre-existing conditions, so you’ll need to serve this time before you can claim any benefits.
What will my out-of-pocket costs be?
Even with a Gold-tier hospital policy including pregnancy and birth, you will likely still face significant out-of-pocket costs if your baby is delivered via the private system. These costs could be anywhere between $5,000 and $10,000 based on analysis by Money.com.au.
These gap payments apply when providers charge more than what your insurer plus Medicare will pay. For example...
- Anaesthetist fees For epidurals or C-sections, anaesthetists often charge above the MBS fee, leaving you with a gap of $200–$800 or more.
- Assistant surgeon A second doctor assisting with a C-section may not be fully covered, resulting in several hundred dollars in out-of-pocket fees.
- Paediatrician If a paediatrician assesses your newborn, they may charge above the rebateable amount, which is another common gap expense.
- Hospital excess Most private hospital policies require an excess payment (often $500 or $750) when you’re admitted for the birth.
Dr Stephanie Miller, Obstetrician
“People aren't always aware that there will often be additional costs for birthing even if you have private health insurance. So things like the paediatrician that reviews your baby after birth, anaesthetist that you may require if you access an epidural during labour or you end up in an emergency caesarean requiring regional or a general anaesthetic – they may all charge fees on top of what you've paid for in your private health insurance and these will be charged to you after you birth.”
Dr Stephanie Miller, Obstetrician
How to reduce out-of-pocket costs
1
Choose a health fund with a “no-gap” scheme
Many insurers have a list of doctors, specialists, and hospitals that participate in their “no-gap” or “known-gap” arrangements. These agreements limit or eliminate out-of-pocket costs for services that are otherwise covered by your hospital policy.
2
Select in-network hospitals and doctors
Use hospitals and obstetricians that have contracts with your health fund. This increases the chance that your hospital accommodation, theatre fees, and key specialists will be fully covered.
3
Ask for Informed Financial Consent (IFC)
Before treatment, ask every provider (e.g. obstetrician, anaesthetist, paediatrician) for a detailed breakdown of their total fees, how much will be covered by Medicare and your insurer and any expected gap you’ll need to pay. This allows you to shop around or negotiate if you want to avoid gap charges.
Is it worth getting health insurance cover?
Whether private health insurance for pregnancy is worth it depends on your individual circumstances, preferences and what you value most in your maternity care. Here are some benefits of the public and private system to consider.
The benefits of going private
Obviously one of the biggest advantages of private health insurance with pregnancy is that it can make it more affordable to access private health care.
This gives you the ability to choose your obstetrician and receive consistent care throughout your pregnancy and at the birth. This is highly valued by many expectant mothers, particularly those with birth anxiety, previous birth trauma, or complex emotional needs.
Private patients can also choose their hospital and may benefit from a more comfortable environment, including private rooms and the ability for partners to stay overnight.
Appointment times are often more flexible and predictable, which can be particularly valuable if you’re time poor. If you live in a regional or remote area, private care may also give you access to services like telehealth appointments with your obstetrician at a time suited to you which may suit your specific circumstances better.
Pain relief options like epidurals may also be more readily available in private hospitals, where anaesthetists typically have lower patient loads than in the public setting.
The benefits of going public
If you’re comfortable being cared for by different providers, the public system offers excellent, safe and free care. This is particularly the case if you can access a midwifery continuity model of care such as Midwifery Group Practice (MGP) which provides continuity of care throughout pregnancy, birth and the postnatal period for women with low-risk pregnancies.
Ultimately, clinical care standards are high in both systems. Along with the lower cost for patients of the public system, Dr Stephanie explained that public hospitals are generally better equipped to care for very complex high-risk pregnancies and emergencies, due to the access to specialist units like ICU and Neonatal Intensive Care Unit on site.
Emergency teams are also often more easily and readily available in the public setting, due to higher numbers of staff available out of hours, especially in the tertiary hospital centres.
Dr Stephanie Miller, Obstetrician
“Whether it be private or public, I always encourage people to consider a continuity model of care as this can be of such value. If you’re going through a public hospital, asking for MGP care or whatever the equivalent is in your hospital, so you have continuity of care with the same midwife, is really valuable for anyone, especially first-time mums.”
Dr Stephanie Miller, Obstetrician
In summary: Public versus private pregnancy cover
Public healthcare (Medicare)
Cost Mostly free. Medicare covers GP/shared care, hospital birth, and midwife-led services. Some relatively small out-of-pocket costs for tests and scans.
Choice of care provider No choice of obstetrician. Care is typically provided by a team (e.g. hospital midwives, rotating doctors).
Continuity of care Limited continuity unless in a program like MGP (Midwifery Group Practice).
Hospital accommodation Shared rooms are common. Private rooms may be available but not guaranteed.
Partner overnight stay Often not allowed, especially in shared rooms.
Birth environment Functional and well-equipped but basic. Less emphasis on comfort.
Pain relief and interventions Access to epidurals, gas, C-sections, etc. However, timely intervention may be subject to the availability of specialists likes anaesthetist.
Management of complications Excellent access to emergency care, neonatal units, and high-risk specialists.
Waiting period None, Medicare applies automatically.
Private healthcare (with insurance)
Cost Significant out-of-pocket costs (often $3,000–$10,000+), even with top-level hospital cover. OB fees, scans, and appointments billed separately.
Choice of care provider You can choose your own obstetrician to manage your pregnancy and attend the birth.
Continuity of care You can usually see the same specialist throughout pregnancy and birth.
Hospital accommodation Often includes a private room with ensuite. Quieter environment and more comfort-focused amenities.
Partner overnight stay Typically allowed, especially in private rooms.
Birth environment More personalised and comfort-oriented (e.g. meals, décor, room service).
Pain relief and interventions Mostly the same clinical options available, but potentially greater autonomy in decision-making (e.g. access to an epidural).
Management of complications If complications arise, transfer to a public hospital may be necessary.
Waiting period 12-month waiting period applies.
