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Miscarriage or Termination of Pregnancy

Reviewed and updated 31 March 2024
basic
RO
bronze
silver
gold
RRestricted
OOptional
Covered

What is covered under Miscarriage or Termination of Pregnancy?

Hospital Cover for Miscarriage or Termination of Pregnancy includes hospital treatment to investigate and treat miscarriage of a pregnancy or to terminate a pregnancy.

Examples include:

  • managing pregnancy loss from 14 weeks 
  • ultrasound guided needling and injecting of ectopic pregnancy (where the fertilised egg implants itself outside the uterus)
  • performing an abortion.

This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS)


Which Hospital Cover tiers include Miscarriage or Termination of Pregnancy?

TierClinical category covered?Can insurers offer restricted cover?
BasicOptionalYes
BronzeOptionalNo
SilverOptionalNo
GoldYesNo

What does it mean if cover is ‘optional’?

‘Optional’ means that the Australian Government allows insurers to choose whether or not to cover the clinical category under that Hospital Cover tier.

What does ‘restricted cover’ mean? 

Restricted cover means the insurer pays only limited benefits. 

If insurers offer cover for Miscarriage or Termination of Pregnancy under Basic Hospital Cover, they can do so on a ‘restricted’ basis. If you are admitted as a private patient in a private hospital for treatments under this clinical category, you will face considerable out-of-pocket costs.

Always check with your insurer before agreeing to be treated as a private patient in a private hospital if you have restricted cover for Miscarriage or Termination of Pregnancy. 


Does Medicare cover Miscarriage or Termination of Pregnancy?

Yes. Medicare includes all treatments under the Miscarriage or Termination of Pregnancy clinical category.

If there is an MBS item number for the treatment, Medicare covers it. 


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