Pregnancy and Birth

What is covered under Pregnancy and Birth?

Hospital Cover for Pregnancy and Birth includes hospital treatment to investigate and treat conditions associated with pregnancy and childbirth.

Examples include:

• antenatal attendance
• managing labour or birth, including by Caesarean section
• managing pre-eclampsia (high blood pressure) treatment
• postnatal attendance.

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

Some treatments you might expect to be in the Pregnancy and Birth clinical category are under different clinical categories. For example: 

• female reproductive conditions not related to pregnancy are listed under Gynaecology
• fertility treatments are under Assisted Reproductive Services
• miscarriage or termination of pregnancy are under Miscarriage or Termination of Pregnancy.

Which Hospital Cover tiers include Pregnancy and Birth?

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 Pregnancy and Birth 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 Pregnancy and Birth. 

Does Medicare cover Pregnancy and Birth?

Yes. Medicare includes all treatments under the Pregnancy and Birth clinical category.

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

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