A:

Check with ACA Health as soon as your pregnancy is confirmed, your current level of hospital cover and whether you are still under any waiting periods (12 months for obstetrics). You may need to upgrade to a family or single parent membership.

Single hospital membership for mothers only cover the cost of the birth of the baby but doesn’t cover any costs incurred by the baby. For a baby to be eligible for benefits immediately from birth, the mother must have contributed to a family or single parent membership for at least 2 calendar months prior to the infant’s birth. (Regardless of whether or not the infant is premature)

When the baby is born, he/she will be considered an out-patient and as such, Medicare pays the first 85% of the scheduled fee and you must meet all costs not covered by Medicare. ACA Health is not permitted to pay benefits on these out-patient fees.

Your newborn (nine days old or less) is only classified as an ‘admitted patient’ if the baby:

• is admitted to an Australian Government approved neonatal intensive care unit; or
• is the second or subsequent baby born in a multiple birth; or
• is in hospital without his/her mother.