Updated: August 2023
Schedule of Fees: OBSTETRICS
- This document describes – in detail – the fees that I charge for your care throughout your pregnancy. This does not include or cover fees that other doctors or hospitals and other providers will charge you. I have not increased my fees for more than two years but must now do so because of increasing costs. I believe my fees reflect my ability, my experience and my availability.
- My overall fees are around $9,000 per pregnancy (depending upon the number of visits and the complexity of your pregnancy and / or birth) and your total out of pocket expense will be around $7,300. This comparatively high out of pocket expense reflects the low value the federal government and health funds place on specialist obstetric services. If you do not have private health insurance, your total out of pocket expenses will be roughly $9,300.
- While it is impossible to provide care for an entire pregnancy without out of pocket expenses I lessen these expenses by “No Gap” billing the delivery fee aspect of your care. This in turn means that the “Planning and Management” fee is comparatively large. This approach maximises the Health Fund contribution to your expenses and minimises the out of pocket component to your fees as best I can.
- The Planning and Management Fee is the only large bill you will receive from me throughout your pregnancy. This is regardless of the complexity of your pregnancy or birth. Providing you are covered by private health insurance, you will then only have to pay for your antenatal visits ($160 each visit). If you have private health insurance, you will not receive any bills from me after the birth.
- Your Planning and Management fee (payable at 28 weeks)
- Includes your contribution to my medical professional indemnity insurance (approximately $100,000 per annum – and I am a safe doctor),
- Assists with the significant costs involved in maintaining my office in the Eastern Suburbs,
- Acts as a retainer acknowledging the provision of 24 hour cellphone based specialist availability,
- Covers visits by me if you attend or are admitted to hospital prior to giving birth,
- Covers all of your postnatal visits,
- Supports most midwifery services at my office such that visits with Marisa are not charged, and
- Helps me to not take on large numbers of patients so that I can maintain the highly personal nature of my service
- Medicare will pay rebates on fees charged while you are not in hospital (i.e. those relating to your visits in my office and the overall management of your pregnancy) and your health fund covers your in – hospital treatment (usually the birth itself).
- Unfortunately out of pocket expenses exist because the federal government’s official schedule of fees is inadequate with respect to the true costs of providing your care. I know it’s difficult to understand but your Health Fund – which is very good for hospital expenses – pays comparatively little towards my services (especially given the 24 hour nature of obstetrics – along with its importance and complexity).
- You may be able to claim up to 20% of your out of pocket medical expenses as a tax deduction although the Government has tightened the criteria for this deduction recently.
A “complicated pregnancy” is broadly defined, but includes pregnancies complicated by:
- Multiple pregnancy
- Premature birth
- Significant diabetes
- Significant high blood pressure
- Other medical conditions and complications
- Placenta praevia
- Fetal distress
- Prolonged labour.
However the manner in which I bill means that you pay me no more for a complicated labour and / or delivery (including a caesarean) than a straightforward birth (your health fund pays me a little more for such births).
If you are not covered by Australian private health insurance for the delivery then the fee for delivery will be $2000, regardless of the complexity of your birth.
PLEASE NOTE: My fees do NOT include the following costs (and the figures mentioned below are VERY rough estimates):
- Ultrasound scans performed by specialised ultrasound services (you will require at least two such ultrasound scans per pregnancy).
- Laboratory tests. Tests conducted on the Randwick hospital campus at the SEALS laboratory are bulk billed and you may wish to have your bloods performed there rather than DHM.
- Hospital accommodation (although this should be covered by your Health Fund)
- Anaesthetists’ fees. Depending upon the situation – and the time of day or night – anesthetists’ fees can range from approximately $1,500 for a straightforward epidural insertion to over $3,000 for involvement in complicated labours that involve epidurals then caesarean sections or complications after the birth. Your Health Fund will refund approximately half of these fees.
- Surgical Assistants Fees for caesarean births. A surgical assistant is compulsory in Australian hospitals and is not avoidable. The cost is approximately $700, with approximately $200 rebated by your health fund.
- Private Paediatric services.
The providers of the above services (a – f) will bill you separately. Their costs are beyond my control and are additional to the fees that I charge. I cannot take responsibility for such fees.