FEES AND COSTS
Prologue is very mindful of caring and advocating for you from a financial perspective at the same time as selecting the best practitioners to be part of your team.
UNDERSTANDING THE FEES AND COSTS ASSOCIATED WITH YOUR CARE
We are committed to being transparent in regards to our fees as well as any others you may come across during your time with us. In this section of our website we outline the Prologue obstetric fees and as a practice we have structured them to be all inclusive and as simple as possible. This means that no matter which way you deliver your baby, these fees will not change.
There is a $400 fee for your initial 45 minute consultation with your Prologue Obstetrician. The fee for your routine consultations with your Obstetrician is $150 and as your pregnancy progresses and you reach your Medicare Safety Net, you will get increasingly larger rebates. You will also have scheduled visits with your Prologue Midwife both during and after your pregnancy, for which there is no charge.
The Planning and Management Fee is a standard feature of the fee structure for all obstetric practices. It compensates for the 24 hour service provided by our team during your entire pregnancy and initial postnatal phase, as well as caring for you during your hospital stay. The Planning and Management Fee is paid at 28 weeks. At that time, we will provide you with an invoice that can then be paid by either credit card (without any surcharge) or bank transfer. Upon receipt of your payment, our team will promptly process your Medicare rebate which is typically around $600. We will be making sure the payment process is a smooth one for you. Therefore, we invite you to share with us any particular requests or need for additional assistance, so we can work with you to make that happen.
For those with Medicare, payment of the Planning and Management Fee will almost certainly see you reach the threshold for the Medicare Safety Net. This means, for the remainder of that calendar year, all payments for any medical appointments with any healthcare provider (including your team at Prologue) will be eligible for a much higher Medicare rebate. You can learn more about the Medicare Safety Net here.
Please note that the Planning and Management Fee is independent of the consultation fee that will apply each time you see your Prologue Obstetrician during your pregnancy. However, as explained above, once you have reached your Medicare Safety Net, these appointments will have a much larger Medicare rebate meaning a significantly reduced out of pocket cost to you.
Below we have outlined the item numbers that will typically be invoiced during your pregnancy along with the minimum Medicare rebates. The quoted delivery fee assumes you have private health insurance#.
*Please keep in mind that the rebates quoted above are the minimum amounts that you will receive from Medicare. Once you have passed the safety net in a calendar year, you’ll receive more back from Medicare than the amounts we have quoted. The Medicare Safety Net is based on a yearly threshold that is different for each individual/couple/family. It is highly likely that you will receive larger rebates than those quoted above. The number of consultations you will have during your pregnancy can sometimes vary but in general it’s outlined here in the appointment schedule. If you ever need to be monitored overnight in hospital during your pregnancy, there will be no charge to you. Other costs that may be incurred during your pregnancy include ultrasound scans and blood tests but your Prologue obstetric team will explain ways of minimising these expenses as we come across them. You may also receive invoices from the following specialists in association with your delivery:
Please note the quotes above are for invoiced amounts. As they will have been given to you and your baby during your hospital stay, you will be able to claim a rebate with both Medicare and your private health fund. This means your out of pocket expense associated with these services will be much less than the invoiced amount. Furthermore, if you have reached your Medicare Safety Net your Medicare rebates will be very substantial.
If you need help submitting these rebate claims, we can provide this to you. As you financially prepare for your obstetric journey, your Prologue obstetric team encourages you to use the following checklist to make sure you are being as financially savvy as possible.
OBSTETRIC FINANCES CHECKLIST:
To learn more about the Medicare Safety Nets, click here.
Check that your health fund will cover your obstetric care in a private hospital. This means your policy will need to cover you for item numbers 16519 and 16522. Prologue delivers at The Mater Hospital and Prince of Wales Private Hospitals only. If your private health insurance covers you for obstetric care, you will not receive an invoice from Prologue for your delivery. This is because at Prologue, we provide a ‘no-gap’ service for deliveries for all health funds irrespective of whether our Obstetricians appear on their ‘no-gap’ list or not.
Once you have chosen the hospital in which you would like to have your baby, you may wish to contact them to check whether any out-of-pocket expense will be associated with your admission. You can contact the hospitals on their numbers below.
The Mater Hospital
(02) 9900 7300
Prince of Wales Private Hospital
(02) 9650 4693
#WHAT IF I DON’T HAVE PRIVATE HEALTH INSURANCE?
If you are not covered for obstetric care by a private health fund, the great news is that you can still pair up with the Prologue obstetrics team for your pregnancy journey and deliver your baby at either the Mater or The Prince of Wales Private Hospital. Please discuss this option with us at Prologue, so we can help you obtain an estimate of the increased costs associated with your delivery and hospital admission.
