Paying the delivery charge (Irish Times Article)

Moonbeam

http://www.irishtimes.com/newspaper/pricewatch/2011/0307/1224291482355.html

Paying the delivery charge


CAROLINE MADDEN

PERSONAL FINANCE: Maternity policy in public hospitals means that it is possible to have a baby without paying anything – but for those who opt for private care, the costs can mount up

HOW MUCH does it cost to have a baby in Ireland? To the uninitiated, this may seem like a trick question – surely it’s free? And indeed it is, if the mum-to-be goes through the public system, but if she chooses to go private the bill can easily top €5,000. Is it worth paying such a gasp-inducing sum? Now that times are tighter, many women who might have gone private in the past are opting for semi-private or public care instead.

Women are entitled to free maternity care, which means antenatal visits, labour and delivery costs and postnatal care will be covered by the State, regardless of whether you have health insurance or a medical card.

The option also exists to go private. The fees charged by consultant obstetricians vary considerably, even within hospitals. For instance, private consultancy fees in the Rotunda vary from €3,000 to €4,500.

Alternatively, you can go down the semi-private route, which generally costs in the region of €1,200. Although some hospitals may charge a lower initial fee, once extras like scans and blood tests are factored in, it tends to creep back up to this sort of level.

Private health insurers will make a limited contribution towards antenatal costs, which helps to ease the burden somewhat. For instance, Quinn Healthcare’s Family Care will refund up to €400 of out-patient consultation costs, as will Aviva’s Hospital Level 2 plan, while Vhi’s Family Plan covers €300 of pre- and post-natal care. Tax relief at 20 per cent is also available on the element that is not covered by insurance.

People who opt for private care cite a number of reasons. The first is continuity of care. Private patients see the same consultant obstetrician at each antenatal appointment. They will attend the delivery of your baby if possible, but this is not guaranteed. If they happen to be on holiday or at a meeting, then you’re out of luck – another consultant will cover for them.

Semi-private patients do not always enjoy the same continuity of care. The system varies between hospitals but generally you will attend a clinic run by a consultant and senior members of his team. They try to have the same person deal with you each time, but this may not be possible. Someone from this team should be available for your delivery, although you may be attended by the doctor on duty at the time. Public patients attend their chosen hospital’s antenatal clinic (or a community-based clinic), and may or may not see the same doctor on each visit. There is also a perception that waiting times are longer in public clinics.

Dr Sam Coulter-Smith, master of the Rotunda, says private maternity patients are paying for “insurance” that they are going to be seen by a more experienced person than a standard hospital registrar. He also makes the point that whether you have to see your consultant four times or 40 times during your pregnancy, no additional charge will apply.

Niamh Healy of Ciudiú, the Irish Childbirth Trust, believes the attitude of going private to ensure you’ve access to the best care is “quite harsh” on the public system. If a woman is going through labour, then midwives are the experts to deal with her, she says. “If anything deviates from the norm, if medical advice is needed, they will be quick to call in a doctor. It might not be a private consultant [but] they will call in expert obstetric care if needed. For the vast majority of women, the care of a midwife is the best care.

“A lot of people who pay for private care are very surprised to know they are going to be randomly assigned a midwife from the labour ward, who will spend most of the labour with them,” she adds. “The doctor really only pops in and out, if all is going well. They’re only really there if he or she is required. The doctor is not with you for 10 to 12 hours unless there are medical issues.”

The second issue is accommodation. The consultancy fees outlined earlier are unrelated to the cost of staying in the hospital for the delivery of your baby. For those with private health cover, insurers will generally pay for three nights’ stay in a public hospital, and if you choose a private hospital they will provide a grant to offset some of this expense.Aviva offers a “grant-in-aid” of €4,000.

“One thing people do like about private and semi-private is that typically they get into better post-natal accommodation,” says Healy. Instead of sharing a public ward, you may be lucky and get a two-bed room or even a private room. However as the number of deliveries have increased in recent years, so too has the demand for beds, and there is no guarantee of a private room.

Anecdotally it seems that women are thinking twice about going private because of financial constraints, and figures from the Coombe Women and Infants University Hospital support this. Although the overall number of babies born at the hospital rose by more than 300 to over 8,800 in 2009, the number of private antenatal registrations fell by 283 to just under 1,600.

By comparison the number of public registrations jumped from about 6,100 to 6,632. Final figures for 2010 are not yet available, but initial data indicates that the trend continued.

Even Mount Carmel, the State’s only private maternity hospital, has had to respond to these straitened times. “We looked at the prices of our [maternity] packages and reviewed them to make them more affordable,” a spokeswoman for the hospital says. It is now offering a new shared-care maternity package – whereby patient care is shared between GP and consultant – starting at €1,250 which includes five visits with a consultant.

A hospital package for first-time mothers costs €4,837. This includes two nights in semi-private accommodation, three pregnancy scans, two blood tests, an epidural if necessary, hearing tests for your new-born and a six-week development check with a paediatrician.

“From that fee they deduct the grant from whichever insurance company they’re with,” she explains. With Vhi Family Plan Plus the grant is €4,000. Vhi settles that with Mount Carmel directly, so the balance is €837. So the combined cost for the maternity and hospital packages works out at €2,087. You can also claim tax relief on this at 20 per cent, reducing the cost to €1,669. “Some people are entitled to a further grant towards consultants’ fees so they should check directly with their insurer,” she says.

Health insurers may apply a waiting period of up to a year to maternity benefits if you are a new customer. Also if you’re considering switching to HSF Health Plan (hsf.ie), familiarise yourself with the way in which its maternity benefits are structured, as the approach differs from other health insurance products.

Under HSF health plans you will receive a birth grant of €1,000 per child, and up to €1,700 towards costs such as consultant fees, depending on the particular plan.

The fees charged by consultant obstetricians vary considerably, even within hospitals. Private consultancy fees in the Rotunda vary from €3,000 to €4,500

How to make a mother of twins laugh: tell her two babies are as cheap as one

THE SECOND QUESTION I was invariably asked when I told people I was expecting twins was, would I have to change my car. The first was whether they were identical. They weren’t. But I did have to change the car. And a perfectly good, fairly new family saloon at that. However, having a two-year-old already, I could not fit three car seats across the back seat and suddenly we were in seven-seater territory.

This is one of the hidden costs of adding twins or higher multiples to your family and one many don’t realise. The Department of Social Protection certainly doesn’t, having recently published a report saying there was “no evidence” to justify higher rates of child benefit paid to the parents of twins and triplets.

You won’t find many parents of multiples agreeing. You need to double pretty much everything for each baby born at the same time. While the babies can sleep in the same cot initially, you will need two. You can spend anything up to €1,000, but a standard cot will set you back around €100. Add two car seats (€150 x 2), a double or triple buggy (from €350-€800), two high-chairs (€100 x 2), two bouncy chairs (€55 x 2) and the costs quickly mount up. And that’s before nappies, wipes, clothes and formula. One mother of twins, with an older child still in nappies, estimates she was spending €140 a week on nappies alone in the early weeks.

A trip to the local GP with two babies can leave parents over €100 lighter before paying for medication. Costs don’t stop after babyhood either. Childcare costs for two babies of the same age are astronomical, making returning to work not viable in many cases. Footwear and school-book costs will be doubled.

A mother of triplets recently moved her boys from cots into beds, necessitating buying three beds in one go. The solution is to beg or borrow baby equipment. Any notion of it being nice to “buy new” goes out the window when you find out he or she plans to arrive with a little pal in tow.

If friends and family can’t lend you anything, check out freetradeireland.ie or the buy and sell sections of parenting web sites, magicmum.com or rollercoaster.ie.

Join the Irish Multiple Births Association (IMBA) and receive a discount card that can be used in shops throughout the country. An example of the many discounts available include 10 per cent off in Clarks shoe shops, 15 per cent off in McCabe’s pharmacies and five per cent off in Tony Kealy’s baby shop.

See imba.ie for details.

– Aoife Carr

rylie

Thanks for posting that Moonbeam, really interesting reading. I had baby rylie through the domino scheme in Holles Street. I couldn't recommend the care more, they were a fantastic team and I felt so well looked after.

The problem arose after I ended up having an emergency section and was on a ward with 8 other women (they squeezed an extra bed into an 8 bed ward) and it was the worst 2 days of my life. Thankfully I was allowed home under the early transfer scheme and again the midwives were absolutely amazing, they called to see us every day for a week. I have to admit though, I swore I'd consider private care if we're lucky enough to have a second baby.

implausible

The first piece of that article is the most clearly-written description of Maternity costs I've read anywhere.

mikemac

Very well written and informative article

Well done to the journalist, she normally does the finance and consumer watch stories so well able to write this one

Orion

Excellent article.

The hidden charges are crazy too. When my twins were born we got a copy of the VHI bill. They were charged 250ish each for bed and board per night! The were sharing a crib and were being breast-fed. It's the medical equivalent of the MOD paying 2000 for a hammer.

gaeilgegrinds1

So public or private or semi? What do ye think? I'm pushing to have this one at home...I want himself to deliver it, we're still in discussions!

smelltheglove

I went semi with my 2. I was lucky enough to have a very quick first delivery so as soon as Iknew it was happeningon number 2 I was straight in there and I was shocked by the public waiting ward I was put into. Around 8 am all the curtains were agressively pulled open so quickly I didnt see a face all I heard was the shout, breakfast is up, if you dont get upand eat it now you wont get anymore:eek:

Both times though I was actually in the exact same bed in a 2 bed room! My sister went in a week earlier thanmealsoon semi and had a 6 bed room. I would definitely recommend semi, I had easy deliveries so no need for a doctor, my sister had a very hard delivery but doctors werecalled in as soon as needed and I doubt her care would have differed in private. I just found the semi pre and after care to be great. (initially my first appointment was public on number 1 and sat in a waiting room with tonnes of others for about 2 hours)

Squiggler

A very interesting and well-written article.

gaeilgegrinds1 wrote: »

So public or private or semi? What do ye think? I'm pushing to have this one at home...I want himself to deliver it, we're still in discussions!

My husband and I are planning a home birth on our little one, estimated due date is just 2 weeks away now. I couldn't recommend it more. The level of care and attention from our midwife has been wonderful. Only one GP visit (to confirm pregnancy and get hospital referral for bloods and backup plan) and one hospital visit (booking appointment for bloods etc). All the other visits in the comfort of our own home.

The HSE pays all or most of the costs and my health insurance will cover any extra costs.

pickarooney

gaeilgegrinds1 wrote: »

So public or private or semi? What do ye think? I'm pushing to have this one at home...I want himself to deliver it, we're still in discussions!

We had our second at home and it was a fantastic experience for all of us. No stress, noise, crowding, manhandling or being bossed about.

How Strange

Public, private or semi private? I went public in the coombe and I can't praise them enough. I was seen by a consultant each visit and shock
horror I saw either one of the same two on each visit. My longest waiting time was 1hr 30mins. I got the highest level of care before, during and after the birth. I was on a 6 bed dorm. The women bringing the food around were lovely and would check you were able to get out of bed and if you couldn't they'd bring the food to you.

Also there weresome lovely women on the ward and I found it nice to have others to chat to while I had my cup of tea. I was in a private room when I was readmitted overnight for an
infection and personally I found it quite isolated but each to their own on that one.

Unless you have the money sitting in the bank and you don't need it for anything else then go public. Semi private is a waste of money really as it's a lottery as to whether you get your semi private room or not.

lynski

How Strange wrote: »

Public, private or semi private? I went public in the coombe and I can't praise them enough. I was seen by a consultant each visit and shock
horror I saw either one of the same two on each visit. My longest waiting time was 1hr 30mins. I got the highest level of care before, during and after the birth. I was on a 6 bed dorm. The women bringing the food around were lovely and would check you were able to get out of bed and if you couldn't they'd bring the food to you.

Also there weresome lovely women on the ward and I found it nice to have others to chat to while I had my cup of tea. I was in a private room when I was readmitted overnight for an
infection and personally I found it quite isolated but each to their own on that one.

Would second this. Had all 3 public in Coombe, the waiting times first time were awful, but bypassed most by going with the midwife clinic, second time were fine (1.5 hrs max) and last time went with the midwife clinic again so no waiting around and all in Naas too!
With my second pregnancy i need extra scans and tests and consultants visits, I got everything I needed and timely too.
First labor and delivery (Emergency CS) were horrendous, and with infection I spent 10 days in hosp in total - first 5 nights in shared ward and rest in private room. Care was good but ward was filthy and toilets were disgusting. the private room was not a luxury when you are in so long it is a necessity for me for peace of mind, peace and quiet and recovery.
I spent no more then 36 hrs in hosp on each of the other 2 labors, deliveries and recovery. They were very very stretched when I was in 2 weeks ago, seriously reusing the little plastic cups they give the drugs out in!
I have never understood why people go private,unless they are going to a private hospital, the care is exactly the same.
When things are normal, with healthy mothers and babies then there is no need for anything other then public care.

LegacyUser

I went to Coombe and delivered my baby on May,2013. I choose a public services. Before i check out from the hospital, i am surely confirmed by midwives that nothing to be pay, then after 1 week at home, i received the hospital bill up to €5+++, at first i just ignore the bill, but its come to first warning, then now they assign a lawyer, i am scared..why they keep calling and charged me..

Iezaj

I went to Coombe and delivered my baby on May,2013. I choose a public services. Before i check out from the hospital, i am surely confirmed by midwives that nothing to be pay, then after 1 week at home, i received the hospital bill up to €5+++, at first i just ignore the bill, but its come to first warning, until third warning,then now they assign a lawyer, i am scared..why they keep calling and charged me..

hoodwinked

i agree with most of the article to a degree, ( i went public and had no issues no long waiting times, had a two bed room...etc in the cumh) i just don't understand why twins get extra child benefit but a mother with two children 9 months apart does not,


they too have to buy two cots, two lots of nappies, twin buggy, two car seats, two beds...etc


just because a birth isn't multiple doesn't mean costs aren't doubled, if anything imo anyone with a year between babies should get the increase.

worded

gaeilgegrinds1 wrote: »

So public or private or semi? What do ye think? I'm pushing to have this one at home...I want himself to deliver it, we're still in discussions!

Domino scheme with holles st was fab. Amazing people work there.

January

Iezaj wrote: »

I went to Coombe and delivered my baby on May,2013. I choose a public services. Before i check out from the hospital, i am surely confirmed by midwives that nothing to be pay, then after 1 week at home, i received the hospital bill up to €5+++, at first i just ignore the bill, but its come to first warning, until third warning,then now they assign a lawyer, i am scared..why they keep calling and charged me..

This thread is three years old. You need to find out why they are charging you. Contact the hospital and see what the bill is for. Thread closed.