What is Medicare?

Medicare is a health insurance scheme funded by the Australian government. It provides you with access to certain types of medical care and hospital services. Medicare can cover some or all of your medical expenses during your pregnancy and the birth of your baby.

Medicare covers:

• free treatment and accommodation for public patients in a public hospital
• free or subsidised treatment from health care professionals, including obstetricians, doctors and eligible midwives
• 75% of the Medicare benefit schedule in-hospital services that you receive as a private patient (this does not include hospital accommodation, theatre fees or medicines)

Am I eligible for Medicare?

All Australian residents are eligible for Medicare, as are some visitors to Australia. You can check your eligibility for Medicare at Services Australia.

If you don’t have a Medicare card, you need to apply for one. Contact Services Australia to find out how to enrol.

What is covered by Medicare during pregnancy, birth and early parenthood?

If you have a Medicare card, your costs during pregnancy and birth will be subsidised by Medicare. Your costs and how much Medicare covers, will depend on your choice of care and where you give birth.

Antenatal care

While you are pregnant, Medicare may help with the costs of:

• midwives and/or obstetricians in the public system
• routine ultrasounds
• pregnancy counselling
• blood tests and routine ultrasound scans
• some immunisations (for example, whooping cough and influenza vaccination are provided free under the National Immunisation Program.)

Medicare will also pay for 3 pregnancy support counselling sessions. Visit the Department of Health website for more information.

Labour and birth

When you give birth, Medicare covers:

• free care from midwives and/or obstetricians in a public hospital, birth centre, or publicly funded homebirth program
• free or subsidised care from a private obstetrician in a private or public hospital

Postnatal care

After your baby is born, Medicare covers some or all of the costs of:

• care from midwives and/or obstetricians in a public hospital, birth centre or publicly funded homebirth program
• immunisations for your baby
• visits to the GP

Medicare will also cover your costs if your baby needs special care.

Your state or territory government may also help to pay some of the costs of services after the birth.

Adding my baby to my Medicare card

After your baby is born, it’s important to add them to your Medicare card as soon as possible. Your midwife or hospital will give you a form to do this. You can find more on the Services Australia website.

What isn’t covered by Medicare during pregnancy and birth?

There are some things not covered by Medicare. They include:

• hospital stay as a private patient in a private or public hospital
• gap fees for private obstetricians, private midwives or doctors caring for you during pregnancy or after the birth
• any fees for private midwifery care for you during labour, and/or birth at home
• out of pocket private hospital expenses, including medicines

What if I am not eligible for Medicare?

If you are not eligible for Medicare, it’s important to take out private health insurance before becoming pregnant. If you do not take private insurance in time you may need to pay the full costs associated with your care.

Where can I get more information?

Find out more from Services Australia.

If you’re not an Australian resident, there’s more information on pregnancy care on a visa in Australia.