Public or private maternity care in Australia: what Medicare covers and how to choose

Public care with Medicare costs little or nothing; private care lets you choose your obstetrician but brings gap fees. Here is the honest comparison.

Updated October 13, 2026 · sources checked October 13, 2026

In short

In Australia, giving birth as a public patient in a public hospital or birth centre is covered by Medicare if you have a Medicare card. Private care lets you choose your obstetrician and hospital, but Medicare pays only part, private health funds usually require 12 months' membership before covering pregnancy, and gap fees are common.

The models of care side by side

Model	Who you see	Where you give birth	Cost with a Medicare card
Public hospital clinic	Hospital midwives and doctors, not always the same person	Public hospital	Covered as a public patient
GP shared care	Your GP or a local midwife, plus some hospital visits	Public hospital	Hospital care covered; GP visits covered if bulk billed
Midwifery group practice (caseload)	One known midwife, with a small backup team	Public hospital, sometimes birth centre or home	Covered as a public patient
Birth centre	A known midwife or small team	Birth centre, low-risk pregnancies	Covered as a public patient
Public homebirth program	A known midwife and backup midwives	Home	Covered where available
Private obstetrician	Your chosen obstetrician; hospital midwives during labour	Private hospital, or a public hospital as a private patient	Medicare pays part; your fund may pay part; gap fees likely
Private midwife	The same midwife throughout	Home or hospital	Medicare may pay part of eligible midwife care; out-of-pocket fees

What Medicare covers

During pregnancy, Medicare may help with:

appointments with midwives and obstetricians in the public system;
telehealth and phone consultations;
routine ultrasound scans and blood tests;
some vaccines under the National Immunisation Program;
up to 3 pregnancy support counselling sessions per pregnancy.

For the birth, Medicare covers care from midwives and obstetricians in a public hospital, birth centre or publicly funded homebirth program, and your stay there. As a private patient in hospital, Medicare pays 75% of the Medicare Benefits Schedule fee for in-hospital medical services, but not accommodation, theatre fees or medicines.

What Medicare does not cover

your hospital stay as a private patient, in a private or a public hospital;
gap fees from private obstetricians or private midwives;
private midwifery fees for a home birth;
out-of-pocket private hospital costs, including medicines;
some tests, such as non-invasive prenatal testing (NIPT).

If you are not eligible for Medicare, you pay the full cost of care in both public and private hospitals; check your visa health insurance early.

Private health insurance: the 12-month rule

Most private health insurance policies have a 12-month waiting period for pregnancy and birth. To use private obstetric cover, you need the policy, or the upgrade, in place about 12 months before you become pregnant; otherwise you pay for private care yourself. Some policies do not cover obstetrics at all, or only as a private patient in a public hospital.

Check too how your fund covers your baby: many funds ask you to move to a family policy 1 to 3 months before the birth, some up to 12 months before. Your baby's nursery care is charged separately from your own stay. A premature baby needing neonatal intensive care is usually cared for in a large public hospital, where most costs are covered by Medicare for public patients.

Why midwifery continuity of care is worth asking about

In midwifery group practice, one midwife you get to know cares for you through pregnancy and is on call for your birth, sometimes until 6 weeks after. Pregnancy, Birth and Baby links this model with a more positive labour and birth experience and a lower chance of preterm birth. The Cochrane review by Sandall and colleagues (2016) compared midwife-led continuity models with other models of care and is a key part of that evidence. Places are limited, so ask at your first appointment.

Questions to ask before you choose

Who would I like to care for me: a midwife, my GP, an obstetrician?
Where do I want to give birth: hospital, birth centre or home?
For private care: what is the obstetrician's total fee, what does Medicare pay back, and what will my fund pay?
What are the extra costs for an anaesthetist, a paediatrician or a caesarean?
If my baby needs special care, what does it cost me?

The Private Health Insurance Ombudsman (1300 737 299) and the government's Medical Costs Finder can help you compare. Pregnancy, Birth and Baby (1800 882 436) can talk you through your options.

Questions parents ask

How much does it cost to have a baby in a public hospital in Australia?

With a Medicare card, care and accommodation as a public patient in a public hospital or birth centre are free. Some services outside hospital may have a gap if your provider does not bulk bill, and tests such as NIPT are not covered.

How long before pregnancy do I need private health insurance?

Most policies have a 12-month waiting period for pregnancy and birth, so the cover needs to start about 12 months before you become pregnant.

What is GP shared care?

Your pregnancy care is shared between the hospital and a local GP or midwife. You see your GP for many visits and the hospital for some, and you give birth at the public hospital.

What does Medicare not cover in pregnancy?

Private hospital stays, gap fees from private obstetricians or midwives, private home birth midwifery fees, private hospital medicines and some tests such as non-invasive prenatal testing (NIPT).

Sources

Pregnancy, Birth and Baby — What is the difference between public and private care in pregnancy? checked October 13, 2026
Pregnancy, Birth and Baby — Medicare during pregnancy checked October 13, 2026
Pregnancy, Birth and Baby — Private health insurance and pregnancy checked October 13, 2026
Pregnancy, Birth and Baby — What is midwife continuity of care? checked October 13, 2026
Sandall J et al. (2016), Cochrane — Midwife-led continuity models versus other models of care (PMID 27121907) checked October 13, 2026

Mamavela explains; it does not replace your midwife, doctor or pediatrician, who know your situation. If something worries you, call them. In an emergency, call 911 (US), 999 (UK) or 112.