Those of you who have private health insurance and who have gone through the public system without paying might have assumed that your private health insurance was picking up the tab. Not necessarily. Those of you who have no health insurance and have given birth before will know that maternity care is free in this country, if the mums-to-be go through the public system. However if the Mum chooses to go private in a public hospital, the bill can easily top €5,000. So what is the difference and is it worth it?

All women are entitled to free maternity care in the State, which includes cover for antenatal visits, labour & delivery costs and postnatal care, regardless of whether you have health insurance or not. 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 and there is much anecdotal evidence of this from various surveys as well as mother’s postings on various online sites where new mothers discuss such issues.

Many couples therefore choose to go private within the public maternity hospitals. This means that they will choose to have a private consultant obstetrician available to them for the term of their pregnancy. 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 unavailable you will have another consultant to stand in for them. The fees charged by consultant obstetricians vary even within hospitals. For instance, private consultancy fees in the Rotunda vary from €3,000 to €4,500 while the National Maternity Hospital in Holles street and the Coombe average at approximately €4,000. Private patients are essentially paying to ensure that they are going to be seen by a more experienced person than a standard hospital registrar and have availability to their consultant on a much more frequent basis.

Alternatively, you can go down the semi-private route, which usually costs in the region of €1,200 once you add in the extras such as blood tests and scans. However semi-private patients do not usually enjoy the same continuity of care. Again different hospitals offer different packages but generally you will attend a clinic run by a consultant and senior members of his team. Ideally you may be dealt with by the same person each time but this is not always possible. Someone from your appointed team should be available for your delivery.

Apart from private consultants the other issue is accommodation which is unrelated to the cost of consultants. With public hospitals, those with health insurance will usually be fully covered for up to three nights in a public hospital and may be entitled to a semi private or a private room, rather than a public ward, however there is no guarantee of a private room as there is a high demand for beds and private rooms may not always be available.

The third option is to use the State’s only private maternity hospital, Mount Carmel, where you have certainty of a private consultant and at least a semi private room. This option however has traditionally been thought of as far more expensive than the public hospital alternatives. However this perception seems to be far from reality and is something I think deserves further examination. So let’s do that.

Assuming you have private health insurance and have decided you want to avail of a private consultant, we have ascertained that if you choose go to one of the public hospitals, you will pay between €3,000 and €5,000. Of this you will receive a maximum of €400 towards out-patient consultation costs under antenatal costs. Having paid this much you still have no guarantee of a private or semi private room. Of we assume you pay €3,000 for your consultant. Your net cost after all allowable reliefs would be €2,080.

Mount Carmel is now offering a new Shared-Care Maternity Package – whereby patient care is shared between GP and consultant – at €5,074 this includes five visits with a consultant and approximately 6 visits with your G.P at no cost under the infant and maternity care scheme. The package includes 2 nights semi private accommodation, 3 x pregnancy scans, 2 x pregnancy bloods, delivery fee for the hospital, an epidural (if you plan to have one), hearing test for newborn baby and your baby’s 6 week developmental check. Also included is a complementary pregnancy support programme where expecting mothers get to meet with a midwife, dietician, lactation consultant and a physiotherapist. Add the cost of your consultant at €1,650 and the combined cost for the maternity and hospital package works out at €6,724. From this fee you can deduct the grant in aid available from your health insurance. With Aviva’s new Level 2 Health Plan for couples planning families, the grant in aid is €4,500. The insurer settles with Mount Carmel directly, leaving a balance is €2,224. You can receive up to €400 towards the cost of your out-patient consultation costs under the ‘pre and post natal care allowance on the level 2 Health Plan subject to your excess. You can then claim tax relief on the balance at 20 per cent, reducing the cost to €1,459.20. A booking deposit of €350 of the hospital fees is payable on booking with the hospital with the remainder due 10 weeks before delivery. The consultant fees are paid in three installments at each scan (12 weeks, 22 weeks and 34 weeks).

This works out approximately 30% cheaper than the public hospital’s private offerings even using the average costs and after accounting for tax relief. Granted the Mount Carmel package is only for 2 nights but an extra night in a semi private room will work out at about €360 after tax relief.

Their other offering is to opt for the full Private Consultant led Maternity Package where you would enjoy all the same extras as under their Shared Care Package plus unlimited antenatal visits with your consultant. You also have the option of choosing a private or a semi private room for your hospital stay, all for €2,868.80. This amounts to paying just €788.80 more that the public hospital equivalent.

All of Mount Carmel’s Maternity accommodation (bar one room) have 2 beds per room. The other one has just 4 beds.

Aviva’s Level 2 Health Plan offers the highest grant in aid of €4,500 towards private maternity of any plan on the market and arguably has the most comprehensive ancillary maternity benefits available also. Health insurers may apply a waiting period of up to a year for maternity benefits if you are a new customer or if you are upgrading your maternity cover. So if you’re planning in advance and this is something that would interest you, you should act quickly.

Patrick Brennan
Director of Corporate Business
Irish Health Insurance

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