Is it easy to move from private to public for delivery?

L

Liquorice

Registered User
I am newly pregnant and planning on going private for my maternity care and delivery. We have no insurance though, so will be paying for it all ourselves. I think this should be fine if the pregnancy is straightforward, but I am concerned about costs escalating outside of our budget if complications arise further down the line. If this were to happen, I would want to move to the public system.

Does anyone know if it is relatively easy to move across to the public system at any point during the pregnancy? Or whether past a certain date they won't take you or they will charge a lot of money to take you?

I have to have a c-section for medical reasons and I am wondering whether they would allow it if I turned up at say, 35 weeks, with complications but with no prior history with the hospital; would I be slotted into the system or would it not be as simple as that?

Does anyone have any idea?

Also, if your baby is born in a private hospital but has problems, would it be possible to transfer the baby's care to a public hospital or would you have to stay at the same private hospital?
 
Hi Liquorice,

Dr Doo would book you into Queen Mary anyway i think. Might be worth checking him. When my first scan showed twins, he told me he would automatically book me into Queen Mary as well as a private. I don't know how the fees work if you have complications and have to move from a public to a private - as I understand it, any emergencies in Matilda say end up at Queen Mary anyway.

We have insurance but it's not a lot so we will probably still end up paying half the fees. I don't know how many insurance companies do cover the full package. Interestingly when I had a collar bone operation, It cost about the same as a c section yet I was fully covered, but not for maternity. Go figure :-)
 
if you are a hkid holder, then no public hospital will turn you away, no matter if you had pre-natal checks with them or not. if you have a hkid and you use the public part of the public hospital (not the private) then you will pay the nominal fees ($100/day) that everyone else who is a hkid card holder pays.
 
Keep in mind that costs for a routine c-section can increase greatly if you have any complications during or after. My final bill at Matilda was 4-5x the cost of a regular c-section due to stuff that happened after the delivery. Not sure if they would have transferred me to a public hospital if I had requested. But even if I had transferred, significant costs for emergency procedures were already incurred at Matilda. also, if you go into labour 'after hours' you would the fees for an emergency c-section in the middle of the night or on a weekend are quite a bit higher.

If you need a c-section for medical reasons, it might be good to at least touch base with the public hospital to confirm that they will perform a c-section based on your particular condition as they do not do 'elective' c-sections in the public system and their doctors will need to evaluate you to confirm a c-section is necessary.
 
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Oh, and if the baby needs special care, they will transfer to the public system from Matilda. A friend delivered twins at Matilda and one of the babies was transferred to Queen Mary because they didn't have the equipment of staff at Matilda to care for the baby. Not sure how it would work if it was not a medical necessity, i.e., complications but Matilda did have the capability to handle. Might just call them and ask how that would work.
 
Yes, it's easy to transfer from private to public (though not the other way round!)
Yes, in an emergency, you'll end up in public anyway, even if you paid for private.
Good luck!
 
Thanks for all your responses.

Elle - I had a c-section with my first at the Prince of Wales, so they should be fine. Of course I naively hadn't really considered complications during the delivery...rather assuming that any potential complications would be flagged beforehand. Chances of complications during a planned c-section should be relatively low though shouldn't they? Can I ask what happened with yours?

Sapphire40 - thanks. Will definitely check with Dr Doo.
 
Liquorice said:
Thanks for all your responses.

Elle - I had a c-section with my first at the Prince of Wales, so they should be fine. Of course I naively hadn't really considered complications during the delivery...rather assuming that any potential complications would be flagged beforehand. Chances of complications during a planned c-section should be relatively low though shouldn't they? Can I ask what happened with yours?

Sapphire40 - thanks. Will definitely check with Dr Doo.
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Yep, if you've had a previous c-section I think you're okay for a c-section in public, but be sure to check. I have a former colleague who was strongly encouraged to do a VBAC in a public HK hospital (not Queen Mary) so it might be good to just confirm the policy of the public hospital you may end up using.

There is always a risk of complications with a c-section, both during and after the procedure, all sorts of things can go wrong with a major operation and I know plenty of people who have had various post c-section infections, both localized at the incision site and systemic. In my case, went into labour early, a few weeks before scheduled c-section, ended up having an emergency c-section at night on a weekend (increases costs all around). They accidentially paritally collapsed one of my lungs during the c-section. Got pneumonia and some other blood infection in the hospital a day after delivery, ended up in some sterile intensive care room for several days. Before the delivery none of these complications were even contemplated, stuff just happens and in my case it was really expensive (fortunately i did have insurance to cover it, but even seeing the final bill was frightening).
 
For me the complication was an emergency c-sec as my breech baby started to come early. My private doc had already explained to me the added costs of just a simple emergency c-sec (I think it was 10,000 more just for the OT, and probably higher if the baby chose to arrive on a public holiday; not sure if the docs also charge more for a non-scheduled c-sec) so I decided if it came to an unscheduled c-sec, I'd go public and that's what I did.

For that reason, i continued to attend antenatal appointments now and then in the public system - the nurse there said it was fine to skip in between as long as I showed up from 35 weeks onward I think. Basically, when they were scheduling the appointment I'd just tell them I wanted to skip a few and they'd schedule one later. I did the tests free in the public system. Yes, it meant taking half a day off sick leave to attend the appointment but I was glad I did in the end as then I had all the records in order when I had to go in for the emergency and there was no stress.

I'm sure they'd admit you as a HK ID holder even if you were n't in their system but I'd hate the insecurity of knowing whether to go to the ER or up to the labour ward and frankly, I wouldn't want to go the ER. Not sure what the procedure is if you haven't registered with them and go in to register at 35 weeks. I guess they would have to register you.
 
Liquorice, there's a website that i found the other day which answered a lot of my pregnancy related questions called maternasure. Have a look, it may be useful!

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112233 said:
Liquorice, there's a website that i found the other day which answered a lot of my pregnancy related questions called maternasure. Have a look, it may be useful!

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Thanks 112233. Quite useful listings, but is it run by Navigator insurance company? To be honest I have found them to be pretty useless when I've dealt with them before, so I'd be wary of working with them to take out insurance.
 
yes, it's possible to switch from private to public at any time; public system is REQUIRED to take you.

however, i would strongly suggest you switch at first sign of anything of concern OR just go the public route. the worst case scenario is that something comes up right before you need to deliver and you show up at a public hospital where they have no record of you or your pregnancy (blood types, rh factor, etc). of course, they can order these tests on the spot, but it is not a good scenario if you are having a true emergency and they have to wait around for test results.
 
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