WE MIGHT be in the middle of the biggest baby boom since 1896, but don't be too keen to jump on the bandwagon. By the time your baby is a minute old, you could have dished out €10,000 or more in hospital fees. And that's before you've even started to raise your little bundle of joy.

If having a baby, you can attend hospital as a public, semi-private or private patient. The key advantage of public care is that it's free -- you do not have to pay for your antenatal visits, labour and delivery, or postnatal care. Otherwise, your bill could easily run over the €4,000 mark if you go semi-private and don't have private health insurance -- twice that if you attend hospital as a private patient.

However, public patients usually have to wait longer than semi-private or private patients for their first hospital appointment -- which includes a scan to confirm your pregnancy and assess the well-being of your baby. Public patients are also less likely than private patients to be seen by the same doctor at each antenatal visit, and for their delivery.

"If you go publicly, you could be seen by a different doctor each time," says Aongus Loughlin, head of healthcare and risk consulting with Watson Wyatt. "If you go privately, you'll usually see the same doctor through your visits, though that doctor could still be away on holiday at the time you have your baby."

INSURANCE WON'T COVER EVERYTHING

EVEN if you have private health insurance, chances are you will still have to cough up a few grand to have your baby.

Don't assume that your insurer covers all of the maternity services offered by a particular hospital. If you're a Hibernian Aviva customer, for example, and you're attending Dublin's Rotunda Hospital as a semi-private patient, you'll usually still have to pay €1,200 to have your baby there. You might also have to pay for antenatal classes on top of that. Although public antenatal classes are free with the Rotunda, these are held during the day so workers might not be able to make these. Six evening antenatal classes at the Rotunda cost €150.

If you're attending the Coombe Women's Hospital in Dublin as a semi-private patient, you'll generally have to pay about €1,050 on top of your insurance -- but it could be more.

"A mother with VHI Healthcare Plan B who attends the Coombe or Rotunda semi-privately will usually have to pay an amount in addition to what is paid by VHI," said a spokesman for VHI. "We understand that the out-of- pocket amount comes to around €750 for the obstetrician, plus around €300 for ultrasound scans."

THE €10,000 BILL

IF you don't have private health insurance and want to attend hospital as a semi-private or private patient, brace yourself for a hefty bill. An overnight stay alone in a private room in a HSE regional hospital costs €913; a night in a semi-private room costs €713. These costs could increase once Budget 2010 kicks in next year.

You'll also have to pay for your delivery, antenatal care, consultant and other fees. In the National Maternity Hospital (NMH) in Holles Street, for example, the epidural anaesthesia costs €289, a Caesarean section costs €323, ultrasound scans cost €110 each (you'll usually have three), the pathology fee is €105, and the paediatrician's fee is €75.

If you are semi-private you'll also have to pay consultant's fees -- €500 for antenatal visits in the NMH, €313.94 for a normal delivery and €467.97 for a Caesarean section. So if you don't have insurance, attend the NMH as a semi-private patient, have a Caesarean section and stay in hospital for five nights, it could easily cost you over €5,000 to have your baby there -- or more than €10,000 if you attend as a private patient.

If you have a complicated birth and your baby needs to be kept in a special unit after the birth, you will usually have to pay extra for this. In the Coombe, it costs €713 a night to keep your baby in the special care unit; in the NMH, it costs between €594 and €713 a night.

The only private maternity hospital in the country is Mount Carmel. A three-night private maternity package costs €5,990 in Mount Carmel but if you have insurance, the actual cost of that package to you could be €1,990. You will also have to pay consultant fees, which usually range from €3,500 to €3,800.

You will usually be able to claim back a fifth of any costs not covered by an insurer in tax relief.

INSURANCE MINEFIELD

EVEN if you have private health insurance, getting your head around the charges covered by your insurer is a minefield.

Are you covered for ultrasound scans? What about the epidural anaesthetic at delivery? If you have a Caesarean section and have to stay in hospital for more than three days after the birth, will your insurer cover the full cost of this? Before you start attending your hospital for antenatal care, ring your insurer and hospital to clarify what exactly is and isn't covered by your plan.

None of the private health insurers is any better than another for maternity cover, according to Loughlin, but if you are planning to have a baby, shop around their plans -- particularly if you want to go to a private hospital. Some plans will offer better maternity cover than others. VHI's First Plan Starter, for example, covers only up to €381 of the cost of accommodation in a public hospital.

As a night in a semi-private room in a regional public hospital costs €713, you'd have to cough up for most of your maternity hospital bill yourself under First Plan Starter. Other VHI plans, including First Plan (levels 1 and 2) and Plan B, provide full cover for private accommodation in a public hospital for up to three days. If you choose to have your baby in a private hospital, VHI pays an allowance of between €2,275 and €3,500 towards the cost of three nights' accommodation, depending on the plan.

"If a mother requires Caesarean section, we pay the accommodation costs in full for as long as the stay is medically necessary," said a spokesman for VHI. "In addition, we also increase our grant-in-aid allowance to the obstetrician and the anaesthetist."

Quinn Healthcare's Essential Starter pays only a few hundred euro towards the cost of your hospital accommodation -- however, its Essential Plus plan pays up to €4,000 towards a three-night stay in hospital.

Hibernian Aviva's "me plan" is not designed for those planning a family and offers only minimum maternity benefit. Its Level Two Hospital and Everyday plans pay up to €4,000 towards the cost of accommodation and delivery in a private hospital. Levels One and Two of its Hospital and Everyday plans provide full cover for up to three nights in a public hospital.

"This means that the cost of accommodation and delivery will be covered, whether this is for induced births, normal delivery or Caesarean section," said a spokesman.

For a breakdown of the different maternity benefits offered by each insurer's plans, visit the consumer information section of the Health Insurance Authority's website (www.hia.ie).

If you are planning a family and do not have private health insurance, unless you do so soon, you may have no choice but to go public. Once you join an insurer, you must wait a year before you are covered for maternity.

Once you have your baby, a raft of other costs await you -- including cradles, cots, car seats, buggies, nappies, baby bottles, clothes, and so on. Sadly, none of these will be covered by your private health insurer. And unless your employer covers your full pay while you are on maternity leave, you'll have less money to dish out for such expenses than you did while working.

The most you can expect from State maternity benefit is €280 a week for six months.

Having second thoughts already?

Sunday Independent