Expat wants to have a baby in the UK...

[Anjiyer]

We have just moved to Scotland from the USA and have a 3-year-old daughter. We want to have a second child as soon as we can, but are not sure how the hospital/ NHS/ medical insurance works. If we go private with the delivery etc, how expensive will it get?

[expatinscotland]

Yes, I got in there before the fees went up.

I actually did blow it off for a couple of years, just couldn't be arsed. But when I first came here, visas for spouses of British nationals were free! Them were the days.

It's all what you're looking for in a birth experience, but if you do need to go to London make sure you use the search option on here to get some information about private maternity services there.

[madmouse]

see here and here

It does depend very much on your immigration status.

There is however a little known rule that the NHS may not refuse a woman essential maternity care if they cannot pay their bill (In my work as an immigration lawyer I have used this to get the NHS bills dept off the back of destitute failed asylum seekers - so quite a bit different from you - but it is good to know)

[star6]

MrsSnorty, if you're on a work visa or student or have a valid other residency arrangement in uk as a us citizen, you are entitled to NHS care. I am currently on a work visa, but have been here for several years... from the very first day that I arrived on this visa, I was entitled to NHS care as taxes were coming out of my paycheck.

I was disappointed that my private insurance (it's uk insurance that I get through my job here) did not cover maternity costs... I do know people who had US private insurance that covered maternity costs internationally, though - so it's possible. I am 33 weeks with my first, have had a mixed experience with NHS, but overall I'm happy. I see a private gp whenever I'm really concerned (like when my iron level hb was at 4.8 and my gp told me to take 3 iron tabs 3X per day instead of the 2 tabs 3X a day that I was already on...). I trust my private gp (that my insurance usually pays for - just not for antenatal appts) so was happy to just pay for the appointment to get that sorted. You CAN mix private with NHS, but not a good idea tell your NHS midwife/hospital/gp that you are seeing someone privately as well... unless you are put on a treatment/medication that they would need to know about. My NHS gp was very stroppy about the fact that I had gotten treatment privately as well, but in the end it was fine and I usually see the NHS one - they are generally very good!! Especially the Midwives.

[MrsSnorty]

Think you have to have been resident (and paying National Insurance) in the UK for two years to be entitled to NHS care. I remember the hospital staff asking if I'd been here for that long when pregnant with DS (and I'm English!). May be wrong though. If I'm right I imagine you could still have NHS treatment but would be billed for it.

[Anjiyer]

Thanks for all the information...now I have a fair idea of what to expect...

[expatinscotland]

I think the main issue you're going to face going private is that you will, unless they opened something up in Edinburgh - it's been nearly a year since we left, need to go to England or Wales for the birth.

As prettybird pointed out, there may not be any private hospitals that handle delivery in Scotland.

Certainly possible, but you might want to do a search on this board about private hospitals in, say, London. There are many who have gone down this route, but you may have some logistical costs which are not covered by insurance.

Also, some hospitals, depending on the trust, will not treat you there antenatally if you are going elsewhere for the delivery.

Your other option is to return to the US for delivery.

I know a couple of people who did this as they were not comfortable with how maternity care and delivery are handled here in the UK, even privately.

During the preganany with a second child, you don't get seen nearly as often as with the first unless you develop a complication.

Leonie is right, OBs don't get involved here at all unless there is a problem or complication like diabetes or hypertension or a problem occurs during delivery.

And then, you don't get to chose the OB.

I had to have a forceps delivery with DD1 and the OB consult was just whoever was there. She was fab, but I wouldn't know her from Adam and it wasn't a matter of choice.

This time round, I only saw an OB to get a referreal for my antenatal depression. All she did was talk to me about my moods and past history of post-natal and ante-natal depression and make the referral. I still have all my care with the midwives because there is nothing physically wrong with me or the baby. But this suits me and I really like the midwife who does the 3rd trimester ladies and deliveries here.

Also, if you are in Edinburgh, you only get one scan on the NHS, at 13 weeks, unless there is something wrong and even then, they will NOT tell you the baby's gender. You will need to pay privately for a 20 weeks scan, anyway.

Furthermore, again if you give birth at Edinburgh Royal Infirmary, you cannot book a private room.

Horses for courses.

Like Leonie, I prefer the British attitude towards pregnancy and delivery and could never deal with what I feel is the intrusiveness of the American system on the whole, but this is true of many things there and hence the reason why it's been over 7 years since I even went there at all and naturalised as a British citizen as soon as eligible.

[Anna8888]

My sister had two private births in London and no, she couldn't "pick'n'mix". All her antenatal care was paid for and with her obstetrician.

When she saw the far better level of care I received antenatally and for free on the NHS, she was a bit about the private obstetric care she had received.

[Anjiyer]

Have learnt that my US policy will cover maternity. Is it possible that I utilise the NHS for part of the care and the private coverage for the delivery costs etc?

[chandellina]

some UK policies cover it - DH's AXA policy had a gold version on offer that covered something like £10k worth of maternity costs. (though we didn't take it and went through NHS, per usual.)

[youcannotbeserious]

Yes, your US insurance might cover maternity... but UK policies generally don't

Hope you get a the resolution you are hoping for (whatever your birth plan happens to be!)

[wombleprincess]

Commonly, UK private medical insurance rarely covers childbirth unless there are complications and doesnt cover maternity (scans, tests etc). however there are many different policies so check with your provider.

There is some private provision in Scotland if you wish to self pay but private provision generally outside london for maternity and birth is limited. this may, therefore, limit your options even if you are insured - eg if you are in perth you might not want to go to glasgow to give birth! Private delivery you should budget 4k with scope for complications, longer stay.

ofcourse, there is the option of a private midwife at home if that was your preference and there is pretty nationwide coverage on this but for all other care you could use the NHS.

[Anjiyer]

I am registered with a GP already. We are also covered by private insurance. Will talk to both to get this clarified.

[youcannotbeserious]

Anjiyer - Are you registered with a GP? If you are, then they will be the first place to talk through the options.

If you go private, be prepared for a bill around £10K and, AFAIK, you will need to go to London for the actual delivery. And, I think you might find it difficult to find a consultant with the right insurance to offer private ante natal cover (I couldn't find one locally, but only live 30 minutes from London, so it wasn't a deal breaker to drive in, IYSWIM)

But, do talk through your options with your GP.

AFAIK, there aren't even any residency requirements to be seen by the NHS, but not sure if that covers US nationals or just the EU?

[prettybird]

VF - I was very amused when I found out. The midwoves loved the fact that the slebs used the "bugs room" - and never even realised that that was why they got thier privacy. Basically, the rest of us were being protected from them

[prettybird]

I got one of the "ordinary" single rooms (which are not bookable) at the Queen Mums when ds was 36 hours old as he got bad jaundice and needed to be under lights. Like ERI, they are for those mums/babies that need them.

[ViolentFemme]

LOL at slebs giving birth with us mere mortals. I had always assumed there would be a birthing ward at Ross Hall or the like. They should put up plaques on the wall...

[expatinscotland]

At ERI, you cannot book a private room. You can at St. John's in Livingston, IIRC, but not at Edinburgh Royal Infirmary.

They keep them aside for csection people, mums of mulitples, mums of babies in the NICU/SCBU or mums who have complications - I had one with DD1, but only because I spiked a fever whilst waiting for a bed to come free after forceps delivery.

[Anjiyer]

Thanks for all the responses. Guess I will need to check with our insurance and the NHS.

[prettybird]

Yes - to expand on ExpatinScotland's commnes: you can go rpivate for scans, but for delivery there is no, as far as I am aware, private provision in Scoltand.

WHen I was back in the maternity hospital shortly after ds' birth with a nasty infection (caught, we think, from one of the cats - long story), I was in the isolation room, aka the "Bugs Room" with my own toilet and bathroom.

.....it was also where they would put the "celebreties" like Carol Smillie and Anna Winona-Richardson as it was closest thing they had to a private room. They didn't know it was called the Bugs Room though!

This was the Queen Mother's Hospital in Glasgow.

[sunshine185]

i'm in london and with ds we did some of our care privately at the london portland hospital, during our antentatel classes we met lots of expat americans who went private on their work's health insurance. in the UK my husbands health insurance didn't cover maternity but in north america it did!

i would check into what is offered in terms of your insurance from the US as going private and part nhs here(if you wanted) would be more comfortable... up to you.

good luck!

[expatinscotland]

Well, yes, they do, Jfly, but if you're an American living in the UK then you're hardly going to be an individual who is on benefits - unless you have ILR or are a dual national.

Some come as students, and they are entitled to NHS treatment as it is considered to be paid for out of the extra international fees they pay.

I am an American immigrant to the UK and now a dual national myself. My husband is a Scotsman.

But I have had both of my children here, soon to have no. 3 in October, so don't have any comparison to how maternity works in the US.

Like pretty, however, I don't know of any hospitals in Scotland that offer private maternity care and it may or may not be covered on private medical insurance.

I had two children in Edinburgh but this one will be born either near Glasgow or here in the Western Highlands.

[ObsidianBlackbirdMcNight]

If you live here legitimately you will be entitled to NHS care which will cover everything from scan to delivery and after. If you are interested contact BUPA or someone re private maternity care but you really don't need to.

[JFly]

You are entitled to NHS care if you are resident in the UK, as far as I know, but you may have to pay for it under certain circumstances.

Presumably you are here on a visa of some sort? If you're in fulltime employment, you should be able to receive treatment without any charge. I'm an American married to a Brit and I had to register for a national insurance number at my local job centre and then get an NHS number (different) when you register with a GP. Have a look online if you have other questions.

www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/D H_074374

I don't want to start an argument, but individuals who don't pay tax still receive free NHS care, expatinscotland, don't they? For instance, those on benefits don't pay tax and may never have paid tax in their lifetime. I know that's not the OP's position, but just to explain as I found that confusing when I first arrived here.

Also I believe some private insurance does indeed cover maternity, as I know individuals who have such coverage.

HTH.