Maternity

Maternity non-LMC services means the primary maternity services that are either in addition to lead maternity care or services sought on a casual basis outside lead maternity care, henceforth known as Primary Maternity Single Services (PMSS).

 

Who is eligible for publicly funded maternity services?

Pregnant women are eligible for free and subsidised maternity-related services if they:

  • are eligible for publicly funded health and disability services in their own right OR

  • their husband, civil union partner or de facto partner is a/an:

    • New Zealand citizen

    • New Zealand resident or permanent resident visa holder

    • Australian citizen or Australian permanent resident visa holder who has been living, or who intends to live, in New Zealand for two years or longer

    • refugee or protected person, or is applying or appealing for refugee or protected person status, or is a victim or suspected victim of a people trafficking offense

    • work visa holder able to stay in New Zealand for 24 consecutive months (time spent lawfully in New Zealand immediately before the start of the work visa counts toward the two year requirement) (work visas start on the person’s first day in New Zealand)

    • interim visa holder who was eligible immediately before the interim visa was issued 

  • are pregnant with a child that is found to be a New Zealand citizen by birth.

  • Partners of NZ Aid Programme students studying in New Zealand are eligible in their own right.


The basis of this funding is to provide the child of an eligible person, regardless of whether the eligible parent is male or female, with antenatal, labour and birth, and postnatal care, so that the baby will be as healthy as possible.

 

What maternity services are funded?

Most maternity care is free for women who meet the criteria above. There may be charges for antenatal or childbirth education classes, and some tests at a private laboratory. There may also be charges for ultrasound scans. Private obstetricians and private maternity hospitals will also charge a fee.

Provided they meet the eligibility criteria above, pregnant women are eligible for the following maternity-related services:

  • primary maternity services within the meaning of clause B1 of the Primary Maternity Services Notice 2007 (see Primary maternity services below) AND

  • all maternity services provided by DHBs AND

  • any other secondary or tertiary services for a condition of the mother or child that a clinician has determined will significantly impact on the pregnancy or its outcome.

As mentioned above, these services are funded to ensure that the child of an eligible person has the best chance of being healthy. However, recognising that not all pregnancies are viable, the above definition of maternity-related services includes ectopic pregnancies, miscarriage services, pre-eclamptic toxaemia, eclampsia, and terminations of pregnancy for fetal abnormality.

 

Cover under Reciprocal Health Agreements with the UK and Australia

Some women are not fully eligible for publicly funded maternity services, and do not have eligible partners, but are eligible for a limited range of services under reciprocal health agreements New Zealand has with Australia and the United Kingdom.

If a UK citizen or Australian resident is pregnant and covered under one of these agreements, they are eligible for immediate and necessary maternity care, including labour and birth, and immediate post-natal services. They must meet other eligibility criteria for fully funded LMC services.

Reciprocal health cover does not extend to partners or dependants of people covered by these agreements. See Reciprocal Health Agreements for further information.

 

Maternity funding: 

  • First Trimester Single Service                   $75.00

  • Urgent Single Service                                 $50.50

  • First trimester pregnancy loss                  $125.00

  • Second trimester pregnancy loss             $165.00

  • Second trimester pregnancy loss partial   $82.50

  • Rural support                                                 $556.00

All prices are exclusive of GST,  please note prices are subject to change and the above figures are current as of 15 March 2023.

 

 

Resources:

GEN2040

Primary Maternity Single Services Claiming - 1 July 2022

Primary Maternity Services (Full Notice) - 29 November 2021

(Please note fees are subject to change, the fees in the claiming document are correct as of 1 July 2022)