Aoife Nolan had a stressful first five months of pregnancy after her local hospital refused to provide maternity care.

A heavily pregnant Irishwoman on a 457 visa has spoken out about the reciprocal health cover agreement (RHCA) between Ireland and Australia, claiming there is a lack of clarification and understanding, especially when it comes to antenatal care.

Aoife Nolan, a Cork native who now lives in Bunbury, Western Australia, said she had an incredibly stressful first five months of pregnancy, following her local hospital’s refusal to provide her with maternity care.

Irish citizens on a 457 visa are ineligible for Medicare and are obliged to arrange private health insurance. However, Irish health insurers apply a 12-month waiting period before covering pregnancy.

While Bunbury Hospital acknowledged that Ms Nolan would be entitled to treatment if it was deemed “medically necessary”, the mother of one said it is not acceptable that antenatal care did not appear to fit that criteria.

“If I turn up for labour it’s deemed medically necessary and they have to take me. My issue was not with that, it was with antenatal care, because the hospital was essentially saying that it’s not medically necessary and I beg to differ, I do think it is medically
necessary,” she said.

Ms Nolan said  the cost of attending a GP for blood tests and antenatal care was ludicrous, and it seems there is one rule for one hospital and a different rule for another.

Things worsened when the hospital asked Ms Nolan to write a letter to convince them she was a genuine case and had not flown into the country just to give birth.

Ms Nolan thought this was laughable, considering she has been in the country for some years and was not pregnant when she arrived.

After refusing to write the letter, Ms Nolan then decided to go higher up and made contact with Kim Hames, the WA Minister for Health.

Mr Hames’s response read: “You are entitled to receive medically necessary treatment in public hospitals on the same basis as Australian residents. According to the advice from the Commonwealth government, this entitlement includes being able to access services for the birth of your child.

“The DOH advises that your situation, in being both a 457 visa holder and from a country with which Australia has a RHCA, is not one that has often been encountered.

“It is understandable that there may have been some confusion at Bunbury Hospital regarding your eligibility. The DOH advises it will seek to ensure that hospitals are made aware of the eligibility for services of persons in your circumstances.”

After months of arguing face-to-face, over the phone and in person with
officials, Ms Nolan has now decided to have a home birth, where she will be provided with free antenatal care.

“If I hadn’t opted for a home birth I would still be fighting with the
hospital,” she said.

The Corkwoman believes a memo needs to go out to all operations directors in Perth and regional hospitals, stating the guidelines for 457-visa holders and pregnancy.

An Irishwoman on a 457-visa was relieved to learn her pregnancy care is covered by Ireland’s reciprocal health cover agreement (RHCA) with Australia.

The Irishwoman, who wishes to remain anonymous, had fallen pregnant before arriving in Australia.

Irish citizens on 457 visas are ineligible for Medicare, unlike those from the United Kingdom.

Like other nationalities, Irish 457 visa-holders are required to arrange private health insurance.

The pregnant woman became concerned when private health insurer IMAN said it would not cover costs during her pregnancy because she had been a policyholder for less than 12 months.

Irish health insurers also apply a 12-month waiting period before covering pregnancy care. But the woman learned from a major public hospital in Sydney last week that all her care would be covered.

The hospital’s patient liaison officer told the woman the public system was obliged to treat pregnancy care as if it were a medical emergency.

“Some subclass 457 visa holders may have access to Medicare under reciprocal health cover agreement (RHCA) arrangements with other countries,” said the Department of Immigration.