Medical Aid If You’re Already Pregnant

pregnant medical aid

It’s common to think about the financial impact of childbirth only once you’re already pregnant.

In terms of medical aid cover for the pregnancy, and the birth itself…this is simply too late. However, that doesn’t mean it’s not important to go ahead and secure medical cover, for yourself and the soon-to-be new member of your family.

Pregnancy – a pre-existing condition excluded from medical aid cover

What many women don’t take into account is the exclusion policy of medical aid schemes in South Africa. As pregnancy is considered a pre-existing condition, it is excluded from all benefits for the first 12 months of scheme membership.

That effectively means there is no medical cover for the period leading up to the birth, nor for the delivery itself.

The fact of the matter is if you are already pregnant before you join a medical aid scheme, you and your partner will have to find the funds to cover the costs of antenatal care, and pay for the birth of baby from your own pocket.

Expect to pay R60k and upwards for a normal birth

In the private scenario, you can expect to pay R60,000 and upwards for a normal birth. When there is no medical aid cover, healthcare providers and hospitals usually request full- or part-payment, upfront.

When complications arise, medical costs can skyrocket. Without the buffer of medical aid, a normally joyous occasion can turn into a financial nightmare.

That is the bad news. Now for the good news.

The good news - baby is covered

At the moment of birth, your baby is covered by medical aid. The only proviso is you must register baby with the scheme within a specified period, which is usually 30 days.

That is the core reason why it is so vitally important to join a medical aid scheme – to ensure your baby gets the best possible healthcare from the get-go.

When you join a scheme before you are pregnant, you obviously have full access to all the maternity benefits the scheme has to offer.

When you become a member after you are pregnant, your little one gets the protection he or she deserves from the instant they first draw breath!

If you are planning to start a family, or already have a baby on the way, it’s time to sign up at a medical aid scheme right away.

Best medical aid for maternity benefits

Which medical aid schemes offer the most comprehensive maternity benefits?

In reality, there is not that much that separates one scheme from another in terms of basic benefits. Having said that, here is how two of the top medical aid schemes in South Africa cover pregnancy and childbirth:

Discovery Health maternity benefit

Discovery Health offers targeted cover for antenatal care, child birth, and baby’s early childhood.

The scheme covers gynaecologist, GP or midwife consultations, and offers benefits for ultrasounds, blood tests and prenatal tests.

The costs of a private ward and essential devices are paid for members, or beneficiaries, belonging to the Top option.

Benefits cover the new-born until the age of two, and include visits to the GP or paediatrician; post birth consultations with a midwife or gynae, and nutrition, mental health and lactose consultations.

The number of paid visits varies from option to option, and there is around the clock support for new mums.

Bonitas maternity and child care benefit

Bonitas covers ante- and postnatal consultations, 2D ultrasound scans, and amniocentesis. They also cover the cost of a private ward on some of the plans.

Childhood immunisations and paediatrician consultations are covered by the childhood care benefit, so too is a new born hearing screening, and congenital hypothyroidism screening.

The cost of the birth itself is paid from the hospital benefit.

At IFC, our medical aid consultants have in-depth knowledge of the leading medical schemes in South Africa, and the maternity benefits they provide. Call 021 593 3012 for the best advice or request a quote online