Pregnant? Which Medical Aid?

Plan ahead for a worry-free pregnancy.

The important thing to do, if you are planning to fall pregnant, is making sure you are on a medical aid first. Most will not provide cover if you fall pregnant before joining the scheme. This could result in you facing a large medical bill for treatment during pregnancy and the delivery or using public healthcare to reduce the costs.

Most medical aids in South Africa will provide expenses for checkups and treatment during your pregnancy, hospitalisation and delivery and some antenatal benefits. That is, provided you were on the plan before falling pregnant. Joining a plan after falling pregnant could mean you are subject to exclusions or a waiting period.

The scheme can impose a general waiting period of 3 months and a specific waiting period of 12 months in the case of pregnancy. This means that you will not be covered. This is a standard practice and covered by the medical schemes act.

Potential Costs

Apart from treatment and checkups during the pregnancy, the delivery can cost in excess of R 30 000 for a normal birth in a private hospital in more than R 45 000 should you require a caesarian section.

What is also important to do is to decide which hospital you wish to use for the delivery. Some schemes on some medical aids will restrict you to a particular hospital group. Make sure this fits in with your plans.

When comparing medical aid options for a pregnancy it is important to do your homework and get good advice. Some plans will, for example, require a co-payment for confinement and other aspects of the birth. Make sure you are aware of these costs and plan and budget accordingly.

Antenatal blood tests, fetal scans and pediatrician visits are some of the other expenses you might need to cover. Check the cover on these and other antenatal expenses beforehand so that you know exactly what I covered and what is not.

Fortunately, the baby will be covered from birth even if you joined the scheme late and the delivery was not covered. Just confirm the extent of the cover.

If you are considering falling pregnant, it is important to plan ahead. Investigate and understand the various medical aid options before you fall pregnant. Find a plan that suits your needs and budget to ensure a stress-free pregnancy and delivery.