Pensive pregnant woman holding her pregnant stomach

Maternity Medical Aid

WE WILL FIND YOU THE BEST MATERNITY BENEFITS

Click here for a
FREE call back

Are you looking for maternity medical aid cover or health insurance plans for pregnancy? Or maybe you’re looking for something more specific, like what medical expenses will be covered immediately when already pregnant?

WE CAN HELP YOU TO FIND MATERNITY COVER THAT BEST SUITS YOUR NEEDS.

Are you looking for maternity medical aid cover or health insurance plans for pregnancy?

FREQUENTLY ASKED QUESTIONS

All medical schemes, even if you are just on a hospital plan, cover child birth. The actual birth of the child is one of the biggest expenses you will have during this process. The cover for birth is robust, meaning you will not normally need extensive out of hospital benefits to ensure the most important pregnancy medical expenses are covered. This will include medical expenses for the gynae visits, GP or midwife consultation expenses. The expense of 2D sonars to monitor baby’s growth is also covered by your medical scheme.

Medical schemes like Bonitas, Discovery, Medihelp and Momentum have benefit options that allow expectant mothers to choose their preferred gynaecologist and the hospital where they would like to give birth. The birth plan, antenatal classes, pregnancy check-ups and childbirth options can be discussed with the gynae. To ensure you make the most of the pregnancy expenses paid by your medical scheme, familiarise yourself with your medical scheme benefits as well as the contracted gynaecologists used by your medical aid. Need assistance?

Most medical scheme options will include 2-Dimensional (2D) ultrasound scans to monitor the baby’s health. Ultrasound scans during pregnancy provide information for best planning the baby’s birth and helps the doctor’s to:

  • Check the baby’s growth throughout the pregnancy.
  • Find out if there is more than one baby.
  • Check and confirm the due date.
  • Confirm the sex of the baby. This can also be left as a surprise for parents if they so choose.
  • Look at blood flow patterns and find out the position of the baby.

Some medical schemes may offer 3D and 4D scans at an additional cost.

Antenatal classes provide a sense of community, information on childbirth options, and access to knowledge shared by experts about pregnancy, based on studies and facts. These classes help parents-to-be understand their rights during childbirth and may cover topics such as nutrition, exercise, and hypotension. While not essential, antenatal classes offer valuable support and information.

Postnatal care includes routine clinical examinations and observations of both the mother and the baby. Medical schemes may offer postnatal consultations for lactating (breastfeeding) specialists. Some schemes provide 24-hour nurse lines, telephonic triage (medical advice to determine if the baby needs urgent medical attention), and support for postnatal depression. Understanding available benefits and support is crucial during the postpartum period.

Additional benefits may include a baby program. Timely registration to the baby program provides access to additional benefits like doula support, 24-hour nurse lines, telephonic medical advice, and support for postnatal depression. Some schemes offer baby bags, live healthy pregnancy workshops, and community support through apps. These benefits contribute to the overall health and well-being of both the mother and the baby.

Members can access maternity benefits by registering for specific programs offered by their medical scheme. It’s essential to understand the options, cover, and any potential co-payments. Members should contact their scheme for hospital authorisation and follow any registration processes to ensure seamless access to benefits.

Maternity benefits are designed to support and care for both the mother and the baby during this special time. It’s crucial for members to be informed, proactive, and aware of the available resources and support provided by their medical scheme. Medical schemes are there to assist during the entire pregnancy journey, and exceptions and support are available for unique circumstances.

Some medical schemes offer support for postnatal depression through mental health programs and apps. These may include access to support groups, counselling services, and 24-hour helplines. It’s important for new parents to be aware of these resources and seek help if needed to ensure their mental well-being during the postpartum period.

Pensive pregnant woman holding her pregnant stomach

We have helped thousands of South Africans to find the right medical aid or medical insurance cover at the right price.

useful articles and resources
useful articles and resources

Making sense of
Hospital Plans

WE WILL FIND YOU THE BEST HOSPITAL PLAN

WE CAN HELP YOU TO COMPARE HOSPITAL PLAN PRICES OFFERED BY ALL MEDICAL SCHEMES IN SA.
Do you want information about Discovery Health, Momentum or Bonitas hospital plans? What about medical insurance with a hospital plan, or a hospital plan for pensioners?
Name:

Frequently asked questions

Hospital plan prices vary by age, benefits, and network. Entry-level options are typically lower, but may restrict your choice of hospitals and other healthcare providers, and will carry co-payments. Always compare hospital plan prices with the benefits table, not just the premium.
A hospital plan is a type of medical aid plan but, as the name suggests, you will only be covered for in-hospital treatment and PMB related situations. A full medical aid includes both hospital cover and out-of-hospital benefits. With medical aid, you get added cover for day-to-day medical expenses like GP visits, specialist consultations, prescribed medication, dental and optical care, and maternity check-ups (depending on the plan). Some options use a medical savings account or risk pools benefits to fund these costs. In contrast, a hospital plan won’t pay for any of these unless they’re linked to a PMB or part of an approved hospital admission. So, if you’re generally healthy and just want protection for big medical events, a hospital plan might suit you. But if you need ongoing care or have dependants, full medical aid offers broader peace of mind.
A hospital plan is a type of medical aid that covers you for treatment in hospital only. This includes major medical events like surgery, illness, accidents, childbirth, and other procedures that require hospital admission. It typically pays for things like the hospital stay, doctors and specialists who treat you in hospital, theatre fees, anaesthetists, and medication while admitted. Some hospital plans also include limited cover for maternity confinements (birth), and emergency care. However, a hospital plan does not usually cover day-to-day expenses like GP visits, antenatal check ups, scans, or dental work. You may need to use specific hospitals or providers (called DSPs) to avoid co-payments, and pre-authorisation is usually required for planned admissions.
Hospital plans, like all medical aids, do cover pre-existing conditions, but you may face a waiting period before those benefits kick in. There will be a 12-month condition-specific waiting period, which means the hospital plan will not pay for treatment related to that condition during the first year of membership. This applies whether it’s diabetes, hypertension, past surgeries, or pregnancy (if already pregnant when joining). After 3 months, you’ll be covered for Prescribed Minimum Benefits (PMBs) and emergencies as long as you follow scheme rules. Always disclose your full medical history when applying.
Yes, all registered medical aid hospital plans are legally required to cover the 26 Chronic Disease List (CDL) conditions under Prescribed Minimum Benefits (PMBs). This includes cover for approved chronic medication, as well as certain out-of-hospital services like GP or specialist consultations and routine diagnostic tests related to the condition. However, this cover follows a defined treatment plan, and you must use the scheme’s designated service providers (DSPs) to avoid co-payments. If you have a chronic condition outside the CDL list, or need additional treatment not covered under the PMB protocols, a hospital plan won’t fund it.
More affordable hospital plans often have a network of preferred hospitals and specialists. Choosing healthcare providers outside of this network might result in additional out-of-pocket expenses called co-payments. It’s advisable to check the list of approved hospitals and specialists within your plan’s network. It’s also advisable to add gap cover to your hospital plan to help cover any payment shortfalls for in-hospital specialist treatment.
Hospital plans for pensioners should prioritise a wide hospital network, manageable co-payments, and good chronic support (even if day-to-day is separate). Check age-rated premiums and whether your current doctors work at the network hospitals.
The best hospital plan in South Africa is the one that matches your hospital network, specialist rates, chronic needs, age, and budget. Compare network hospitals, co-payments, benefit limits, and any add-on day-to-day options before you choose.

JOIN AS A MEDXPERT USER FOR FREE AND UNLOCK SOLUTIONS TO ALL YOUR MEDICAL AID QUESTIONS ALONG WITH THE ABILITY TO COMPARE HEALTH COVER BENEFITS

Join Here