Pensive pregnant woman holding her pregnant stomach

Maternity Medical Aid

WE WILL FIND YOU THE BEST MATERNITY BENEFITS

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

Compare
Medical Aid 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

A health insurance plan is an FSCA-regulated policy that pays fixed benefits rather than covering the full cost of
treatment. It usually includes access to primary care such as GP consultations, basic dentistry, optometry and
telemedicine through a contracted network. Many plans also offer accident benefits, emergency stabilisation and set
payouts for hospital stays. Because benefits are capped, the insurer pays the predetermined amount and the member
covers any shortfall. Health insurance is often used as an affordable alternative or as a complement to medical aid,
but it’s important to remember that medical insurance is not a replacement for medical aid.

The best app or tool to compare health insurance should show side-by-side benefits, hospital networks, chronic lists,
and real co-payment examples. Pick a South African comparison tool like MedXpert’s that lets you filter by budget,
benefits, and preferred hospital network.

To best compare health insurance plans, start with your must-haves (hospital network, chronic needs, maternity) and
shortlist 2–3 options. Check waiting periods, DSPs, pre-authorisations, and excesses to avoid surprises at claim time.

A medical aid plan is regulated by the CMS (Council for Medical Schemes) and must comply with the Medical
Schemes Act, including funding PMBs and paying for hospital and specialist treatment according to medical tariffs. It
typically covers hospital admissions, specialist consultations, theatre and ICU costs, diagnostics and chronic
medication. Depending on the option, it may also include GP visits, dental and optometry benefits and day-to-day
medical care. Medical aid pays for actual clinical services rather than fixed amounts, offering stronger protection for
major medical events.

The main difference is how they are regulated and how they pay benefits. Medical aid is governed by the Council for
Medical Schemes (CMS) and must cover Prescribed Minimum Benefits (PMBs) and pay for treatment according to
medical tariffs. It funds the actual medical care you receive in hospital or from a doctor. Health insurance, regulated
by the Financial Sector Conduct Authority (FSCA), pays fixed cash benefits for specific events such as GP visits,
accidents or a set hospital amount. It does not have to cover PMBs and does not pay according to what the provider
charges. Medical aid focuses on full clinical treatment, while health insurance provides defined, capped benefits.

When you compare medical plans, look for: network hospitals, specialist rates (e.g., 100% vs 200%+), co-payments,
chronic cover, oncology limits, maternity, and ambulance benefits. Then weigh premium vs risk of out-of-pocket
costs.

Some plans include online/virtual doctor consultations via partner networks. Check if tele-health visits are included,
how many per year, and whether scripting/dispensing is supported.

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