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Image of a pregnant woman lying on the grass for an article on the moneysmart community about medical aid options for pregnant women in South Africa

What to Expect When You’re Expecting: Medical Aid Pregnant Case Study

11/03/2013 • • by
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You just found out you’re pregnant and are so excited! HOWEVER, you do not have medical aid to cover the pregnancy and the delivery. What now?! In this case study we look at 2 pregnant ladies in the same boat: Both in their mid-20’s with no major health concerns, and both currently NOT on medical aid. Mommy 1 has never been on a medical aid. Mommy 2 was on a medical aid for more than 24 months, but cancelled her medical aid 2 months ago. Will a medical aid cover a pregnant woman who wishes to join the scheme? Yes and no! MOMMY 1 Unfortunately for Mommy 1 no new scheme will cover her pregnancy as (according to law) if a person has not been on a medical aid before, the scheme does not have to cover a pre-existing condition for a period of 12 months. Her only solution is to fund the pregnancy and confinement herself BUT she should consider joining a medical aid in any event so that baby is covered from day 1 (in case of complications at birth). MOMMY 2 There is good news for Mommy 2 as she has been on a medical aid continuosly for more than 2 years with a break in cover of less than 90 days. The new scheme will impose a 3-month general waiting period, after which the pregnancy will be covered in full. She must apply as soon as possible for cover so that she is still within the “less than 90 days” break in cover. Her baby might also arrive early or there might be complications that need to be covered for. The Maternity Benefits Under Various Medical Aids Most medical schemes will only cover the IN-HOSPITAL benefits linked to the birth of your baby (also known as confinement). Day-to-day expenses incurred during your pregnancy such as gynaecologist visits and sonars would be from your own pocket on a hospital plan or from your savings if you have a savings option. There are a few schemes that offer SEPARATE MATERNITY PROGRAMMES, which do not affect your savings or your pocket. Looking at the schemes that I deal with regularly, the best valued maternity programmes are offered by Bonitas, Medihelp and Momentum. Bonitas has slightly different maternity benefits on the different options, so I have only picked 2 of these options for the comparison below. Also note that most schemes which offer network options, such as Discovery’s Keycare Plan and Bonitas’ Boncap, also have limited maternity benefits. Below is a comparison of the maternity benefits offered under the mentioned schemes and the relevant costs: 
Scheme 

Image of Bonitas Icon

Image of Bonitas Icon

Image of Medihelp icon

Image of Momentum logo for an article on medical aid in South Africa on the moneysmart community

Option

Bonitas Standard

Bonitas BonEssential

Medihelp Most options

Momentum Most options

Principal Member

R 1 973.00

R 979.00

R 1 026.00

R 914.00

Adult Dependant

R 1 707.00

R 749.00

R 834.00

R 691.00

Child Dependant

R 577.00

R 287.00

R 306.00

R 323.00

Maternity R900 antenatal classes 12 antenatal consults 2 x 2D scans 4 postnatal midwife consults Infant Paediatric Benefit: 2 consults before age 1 2 consults between 1 - 2 years 6 antenatal consults 2 x 2D scans 4 postnatal midwife consults   Infant Paediatric Benefit: 2 consults before age 1 1 consult between 1 - 2 years 12 gynae/GP visits 2 x 2D scans Infant Paediatric Benefit: 2 paediatric visits in baby's 1st year 12 gynae/GP visits 2 x 2D scans (one before 24th week and one after) Infant Paediatric Benefit: 2 paediatric visits in baby's 1st year
  moneysmart tips for women who fall pregnant without any medical aid: 
  1. Plan carefully and save as much money as you can.
  2. You do not need to go to the gynaecologist every month UNLESS there are complications.
  3. Phone a few hospitals to find out about affordable delivery packages.
  4. Some GP’s can also do the necessary maternity checks (urine test, blood pressure, heart rate), so consider the savings in going this route for at least the first few months.
  For any medical aid queries or advice, please feel free to email Nelda directly or tel. (021) 975-8324. Alternatively you can find further information form the medical aid schemes' websites:
  • Bonitas Medical Fund (http://www.bonitasmedicalfund.co.za/)  or telephone:  (0860) 002 108
  • Momentum Health (https://www.momentum.co.za/for/you/products/health) or telephone: (0860) 117 859
  • Medihelp (https://www.medihelp.co.za/) or telephone (0860) 100 678 

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