Not sure who and what you will need for the birth? Is there a possibility that you might prefer a home birth, or a private hospital even though you are not a member of a health insurance scheme? Don’t leave it too long to decide. Whatever you decide, you’ll probably need to be part of a HMO plan or the NHS to cover your pregnancy and birth – and you can’t make that decision at the last minute!
If you do not belong to a Medical Aid Scheme you have the option of having your antenatal care, delivery and postnatal care at a state hospital. The Ministry of Health utilises the primary healthcare (PHC) approach in providing early and quality ante- and postnatal services. They also offer essential infant and child health services and nutritional advice. Antenatal service is free at local clinics, but tests and registration could come with charges.Your other option is to go to a private hospital – but then you’ll have to foot the bill up front.
It is important to think of what you want in advance, and know what model of birth care you want – whether it is natural, caesarean, water birth or hospital birth. Check with your medical scheme or any existing medical policy you have to ensure you’re covered. Remember that there might be other expenses that your scheme will not cover.
What does your Medical Aid cover?
It’s also important to understand what you are covered for at a private hospital. HMO's in Nigeria do pay for childbirth delivery costs. However, your scheme may not cover the rates of private doctors or specialists, who charge significantly higher cash rates these days. While you can be assured that you and your baby will be covered for the hospital’s bills in full on your medical aid, you have to be cautious about the bills from all the doctors involved.
Check that your private health cover includes any additional services that you or your baby may require in the event that something goes wrong.
All in all, it can be an expensive business. Depending on which private hospital you choose to have your baby and the rates of your obstetrician/ gynaecologist, anaesthetist and paediatrician.
Maternity support
Many medical schemes offer their pregnant members maternity support in the form of advice, guidance and information throughout their pregnancies. The best thing to do is to familiarise yourself with what is available to you through your medical scheme, and discuss these plans with a medical scheme consultant. This will help you to make the best choice when selecting a medical scheme plan for your mid- to long-term healthcare needs.
Choosing a scheme for your pregnancy
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Most South African medical schemes won’t cover you if you’re already pregnant when you join – thus you will be responsible for all your own pregnancy-related expenses.
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Just as you planned your pregnancy, plan your medical cover – join a medical scheme well in advance – to minimise the costs associated with pregnancy and childbirth.
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Assuming that you were already a member when you fell pregnant, your medical aid scheme will cover many of the basic costs associated with pregnancy and childbirth, such as hospitalisation, and – depending on the type of plan you have – maybe even certain antenatal benefits.
Benefits offered by medical schemes:
Depending on whether you have a hospital plan or a day-to-day medical plan, the costs of your confinement will be covered (though some may be subject to co-payments):
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Some medical schemes will contribute to the cost of foetal scans and certain antenatal blood tests even if you’re only on a hospital plan. Day-to-day plans may also cover antenatal visits, additional growth scans and, in some cases, a certain number of paediatrician visits following the birth.
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Some medical schemes offer cover for antenatal classes up to a set amount, and may also provide cover for home births, provided that a registered midwife is present.
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Regardless of whether or not your pregnancy was covered by your medical scheme, your baby will be covered from birth if you are a medical scheme member and have registered the baby’s birth.
Before you become pregnant
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Make sure your medical scheme includes obstetric-related services – if not, take out, or transfer to one that does.
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Draw up your budget
Once you are pregnant
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Choose your hospital and obstetrician
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Check that your chosen hospital is part of your medical scheme (although most hospitals accept all medical schemes – just check with your clinic if it is covered).
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Ask your obstetrician or any specialists involved in your treatment for a written quote of any “out of pocket” expenses you might have.
After your baby arrives
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Add your new baby to your health cover after birth
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Check what post-birth support services are available to you and your baby through your medical aid scheme.
