Medical aids will allow women who are pregnant to join the scheme. However, the childbirth costs for the current pregnancy will not be covered by the scheme. This is part of the pre-existing waiting period for pregnancy and applies to any medical condition that has been present from the time of joining the scheme. However, there are many good reasons for a pregnant woman to join a medical aid as the baby may still be covered as well as other non-pregnancy costs.
Pre-Existing Pregnancy Medical Aid Cover
Everyday scores of women in South Africa scramble to find a medical aid that will cover them for the current pregnancy and childbirth. Whether you are 1 week pregnant or 6 months does not matter. It is still a pre-existing condition. This does not mean that you cannot join a medical aid. Every scheme will accept any person of any age or health status if they can afford the monthly premiums.
However, this does not mean that you are automatically covered from day one of being accepted on a medical scheme. You will have to pay for the cover from day one but there are waiting periods in place, and for good reason. Therefore you should sign up for medical aid the moment you can afford its – even if you are young and healthy and will most likely not need any medical care anytime soon.
Desperate pleas and angry rants from expectant mothers wanting medical aid cover is neverending and is something that every medical aid in South Africa has to contend with. At one time, medical schemes did cover the pre-existing pregnancy’s costs if a woman joined in the first month or sometimes first trimester of pregnancy. However, many women would then leave the medical aid after pregnancy and childbirth cost’s were paid by the medical scheme.
This does not mean that you should not join a medical aid now if you can afford it, even though your current pregnancy will not be covered. Remember that future pregnancies will be covered once the 12 month pre-existing waiting period is over, and there is still your newborn baby to think about. He/she may need extensive medical care and without medical aid, it is either a matter of paying cash or going to a public hospital.
Alternative Options For Pregnancy Exclusion
There is no other financial product that will cover the cost of a pre-existing pregnancy. In fact there is no other product to match the benefits of medical aid. An alternative healthcare cover known as medical insurance is now being widely touted as a cheap alternative to medical aid. Hospital cash back plans, repackaged as hospital insurance or health insurance, is also being sold under this pretext.
However, South African consumers should not be misled. Neither medical insurance nor health insurance are medical aids. These alternative financial products do cover health-related eventualities but will not match the level of cover offered by medical schemes.
Neither products will cover a pre-existing pregnancy although they do have maternity benefits. Either way a private hospital or private practitioner will not accept medical insurance or hospital cash back plans as a guarantee of payment as medical aids are accepted. The only option is to pay for your current pregnancy and childbirth costs in cash, or opt for a government clinic/hospital.