Medical aid: Not covered?


So you’ve just found out that you’re pregnant. You’re probably experiencing many different emotions at the moment –happiness, maybe shock, nervousness and, of course, worry. One of your main worries may involve finances, especially if you’re not currently on a medical aid. You’re still allowed to join a medical aid at this stage, but unfortunately, there’s no medical aid in South Africa that will cover your pregnancy and childbirth if you fell pregnant before joining the medical scheme, or any medical scheme. The reason for this is that it is general practice for medical aids not to cover any medical bills that are related to pre-existing conditions (so any medical condition you had before you joined the medical aid, such as being pregnant).

In the past, there were certain medical aids that would cover pregnant women. However, after many cases of women falling pregnant, joining a medical aid, getting the benefits during pregnancy and childbirth, and then cancelling their membership after the baby was born (ensuring that the medical aid saw no financial returns on the membership but in fact lost money), medical aid schemes stopped offering this cover.

It’s a good idea to sign up for medical aid now, regardless. Besides the fact that it is a good safety net in case you get sick or are in an accident, your baby will be covered the minute he or she is born. This could save you many years of paying off medical bills, especially if your baby is admitted to neonatal intensive care for any reason.

How to cope financially at this point

Without medical aid to help during pregnancy and childbirth, you need to think your choices through more carefully. Attending a government clinic that is in your area will allow you to be examined by midwives and also give you the benefit of ultrasound scans if they are needed. If you attend a government medical institution during your pregnancy, remember to make appointments well ahead of time, get there early, and be patient in queues.

Doing plenty of your own research regarding your pregnancy and listing all your questions will ensure you get the most out of your midwife appointment, and that will get you the right answers. If medically possible, opting for a vaginal birth at a government clinic or hospital will be your best option. If you need a c-section, however, the decision must be medically motivated, and the surgery will take place at a government hospital instead of a clinic.

Make use of free services such as the antenatal classes offered at your local clinic, and if you want to have a scan (perhaps to find out the gender), you could think about saving up and getting one privately if your clinic doesn’t offer this service.

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