5 Best Hospital Plans for Pregnancy Coverage
The 5 Best Hospital Plans for Pregnancy Coverage in South Africa revealed.
We tested them side by side and verified their hospital plans.
This is a complete guide to the best hospital plans for pregnancy coverage in South Africa.
In this in-depth guide you’ll learn:
- What is a Hospital Plan?
- How does pregnancy coverage work?
- Which hospital plan has no waiting period for pregnancy coverage?
- Do hospital plans offer maternity cover when you’re already pregnant?
- Best hospital plans for already pregnant women?
So if you’re ready to go “all in” with the best hospital plans for pregnancy coverage in South Africa, this guide is for you.
Let’s dive right in…
Best Hospital Plans for Pregnancy Coverage (2023)
|🩺 Medical Aid||✔️ Offers Plans for Pregnancy Coverage?||⚕️ Plan Offered||👉 Sign Up|
|1. FedHealth||Yes||flexiFED Savvy||👉 Apply Now|
|2. Discovery Health||Yes||Discovery KeyCare Plan||👉 Apply Now|
|2. Momentum Bloom||Yes||Ingwe Student Option||👉 Apply Now|
|4. BestMed||Yes||Network Plans||👉 Apply Now|
|5. Bonitas||Yes||Boncap Student||👉 Apply Now|
5 Best Hospital Plans for Pregnancy Coverage Summary
- Fedhealth Medical Scheme – Overall, Best Hospital Plans for Pregnancy Coverage
- Discovery Medical Scheme – Top Extensive Health Protection in South Africa
- Momentum Bloom – Broadest Range of Low-Cost Hospital Plans
- BestMed Medical Scheme – Best Customer Service Medical Aid
- Bonitas Medical Aid – Best Pay-As-You-Go Private Healthcare
Introduction to Hospital Plans Suitable for Pregnant Persons
In the event that you are involved in an accident and require immediate medical attention, a hospital plan will pay for any necessary operations that are carried out in a private hospital on your behalf.
In the event that you require coverage for medical attention that is provided outside of a hospital, such as seeing your primary care physician, going to the dentist, or obtaining new glasses at the optometrist, a hospital plan will not cover these expenditures; however, a medical aid plan would.
As a result of this differential, hospital plans are far more affordable than complete medical aid plans, given that you receive a significantly lower level of coverage.
In order to be eligible for coverage under a hospital plan, you will need to pay a monthly premium. This premium will pay for the medical care you get while an in-patient in a private hospital. Outside of the hospital, you would be responsible for paying for any medications or medical appointments.
In the event that you need to go into the hospital for a treatment that has been pre-planned, you will be required to obtain authorization from the provider of your hospital plan in advance. If the surgery is an emergency, however, your provider will make arrangements for your admission directly with the hospital.
Discover what is the advantages of Maternity Cover
What Pregnancy-Related Costs Does a Hospital Plan Cover?
An in-hospital delivery will incur hospital-related expenditures, such as those for the operating room, X-rays, and blood tests; these costs will be covered by a Hospital Plan. Due to the fact that maternity cover is a cost that is incurred only once, there are Medical Aid plans that also include certain out-of-hospital maternity benefits.
Also, keep in mind that a hospital plan is exactly what it sounds like: a plan for hospitals. Your health insurance will most likely not pay the cost of giving birth at a location that is medically speaking not a hospital if you choose to give birth in that location.
Does a Hospital Plan Cover Pregnancy Complications?
It is reasonable to anticipate having between 10 and 12 appointments throughout a healthy pregnancy in order to complete the numerous exams and inspections that are required. On the other hand, if you have any issues throughout your pregnancy, your obstetrician may recommend more frequent check-ups and additional testing to ensure both your well-being and that of your unborn child.
Complications or having to take further precautions can be caused by a wide variety of different circumstances, and the necessity for additional treatments might vary greatly. For instance, if you are overweight or underweight throughout your pregnancy, or if you have pre-existing health concerns such as diabetes or hypothyroidism (an underactive thyroid), you may also need to see a dietician to ensure that you are eating the appropriate foods for your condition. This may be done by consulting with a professional.
If you are admitted to the hospital, you will incur medical fees, and having a hospital plan can help you pay for those charges. Your plan will contribute a predetermined amount towards the costs of your admission, stay, medical bills, and any other expenses that are incurred. Not all hospital plans are made equal; some offer more comprehensive benefits and require less co-payments, while others have more stringent regulations, exclusions, and caps on coverage.
It is essential that you are aware that hospital plans will only reimburse you for costs incurred while you are a patient at the affiliated medical facility. Out-of-hospital charges, such as visits to your primary care physician and acute medication, will be your responsibility to pay for financially. Even if you are not currently hospitalised, all medical aid plans, including hospital plans, are required by law to include prescription coverage for a set list of 27 chronic conditions that are included in the Medical Schemes Act as Prescribed Minimum Benefits (PMBs). This is the case regardless of whether or not you are hospitalised.
You will need to acquire pre-authorization from your provider before you may be admitted to the hospital, unless the situation is an emergency, in which case the hospital will arrange admittance with your physician on your behalf.
A general waiting period of three months, during which time no claims will be paid, and/or an exclusion term of twelve months for any pre-existing medical disorders are both allowed to be imposed by any and all medical assistance. There are no prerequisites or holding periods required to be hospitalised due to an accident. In addition, benefits will not be given out if the beginning date of the hospitalisation occurs during the waiting period, and the hospitalisation continues beyond the end of the waiting period.
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Hospital Plans Suitable for Pregnancy Coverage
Birth is the most expensive part of any pregnancy. For labour and delivery, you have to stay in the hospital and see experts like a gynaecologist, an obstetrician, and a doctor for the baby. Both the mother and the baby will need to stay in the hospital for at least a few days after the birth.
Private hospitals in South Africa are very expensive, and most people cannot afford them. This is where the hospital coverage in medical aid cover is most helpful. But a hospital plan will not pay for a woman’s childbirth costs if she is already pregnant when she signs up, and there is no way to get around this rule.
If your hospital plan does not cover all of your costs, you may need gap cover, which pays the difference between the medical aid rates and the higher fee charged by the hospital. So gap cover is something you add to your current medical aid or hospital plan.
Discovery Health, Momentum, Medihelp, KeyHealth, Profmed, Bestmed, Bonitas, Health Squared, Medshield and Fedhealth may all provide sensible options for you.
Note that although there is no immediate cover for pregnancy and childbirth costs if the member is already pregnant, it does not mean that a pregnant woman cannot join a medical aid and opt for a hospital plan. A hospital plan does cover the pregnant women but just not for the pregnancy and childbirth costs for that pregnancy only.
Moreover, the new-born baby will be covered instantly providing protection for the parents if there are costly bills like neonatal ICU hospitalisation.
Read more about Medical Insurance for Pregnancy in South Africa
1. Fedhealth Medical Scheme
Fedhealth’s hospital plans are innovatively designed to give more control over how cover is structured.
FedHealth offers benefits like:
- Private in-hospital cover
- Generous maternity and childhood benefits
- Three ways to structure day-to-day benefits on our flexiFED options
- Unique benefits paid from Risk like trauma treatment at a casualty ward
- Upgrades to a higher option any time of the year when life happens, like a pregnancy
Fedhealth Hospital Plans suitable for pregnancy coverage are:
flexiFEDSavvy brings you one of the most affordable hospital plans in the market with the flexibility to use it as a savings plan. It is a personalised, customised and affordable hospital plan with a day-to-day back-up plan and costs from R 945 per month.
flexiFED 1 is an affordable hospital plan that gives medical aid cover at a great price with access to Fedhealth Savings powered by the MediVault to help cover unexpected day-to-day medical bills. A valuable Threshold Benefit kicks in once your claims have reached a certain level. It costs from R 1 583 per month.
flexiFED 2 is the ideal hospital plan if you’re just starting your parenting journey, with generous maternity and childhood benefits. Fedhealth Savings give cover for unexpected day-to-day medical bills, and a Threshold Benefit that kicks in once claims have reached a certain level. It costs from R 2 196 per month.
flexiFED 3 is ideal for young, growing families, with generous maternity and childhood benefits for pregnancy, birth and those busy early childhood years, for from R 2 508 per month.
2. Discovery Medical Scheme
Discovery Hospital Plans range from the most comprehensive and expensive private healthcare cover to basic and more affordable with cost-effective private healthcare cover through a network of providers.
You can get access to comprehensive maternity and post-birth benefits which are covered from a Maternity Benefit at the Discovery Health Rate. This cover does not affect your day-to-day benefits and depends on the plan you choose:
You can look at up to 12 Antenatal consultations at your gynaecologist, GP or midwife, ultrasound scans and prenatal screening including up to two 2D ultrasound scans and one nuchal translucency or Non-Invasive Prenatal Testing (NIPT) screening – subject to clinical entry criteria, a defined set of blood tests per pregnancy, and up to five pre- or postnatal classes or consultations with registered a nurse, up until two years after birth.
3. Momentum Bloom
Bloom Hospital Plan provides affordable private healthcare by Momentum as trusted partner.
It is an entry-level option that offers high-quality and fairly priced private healthcare that includes the following maternity benefits:
- 1 Foetal growth 2D scan per member per pregnancy
- Antenatal pathology tests linked to a Network GP visit and referred by a Network GP, according to the applicable Health4Me pathology list
- Antenatal vitamins provided in accordance with the Network prescribed acute medication formulary. Relevant rules and protocols are applied and pre-authorisation is required.
Other benefits include:
- GP visits – Unlimited Network GP visits per member per year. Network GP visits can either be face-to-face or video call (virtual) consultations
- GP in room procedures – Minor medical procedures performed as part of a Network GP consult in rooms, such as stitching of wounds and nebulisation
- Hello Doctor – Hello Doctor consultations are unlimited and can either be chat, phone call or video call (virtual) consultations
- Acute medication – Provided in accordance with the Network prescribed acute medication formulary. Rules and protocols apply
- Basic pathology – Unlimited when linked to a Network GP visit and referred by a Network GP, according to the applicable Health4Me pathology list
- Basic radiology – Unlimited cover for black and white x-rays, when linked to a Network GP visit and referred by a Network GP, according to the applicable Health4Me radiology list
4. BestMed Medical Scheme
BestMed has a track record of providing young families with access to a network of healthcare specialists, wellness benefits, and cost-effective healthcare coverage options.
All of its alternatives offer young parents significant benefits for preventative healthcare, such as contraception for women, maternity benefits, treatment for pneumonia, vaccinations against influenza, and a variety of other options.
The Bestmed Maternity Care programme, which is accessible for all coverage plans, gives young expectant mothers and fathers access to a plethora of information and services pertaining to pregnancy and childbirth.
Young parents can choose between BestMed Hospital Plans, Network Plans, Savings Plans, and Comprehensive Plans.
BestMed Savings Plans are good options for young parents, since they include extensive hospital cover at private hospitals and a savings account out of which general day-to-day expenses are paid.
The following options are available:
The Network Savings plans are associated with certain Network hospitals and providers.
BestMed Comprehensive Plans are the most expensive in terms of monthly premiums.
Young families who can afford it, may choose from the following:
- Pace1 Comprehensive Plan
- Beat4 Comprehensive Plan
- Pace2 Comprehensive Plan
- Pace3 Comprehensive Plan
- Pace4 Comprehensive Plan
5. Bonitas Medical Aid
Bonitas’ extensive selection of plans are designed to be simple to use while also maximising your benefits. Bonitas is there for young families looking for first time medical insurance.
Bonitas Medical Aid Hospital Plans suitable for pregnancy cover are:
Young healthy adults can also opt for hospital plans, that cover them for emergency and planned procedures in hospital and access to some additional benefits for wellness and preventative care. These options include the Hospital Standard, BonEssential and BonEssential Select plans – the latter using a quality provider network that offers comprehensive hospital benefits.
This category gives access to day-to-day benefits including unlimited GP consultations, layers of virtual care, dental and optical consultations, a private hospital network and more. BonStart Plus is designed for young, economically active couples, living in the larger metros, and looking to expand their family.
The traditional plans are suitable for young families who are already more settled and financially independent. The give an overall day-to-day limit with sub-limits for GP and specialist consultations, acute and over-the-counter medicine, X-rays and blood tests and other out-of-hospital medical expenses. Options include a Standard, Standard Select, Primary and Primary Select plan.
Young parents can also consider one of Bonitas’ Saving plans that cover you while you’re in the hospital and give you extra benefits for maternity, wellness, and preventative care.
The options are called BonFit Select, BonSave, BonComplete, BonClassic and BonComprehensive
This savings options offer sufficient savings to use for medical expenses and extensive hospital cover, with BonComprehensive being a first-class savings plan that offers ample savings, an above threshold benefit and the best hospital cover.
Frequently Asked Questions
Can you get a hospital plan while pregnant?
Yes, you can get a hospital plan while pregnant. Although there will be no immediate cover for pregnancy and childbirth costs, a pregnant woman is covered otherwise, just not for the pregnancy and childbirth costs for that pregnancy only.
Do hospital plans cover giving birth?
A hospital plan covers the hospital account, internal medical devices and emergency medical services. Hospital cover may include home births done by registered midwives with valid practice numbers. You need to pre-authorise your delivery.
How does a hospital plan covering pregnancy work in South Africa?
Hospital plans in South Africa frequently offer particular maternity benefits that pay for costs associated with pregnancies. These benefits often cover prenatal care, labor and delivery in a hospital, and postpartum care. Depending on the particular hospital plan and medical plan, the precise coverage and limits may change. It’s important to keep in mind that hospital plans often concentrate on providing care within the hospital, so costs associated with consultations and treatments received outside of the hospital setting could not be reimbursed.
Is there a waiting period for a hospital plan that covers pregnancy?
Yes, generally hospital plans that cover pregnancy will include waiting periods. In South Africa, waiting periods are sometimes enforced by medical systems to stop people from enrolling in a plan merely to instantly claim for certain treatments or ailments.
Can you give birth at a private hospital without a medical aid?
Yes, you can give birth at a private hospital without a medical aid but you will have to pay a large deposit or even the entire delivery package fee upfront.