5 Best Medical Aid/Insurance for Pregnancy in South Africa
The 5 Best Medical Aids for Pregnancy in South Africa revealed.
We tested them side by side and verified their medical aid plans for pregnancy in South Africa.
This is a complete guide to the best medical aid under R1000 in South Africa.
In this in-depth guide you’ll learn:
- What is a Medical Aid?
- How do you find affordable medical aid for pregnancy in South Africa?
- Which medical aid has the most maternity benefits?
- Which medical aid covers pregnancy immediately?
- How to compare medical aids against each other?
- Which medical aid is best if you are already pregnant?
So if you’re ready to go “all in” with the best medical aid for pregnancy in South Africa, this guide is for you.
Let’s dive right in…
Best Medical Aid/Insurance for Pregnancy (2023)
|🩺 Medical Aid||✔️ Offers Plans for Pregnancy?||⚕️ Plan Offered||💵 Pricing||👉 Sign Up|
|1. Discovery Health||Yes||Discovery KeyCare Plan||R930 per member per month||👉 Apply Now|
|2. Bonitas||Yes||BonComprehensive Plan||R2 033 per member per month||👉 Apply Now|
|3. BestMed||Yes||BestMed Beat1 Network Hospital Plan||R1 710 per member per month||👉 Apply Now|
|4. Momentum Medical Aid||Yes||Evolve Option||R1 539 per member per month||👉 Apply Now|
|5. FedHealth||Yes||myFED Option||R1 275 per month per member||👉 Apply Now|
5 Best Medical Aid/Insurance for Pregnancy (2023)
What medical aid and insurance schemes cover pregnancy
👉 Even with medical aid, prenatal care is a major pregnancy expense. Consultations with a gynaecologist, general practitioner, or midwife may be covered by your Medical Aid (at medical aid rates), and you may also be eligible for benefits for diagnostic procedures including ultrasounds, blood work, and pregnancy tests.
👉 Verify your medical aid’s coverage details. Moms-to-be should select a health plan that either covers all of their medical expenses or includes hospitalisation as a primary option (complicated or not).
👉 Your necessary prenatal appointments and the cost of giving birth in a hospital would both be covered by a medical aid plan with full coverage. The prenatal appointments are also included (again, at Medical Aid rates).
👉 Most of your non-hospital costs will be covered by your health savings account if you have a comprehensive plan. Gap Cover is something to consider if your hospital specialist’s fees exceed the amount covered by your medical aid plan.
👉 Several medical aid schemes will pay for a home delivery and the services of a registered midwife if the mother requests them.
👉 Pregnancies without difficulties often require between 10 and 12 visits to the doctor for various screens and exams. But, if you and your unborn child experience any issues, you may need to increase the frequency of your trips to the OB and the number of standard tests you undergo.
👉 There are several potential causes of complications or the necessity for extra precautions, and a wide range of additional therapies may be called for.
👉 You may want to consult a nutritionist to make sure you’re getting the nutrients you need throughout pregnancy if you’re dealing with complications like diabetes or hypothyroidism (an underactive thyroid) because of your weight or other health issues.
👉 Keep in mind that a hospital plan is designed specifically for use in hospitals. It’s unlikely that your hospital plan will cover giving birth outside of a hospital.
Getting medical aid if you are planning on falling pregnant
👉 A medical aid plan cannot reject a pregnant woman who asks for coverage, but that doesn’t mean you’ll be covered right away.
👉 Depending on your prior coverage history, the medical aid scheme may require you to wait anywhere from three months to a year before receiving any benefits if you are pregnant at the time you apply.
👉 That’s why you should get medical aid to cover your ongoing healthcare needs, not just one unexpected bill.
👉 If you want to start a family soon, you should look for the most affordable option that meets your needs.
👉 So that you can select a cost-effective plan that doesn’t skimp on quality, it’s important to analyse the many perks that fall within your price range. That’s why it pays to get medical aid price estimates from multiple schemes.
Choosing a medical aid for pregnancy
👉 While giving birth is a natural physiological process, it can have significant financial implications. It’s possible that you’ll have to pay for antenatal consultations, scans, and follow-up appointments in addition to the expenditures related to giving birth.
👉 Complications during childbirth, which may necessitate extra surgeries like a C-section or episiotomy, or neonatal intensive care for a new-born, can drive the cost of delivery much over the R27,500 threshold that is considered typical.
👉 The financial stress will be greatly reduced with medical aid coverage. Read more about the best medical aids for females
👉 Pregnancy is considered a pre-existing condition by most medical aid plans. So, you will not be covered for pregnancy and delivery during the first year of your membership in the scheme.
👉 When receiving medical care in South Africa, even if you have been a member of a medical aid plan for more than a year, you may be responsible for paying the difference between what your medical aid is willing to cover and what health care providers actually charge.
👉 Doctors that specialise in treating specific conditions, such as obstetricians, anaesthesiologists, and paediatricians, typically have rates that are far higher than those listed on the NHRPL.
👉 Your out-of-pocket costs during pregnancy will depend on the extent of the maternity coverage included in your medical aid package.
👉 Discover Health Insurance for Pregnancy
1. Discovery Health
👉 Discovery Health Medical Scheme is a top choice for medical aid in South Africa. As long as they comply with its guidelines, the Scheme is open to everybody, including pregnancy women.
👉 More than twenty different plans are available from Discovery Health Medical Scheme, and they’re all fantastic for families because they offer at least some coverage for private hospitals and a wide variety of other benefits.
👉 Due to the flexibility of these programmes, families can get the help they need whenever it’s needed, from a wide range of specialists.
👉 When compared to the average South African medical aid plan, Discovery’s premiums are 14.9% higher but provide the same amount of coverage.
👉 There is also the Vitality wellness programme, which offers incentives like subsidised gym memberships and healthy meals to people who commit to leading healthier lives.
👉 A Board of Trustees, independent from the Scheme, manages the fund on behalf of the members.
👉 Discovery Health (Pty) Ltd., an unrelated financial services firm, oversees the company. All of Discovery Health Medical Scheme’s rules and regulations are derived from the Medical Schemes Act and the Council for Medical Schemes.
Discovery Medical Aid Option Plans Suitable for Pregnancy
👉 The Discovery option gives you a choice between high-priced, all-inclusive private medical aid and lower-priced, all-inclusive private medical aid through a more limited network of providers.
Discovery Health maternity benefit
👉 Prenatal care, delivery, and paediatric care are all specifically covered by Discovery Health’s maternity section. Consultations with a gynaecologist, general practitioner, or midwife are all covered, as are prenatal tests, blood work, and ultrasounds.
👉 Top option members and their beneficiaries are covered for the full cost of a private room and all necessary medical equipment.
👉 Consultations with a general practitioner or paediatrician, a midwife or gynaecologist after birth, and help with breastfeeding, mental health, and lactose intolerance are all part of the new baby’s first two years of life’s worth of benefits.
👉 Support for new mothers is available around the clock, and the amount of paid visits they receive varies depending on the plan they choose.
How Much Are Discovery Medical Aid Monthly Premiums?
👉 Monthly premiums start from R930 per member for the KeyCare Series with medical cover for both in-hospital and out-of-hospital treatment by providers in a specified network and goes up to R8 298 per member for the Executive Plan with extensive cover for in-hospital and day-to-day benefits, extended chronic medicine cover, and unlimited Above Threshold Benefit.
What Is the Waiting Period for Discovery Medical Aid’s Benefits?
👉 Discovery Health Medical Scheme’s general waiting period is 3 consecutive months and the condition-specific waiting period is 12 consecutive months.
How to Claim for Discovery Medical Aid Benefits
👉 You can submit a claim fast and easy in the following ways:
➡️ Scan and upload your claims on the website.
➡️ Scan and email your claims to [email protected].
➡️ Use the Discovery app on your smartphone. If the claim has a QR code, scan the QR code or alternatively take a photo of the claim from within the app.
➡️ You can also submit your claims by post.
Discovery Medical Aid Contact Details
PO Box 784262,
Phone: 0860 99 88 77
👉 Around 40 years into its existence, Bonitas has already made a name for itself as a pioneer in South Africa’s private healthcare industry.
👉 That’s why they’re always looking for novel ways to cut costs without compromising the service they provide to clients. Among other things, this involves keeping an eye on developments in the field, monitoring care to prevent the chronicity of lifestyle diseases, and bargaining for cost reductions.
👉 If you and the other 700,000 individuals the organisation assists take use of its reasonably priced services and vast network of highly trained medical specialists, you may be able to keep your health in check with less financial pressure.
👉 You and your loved ones can choose the ideal plan among Bonitas’ many options. The programmes are designed to be as user-friendly as feasible without compromising the superiority of the aid they render. If you are in the market for your first medical aid plan, Bonitas is a strong contender.
👉 With over R6 billion in the bank, it would appear that the corporation is financially stable.
👉 Bonitas knows it must cultivate genuine relationships with its customers if it is to continue prioritising the wants and needs of its members and acting in a customer-centric fashion. Three separate surveys have all remarked on the exceptional quality of service provided by Bonitas Medical Fund.
👉 Bonitas’ leaders are seasoned professionals, and the non-profit is governed by a Board of Trustees comprised of individuals with backgrounds in health, law, finance, and business.
👉 The index ranks companies across 31 distinct sectors based on how well they deliver on 10 essential service criteria.
Bonitas Medical Aid Option Plans Suitable for pregnancy
👉 Bonitas offers excellent maternity benefits suitable for pregnancy.
Bonitas maternity and childcare benefit
👉 Throughout pregnancy, Bonitas will pay for prenatal and postnatal appointments, as well as 2D ultrasounds and amniocentesis. Some plans even include coverage for a private hospital room.
👉 The children care benefit pays for things like vaccinations, visits to the paediatrician, and screenings for things like congenital hypothyroidism and new-born hearing loss.
👉 The hospital benefit covers the expenses associated with the delivery itself.
How Much Are Bonitas Medical Aid Monthly Premiums?
👉 Bonitas monthly contributions start at R 2 033 for a Principal Member, R 1 555 for a spouse/adult dependant and R 596 per child (max 3) on the BonEssential Hospital Plan and go up to R 8 217 for a main member, R7 749 for additional adult, and R 1 672 for a child for the BonComprehensive plan that offers abundant savings, an above threshold benefit and extensive hospital cover.
You might also like to consider the following plans Bonitas has to offer:
- Bonitas Standard Medical Aid Plan
- Bonitas Primary Select Medical Aid Plan
- Bonitas Primary Medical Aid Plan
- Bonitas Hospital Standard Medical Aid Plan
- Bonitas Standard Select Medical Aid Plan
- Bonitas BonStart Plus Medical Aid Plan
- Bonitas BonStart Medical Aid Plan
- Bonitas BonSave Medical Aid Plan
- Bonitas BonFit Select Medical Aid Plan
- Bonitas BonEssential Medical Aid Plan
- Bonitas BonComprehensive Medical Aid Plan
- Bonitas BonComplete Medical Aid Plan
- Bonitas BonClassic Medical Aid Plan
- Bonitas BonCap Medical Aid Plan
What Is the Waiting Period for Bonitas Medical Aid Benefits?
👉 The minimum general waiting period for Bonitas medical aid is three months for all benefits. Some plans, however, have a waiting period of 12 months, especially regarding a pre-existing condition.
How to Claim for Breast Reduction Benefits from Bonitas
👉 You can send in your claim in the following ways:
➡️ Email your claims to [email protected].
➡️ Post your claims to Bonitas Claims Department, PO Box 74, Vereeniging, 1930.
➡️ Submit your claims in person at one of the walk-in centres.
👉 Follow these simple steps to get your claims paid quickly:
➡️ Ensure your banking details are correct for refunds by electronic transfer (EFT) into your bank account
➡️ Make sure that your account and receipt show your name and initials, membership number, treatment date, the name of the patient as shown on your membership card, amount charged and ICD-10 code.
Bonitas Contact Details
34 Melrose Blvd, Birnam
Phone for General Queries: 0860002108
Email: [email protected]
Email: [email protected]
👉 Almost one million people in South Africa are covered by BestMed, making it one of the country’s major private medical aid providers.
👉 BestMed’s mission is to run a business big enough to make a real difference in the lives of the individuals they serve, but small enough to know the names of those served and to respond rapidly to consumer input.
👉 BestMed is predicated on the idea that people have very different healthcare needs based on factors including their age, marital status, family size, health, preferences, and financial capabilities.
👉 BestMed offers three primary care plans, each with its own unique combination of perks and insurance options.
👉 BestMed offers a wide range of medical aid plans, from full coverage to more limited plans that only pay for inpatient care.
BestMed Medical Aid Option Plans Suitable for pregnancy
👉 BestMed offers excellent maternity benefits suitable for pregnancy and the journey through childcare.
BestMed maternity and childcare benefit
👉 When you find out you’re going to be a parent for the first time, you have every reason to rejoice and a newfound motivation to ensure your family’s financial security. Because of this, BestMed provides superior care and advantages to new parents so that they can relax and enjoy the exciting new chapter in their lives.
👉 All 12 choices are covered by BestMed’s maternity coverage. These maternity benefits can include, depending on the plan you select:
➡️ Consultations with your gynaecologist, GP, or midwife
➡️ 2D ultrasound scan at 1st trimester with your gynaecologist, GP, midwife, or radiologist
➡️ 2D ultrasound scan at 2nd trimester with your gynaecologist, GP, midwife, or radiologist
➡️ Nine fills of antenatal iron and folic acid supplements
➡️ Access to postnatal care, including a postnatal consultation within six weeks after birth
👉 New BestMed members who are already pregnant are unfortunately not eligible for these maternity benefits, but their new-borns are covered by these comprehensive plans beginning on the day of birth.
👉 Starting on day one, these plans provide free immunisations, new-born growth and development evaluations, and an appointment with an occupational therapist as part of BestMed’s preventative care benefits for the whole family.
How Much Are BestMed Medical Aid Monthly Premiums?
👉 At the time of writing, monthly premiums for the cheapest BestMed Beat1 Network Hospital Plan started at R1 710 for a member, with an additional R1 329 for an adult dependant and R720 for a child dependant, to a maximum of 3 child dependants. Additional children join at no additional cost.
👉 The most expensive plan at the time was the Pace4 Comprehensive Plan, with monthly contributions of R9 411 per member and R9 411 per adult dependant. For a child dependant the extra contribution was R2 205, up to 3 child dependants with additional children added as beneficiaries of the scheme at no extra cost.
What Is the Waiting Period for BestMed Medical Aid’s Benefits?
👉 There can be a general waiting period of three months or a specific waiting period of 12 months for a certain condition.
👉 BestMed Medical Scheme will sometimes only pay a claim if it is a PMB. This can happen if you are in a waiting period or if you are getting treatment for a condition that your plan doesn’t cover.
How to Claim for Benefits from BestMed Medical Aid
👉 If your healthcare provider does not submit claims to BestMed, one must submit the original claim directly to the fund administrators.
👉 You can claim by means of the BestMed App, or by scanning and emailing your claim to them.
👉 Details that should appear on all claim documents include:
➡️ Member’s name and contact details
➡️ BestMed membership number
➡️ Patient’s details
➡️ Service provider’s name, contact details and practice number
➡️ Details of treatment, including applicable tariff and ICD-10 codes
➡️ Whether payment should be done to the service provider or the member
👉 You will receive an email confirmation when your claim is received and indexed.
BestMed Medical Aid Contact Details
BestMed Medical Scheme, Glenfield Office Park, 361 Oberon Avenue, Faerie Glen, Pretoria
PO Box 2297
Phone: +27 (0)86 000 2378
4. Momentum Health
👉 One of the top three open medical schemes in South Africa, Momentum Medical Scheme is managed by a company widely recognised as a leader in the healthcare industry.
👉 Momentum Health’s number one goal is to guarantee the scheme’s long-term success while offering remarkable value to its participants.
👉 With Momentum Health Solutions, you may connect with a group of doctors and hospitals that provide affordable, high-quality medical services.
👉 Momentum has partnered with various doctor networks to give treatment at reduced costs to their members, and they also offer a 24/7 medical advice line called Hello Doctor.
👉 With the assistance of Momentum’s actuarial services, incentive and reward programmes that encourage members to live healthily can be created and priced.
👉 Momentum’s breakthrough health coaching model utilises care cohorts to deliver personalised support via advocacy initiatives, enabling members to make educated healthcare decisions and lowering expenses.
Momentum Medical Aid Option Plans Suitable for pregnancy
👉 Momentum offers excellent maternity benefits suitable for pregnancy.
Momentum Medical Aid Option Plans Suitable for pregnancy
👉 Momentum Medical Scheme’s all-encompassing maternity plan is designed to give expectant mothers the help and high-quality treatment they deserve.
👉 Advantages of the specialised, high-quality treatment include prenatal check-ups, ultrasounds, visits from a nurse at home, and immunisations for the new-born.
👉 In order to give extensive pre- and post-natal care to new parents on Momentum Medical Plan, the company has teamed with BabyYumYum, South Africa’s premier parenting web.
👉 Momentum will ask for your permission to enrol in the MyMomentum BabyYumYum programme when you call to sign up for the maternity benefit. You should expect a mail from BabyYumYum outlining all the ways in which you can take use of their services.
👉 Together, Momentum Health Solutions and BabyYumYum, South Africa’s most popular parenting website, will provide a variety of perks for new mothers, including in-home nursing care, access to up-to-date parenting information, a home-cooked meal for the first night after returning from the hospital, and a designer nappy bag stocked with luxurious treats for both mother and child.
👉 Momentum Health and Momentum Health4Me members also have the option of receiving immunisations in the comfort of their own homes, and can access expert guidance around the clock.
👉 The improvements to the maternity benefits programme are the product of months of study into the requirements and preferences of mothers immediately following childbirth.
👉 More than 80% of respondents to a survey of the BabyYumYum community of over 150,00 followers stated they wanted their medical aid to give midwife homecare visits, father support, at-home vaccines, access to support at all hours, and trustworthy postnatal information.
How Much Are Momentum Health Monthly Premiums?
👉 Momentum monthly premiums start at R1 539 for the main member on the Evolve Option and go up to R12 345 for the main member on the Summit Option.
What Is the Waiting Period for Momentum Health’s Benefits?
👉 The general waiting period is 3 months, but since pregnancy is considered a pre-existing condition, it is excluded from all benefits for the first 12 months of scheme membership.
How to Claim for Momentum Health Benefits
👉 You can submit a claim in several ways:
➡️ Use the Momentum App
➡️ Use the web chat facility in the bottom left corner.
➡️ Send an email to [email protected] or send normal mail to PO Box 2338, Durban, 4000
👉 To make sure your claim is processed quickly and accurately, include the following information:
➡️ Membership number.
➡️ Principal member’s surname, initials, and first name.
➡️ Patient’s surname, initials, and first name.
➡️ Date of treatment.
➡️ Amount charged.
➡️ ICD–10 code (code to indicate what condition you’ve been diagnosed with), tariff code (product-specific code for procedures and claims), and NAPPI code (unique identifier for a given ethical, surgical, or consumable product).
➡️ Service provider’s name and practice number.
➡️ Proof of payment if you’ve paid the claim out of your own pocket.
Momentum Health Contact Details
201 Umhlanga Ridge Blvd
PO Box 2338
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👉 Fedhealth has been serving the medical needs of South Africans since its founding in 1936. While much has changed throughout the years, their commitment to providing affordable, high-quality healthcare has remained.
👉 Since Fedhealth is still a cooperative run by and for its members, it is constantly on the lookout for innovative methods to meet the ever-changing healthcare requirements of its customers.
👉 With Fedhealth, you, the member, have a say in the healthcare coverage you receive because of the program’s emphasis on customization. Due to its nature as a membership organisation, Fedhealth places a premium on meeting the requirements of its constituents.
👉 The Scheme’s solid financial standing has allowed it to maintain an AA- Global Credit Rating for the past 14 years and to reserve funds in excess of the required 25% to ensure that its members are taken care of in the event of a financial emergency.
👉 Fedhealth is well-known not just for its standard advantages, but also for its unique Risk-based rewards, which make the standard benefits go even further for members.
👉 There are no limits on the number of visits to a doctor within the network, and you can get a free upgrade once per year, within 30 days of a major life change.
Fedhealth Medical Aid Option Plans Suitable for pregnancy
👉 Fedhealth offers excellent maternity benefits suitable for pregnancy.
Fedhealth maternity benefit
👉 Fedhealth’s Baby Programme is designed to provide expectant mothers with expert guidance, emotional support, and individualised medical attention throughout their whole pregnancy and beyond.
👉 Fedhealth Baby is a compilation of expert advice for new parents that aims to make the transition to motherhood easier and more enjoyable. It includes wonderful freebies, discounts, lessons, and help.
👉 Fedhealth provides an R3,000 subsidy towards the cost of a doula for prenatal and postpartum care. A doula is a trained professional who provides emotional and physical assistance during childbirth. Over the nine months of pregnancy, she will pay regular visits to the expectant mother, providing emotional and physical support as labour begins.
👉 Fedhealth Baby members receive regular email and e-letter updates (to Mom and Dad), health profiles at the beginning of each trimester, financial support for a doula (labour support) during natural birth and a new birth card, a phone call on the member’s estimated due date to check on her progress, and a follow-up on the birth within a week after the due date.
👉 In addition, members can sign up for their Baby Bumps group on the Fedhealth Family Room online member portal, where they can find a wealth of useful information and support during their pregnancies.
How Much Are Fedhealth Medical Scheme Monthly Premiums?
👉 The monthly premiums for the salary-banded myFED option is from R 1 275 per month for the main member. The maxima PLUS extensive medical cover will cost 13 122 per month per the main member.
What Is the Waiting Period for Fedhealth Benefits?
👉 The general waiting period for Fedhealth benefits is usually three months, depending on the medical aid scheme you join. The waiting period for pre-existing conditions is 12 months.
How to Claim Benefits from Fedhealth Medical Scheme
👉 Members can submit claims using one of the following:
➡️ In the Fedhealth Family Room,
➡️ Through a WhatsApp service
➡️ On the Fedhealth Member phone App
➡️ You may also email, fax or post the claims to email: [email protected], fax: (011) 671 3842 or post to Private Bag X3045, Randburg, 2125.
Fedhealth Medical Scheme Contact Details
Flora Centre Shop 21 and 22
Corner Conrad street and Ontdekkers Rd
Phone: 0861 116 016
READ more about 5 Best Private Hospitals to Give Birth in South Africa revealed
Frequently Asked Questions
What are medical aids for pregnancy?
Medical aids for pregnancy, also referred to as maternity benefits or pregnancy coverage, provide healthcare services and support from medical aid schemes or insurance plans that assist expecting mothers during their journey through pregnancy.
What kind of benefits are available from medical aids during pregnancy?
Medical aid plans typically cover services related to pregnancy such as doctor visits, prenatal check-ups, ultrasound scans, laboratory tests, hospitalization for delivery with anesthesia provided as needed, postnatal care as needed as well as high risk pregnancy management or childbirth classes. Some plans may even provide coverage for additional services as needed.
How can I determine if my medical aid covers pregnancy?
To identify if your medical aid covers pregnancy, it’s essential that you review its policy or contact its provider directly. It is vital that you review any terms and conditions, waiting periods, coverage limits or benefits related to pregnancy or childbirth as this will provide an in-depth view of what expenses might be out-of-pocket costs associated with having a baby.
Are there waiting periods for pregnancy coverage?
Yes, some medical aid schemes may include waiting periods when considering pregnancy coverage. Waiting periods are predetermined periods in which members must remain members before being eligible to access specific benefits from that medical aid plan. It’s very important that when considering or switching medical aid plans you inquire about waiting periods so as to ensure adequate protection when planning for pregnancy.
Can I upgrade my medical aid plan for pregnancy benefits?
You may be eligible to upgrade your existing medical aid plan in order to include pregnancy benefits. Speak to your provider regarding possible costs or changes in premiums associated with any changes. It’s also advisable to review all terms and conditions associated with upgrading, such as waiting periods, coverage limits and any other pertinent details before making your decision.