5 Best Medical Aids for Pregnant Women in South Africa
The 5 Best Medical Aids for Pregnant Women in South Africa revealed.
We tested them side by side and verified their medical aid plans.
This is a complete guide to the best medical aid for pregnant women in South Africa.
In this in-depth guide you’ll learn:
- What is a Medical Aid?
- Which medical aids cover pregnancy immediately?
- Which medical aid provides the best care after birth?
- How to compare medical aids against each other to find the right fit for your family?
- What is the average waiting period when joining a medical aid while pregnant?
- Which medical aids cover pre-existing pregnancies?
So if you’re ready to go “all in” with the best medical aid for pregnant women in South Africa, this guide is for you.
Let’s dive right in…
Best Medical Aids for Pregnant Women (2023)
| 🩺 Medical Aid | ✔️ Offer Plans for Pregnant Women? | ⚕️ Plan Offered | 💵 Premiums Per Month | 👉 Sign Up |
| 1. Discovery Health | Yes | KeyCare Series | R930 | 👉 Apply Now |
| 2. Bonitas | Yes | BonEssential Hospital Plan | R2 033 | 👉 Apply Now |
| 3. BestMed | Yes | BestMed Beat1 Network Hospital Plan | R720 | 👉 Apply Now |
| 4. Momentum Health | Yes | Evolve Option | R1 539 | 👉 Apply Now |
| 5. Fedhealth | Yes | myFED | R 1 275 | 👉 Apply Now |
Best Medical Aids for Pregnant Women Summary
- Discovery Health – Overall, Best Medical Aid for Pregnant Women
- Bonitas – Best for Bargaining for Cost Reductions
- BestMed – Top Insurance Coverage Possibilities
- Momentum Health – Offers 24/7 Medical Advice Line
- Fedhealth – Retains AA- Global Credit Rating for the Past 14 Years
How medical aid for pregnant women works
👉 Prenatal care is expensive, even with medical aid cover. Medical Aid may provide benefits for diagnostic procedures including ultrasounds, blood work, and pregnancy tests, in addition to covering consultations with a gynaecologist, general practitioner, or midwife (at medical aid rates).
👉 Check the fine print of your health insurance policy. Expectant mothers should choose a comprehensive health care plan that either pays for all of their medical costs or prioritises hospitalisation (complicated or not).
👉 A medical aid plan that provides comprehensive coverage would pay for all of your prenatal care visits and your hospital birth. Also included are prenatal visits (again, at Medical Aid rates).
👉 If you have a comprehensive health insurance plan, your health savings account should cover most of your out-of-pocket medical expenses. If the costs of seeing a hospital-based specialist exceed the limits of your health insurance, you may want to look into purchasing additional coverage.
👉 If the mother so chooses, her medical insurance company will cover the costs of a home birth with a certified nurse midwife.
👉 Even normal pregnancies usually necessitate 10–12 visits to the doctor for various screenings and tests. But, if you and your unborn child are having complications, your visits to the OB and the amount of routine tests you do may need to be increased.
👉 Complications or the need for further precautions might arise from a number of different sources, and a wide variety of additional treatments may be required.
👉 If your pregnancy is complicated by diabetes or hypothyroidism (an underactive thyroid) due to your weight or other health conditions, you may want to see a nutritionist to make sure you’re getting the nutrients you need.
👉 Remember that a hospital plan is created with the explicit intention of being used in hospitals. It’s highly improbable that your health insurance will cover a home birth.
Learn more about Health Insurance for Pregnant Women
How to choose a medical aid for pregnant women
👉 Despite its physiological normality, childbirth can have major financial repercussions. In addition to the costs associated with giving delivery, you may also have to pay for antenatal consultations, scans, and follow-up appointments.
👉 The average cost of giving birth in South Africa is estimated at R27,500, although complications during labour that require further surgeries like a C-section or episiotomy, or neonatal intensive care for the new-born, can significantly increase this figure.
👉 Having medical insurance will alleviate a lot of financial pressure.
👉 Most health insurance policies treat pregnancy as a pre-existing illness. So, the first year of your membership in the scheme will not include coverage for pregnancy and delivery.
👉 Even if you’ve been a member of a medical aid plan for more than a year, you may still have to pay the difference between what your plan will pay and what health care providers in South Africa really charge.
👉 Speciality doctors’ rates are often much higher than those on the NHRPL, including obstetricians, anaesthesiologists, and paediatricians.
👉 The amount you have to pay out of pocket during your pregnancy will be determined by the maternity coverage provisions of your medical aid plan.
Choosing a medical aid if you are planning on falling pregnant
👉 Any pregnant woman who applies for coverage under a medical aid plan must be accepted, but that doesn’t guarantee instant coverage.
👉 If you are pregnant and apply for medical aid, you may have to wait anywhere from three months to a year before obtaining any benefits, depending on your coverage history.
👉 That’s why it’s a good idea to enrol in a health plan that provides coverage for your regular medical expenses, not just emergencies.
👉 Choose the best cost-effective solution that satisfies your requirements if you want to have a family quickly.
👉 It’s crucial to evaluate the many features available within your budget range so that you can choose a cost-effective plan that doesn’t stint on quality. This is why it is beneficial to compare medical aid costs across different programmes.
Read more about the 5 Best Medical Aid / Insurance for Pregnancy in South Africa reviewed
5 of the Best Known Medical Aids in South Africa For Pregnant Women
👉 There are a variety of leading medical aid schemes that offer comprehensive plans suited to pregnancy. We explore these options in more detail below.
1. Discovery Health
Overview
👉 While looking for medical coverage in South Africa, many people opt for the Discovery Health Medical Scheme. The Scheme is available to anyone, even pregnant women, so long as they follow the rules.
👉 Discovery Health Medical Scheme offers more than twenty various plans, all of which are excellent for families because to their inclusion of private hospital coverage and other perks.
👉 Families can seek assistance from a variety of professionals at any time because to the adaptability of these programmes.
👉 Discovery’s premiums are 14.9 percent higher yet provide the same level of coverage as the ordinary South African medical aid plan.
👉 Those who commit to living healthier lifestyles are rewarded through the Vitality wellness programme with perks like discounted gym memberships and healthy meals.
👉 On behalf of its members, the fund is overseen by a Board of Trustees that is separate from the Scheme.
👉 The company is supervised by Discovery Health (Pty) Ltd., a separate financial services provider. The Discovery Health Medical Scheme adheres strictly to the guidelines established by the Medical Schemes Act and the Council for Medical Schemes.
Discovery Medical Aid Option Plans Suitable for Pregnant Women
👉 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
👉 Discovery Health provides comprehensive coverage, including prenatal care, delivery, and paediatrics. Prenatal care, including doctor visits, bloodwork, and ultrasounds, are all paid for by the government.
👉 The whole cost of a private room and any necessary medical equipment is covered for all top option members and their beneficiaries.
👉 The first two years of a baby’s life are very generous, including everything from visits to the paediatrician or family doctor to postpartum visits with a midwife or gynaecologist and advice on breastfeeding, mental health, and lactose intolerance.
👉 New mothers can get help whenever they need it, and the number of paid visits they get is flexible according on the plan they select.
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,
Sandton,
2146
Phone: 0860 99 88 77
2. Bonitas
Overview
👉 Bonitas has been around for close to 40 years, and in that time it has established itself as a leader in the private healthcare sector in South Africa.
👉 This is why they always seek out new ways to save money without reducing the quality of service they offer their customers. This includes, but is not limited to, monitoring care to prevent the chronicity of lifestyle diseases, bargaining for cost reductions, and keeping an eye on innovations in the field.
👉 It is possible to maintain good health with minimal financial strain if you and the other 700,000 people the organisation helps make use of its fairly cost services and extensive network of highly qualified medical specialists.
👉 Among Bonitas’s many plans, you and your loved ones are sure to find the perfect fit. The programmes aim to be as accessible as possible without sacrificing the quality of the assistance they provide. Bonitas is a great option for your first health insurance policy.
👉 The company appears to be financially secure with almost R6 billion in the bank.
👉 Bonitas understands that it must build true connections with its consumers if it is to continue putting the needs of its members first. Bonitas Medical Fund’s high level of service has been remarked upon in three independent surveys.
👉 Leaders at Bonitas are seasoned experts in their fields, and the organisation is overseen by a Board of Trustees with expertise in medicine, law, finance, and business.
👉 Using performance on 10 critical service criteria, the index ranks organisations across 31 major industries.
Bonitas Medical Aid Option Plans Suitable for Pregnant Women
👉 Bonitas offers excellent maternity benefits suitable for pregnant women
Bonitas maternity and childcare benefit
👉 Bonitas will cover all medical costs incurred throughout pregnancy, including doctor visits, 2D ultrasounds, and amniocentesis. A private hospital room may even be covered by some policies.
👉 Vaccinations, paediatrician visits, and new-born screenings for conditions including congenital hypothyroidism and hearing impairments are all covered by the Children’s Health Insurance Program.
👉 The hospital benefit will pay for everything related to the actual birth.
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.
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
Johannesburg
2196
Phone for General Queries: 0860002108
Email: [email protected]
Email: [email protected]
3. BestMed
Overview
👉 BestMed is one of the largest private medical aid companies in South Africa, providing coverage to around a million people.
👉 BestMed’s vision is to operate a company that is large enough to have a meaningful impact on the lives of its customers, but still intimate enough to know its customers by name and to react quickly to their suggestions.
👉 Because of differences in age, marital status, family size, health, preferences, and financial resources, BestMed recognises that each individual’s healthcare requirements will be unique.
👉 There are three primary care plans available from BestMed, each with its own set of benefits and insurance coverage possibilities.
👉 Plans from BestMed range from comprehensive health insurance to those that simply cover inpatient stays.
BestMed Medical Aid Option Plans Suitable for Pregnant Women
👉 BestMed offers excellent maternity benefits suitable for pregnancy and the journey through childcare.
BestMed maternity and childcare benefit
👉 The joy of becoming a parent for the first time is matched only by the drive to provide adequately for one’s growing family. That’s why BestMed gives new parents the best possible care and benefits, so they can kick back and enjoy this thrilling new chapter.
👉 BestMed’s maternity care plan includes all 12 options. Depending on the specifics of your chosen plan, these maternity benefits may include:
➡️ 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
👉 These maternity benefits are not available to new BestMed members who become pregnant during their membership, but their new-borns will be covered by these all-inclusive plans on the day of birth.
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 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
Head Office:
BestMed Medical Scheme, Glenfield Office Park, 361 Oberon Avenue, Faerie Glen, Pretoria
PO Box 2297
Pretoria
Emails: [email protected]; [email protected],
Phone: +27 (0)86 000 2378
4. Momentum Health
Overview
👉 Momentum Medical Scheme is run by a business widely regarded as a pioneer in the healthcare industry, and is one of the top three open medical schemes in South Africa.
👉 To ensure the scheme’s continued success while providing exceptional value to members, Momentum Health has made this its top priority.
👉 Momentum Health Solutions will help you get in touch with a network of qualified medical professionals who charge reasonable rates.
👉 In addition to providing members with access to a 24/7 medical advice line called Hello Doctor, Momentum has worked with a number of different doctor networks to provide members with discounted care.
👉 Momentum’s actuarial services can be used to design and cost incentive and reward programmes that motivate members to lead healthier lifestyles.
👉 By utilising care cohorts to provide individualised support through advocacy activities, Momentum’s ground-breaking health coaching model empowers members to make informed healthcare decisions while reducing costs.
Momentum Medical Aid Option Plans Suitable for Pregnant Women
👉 Momentum offers excellent maternity benefits suitable for pregnant women.
Momentum Medical Aid Option Plans Suitable for Pregnant Women
👉 The comprehensive maternity plan offered by Momentum Medical Scheme is intended to provide pregnant women with the support and care they deserve.
👉 Prenatal check-ups, ultrasounds, nurse home visits, and new-born immunisations are some of the benefits of the specialised, high-quality care.
👉 Momentum Medical Plan has partnered with BabyYumYum, South Africa’s leading parenting online, to provide comprehensive pre- and post-natal care to its members.
👉 When you call to enrol in the maternity benefit, Momentum will ask for your consent to enrol you in the MyMomentum BabyYumYum programme. In the mail you should find detailed instructions for using BabyYumYum’s services.
👉 In-home nursing care, 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 mother and child are just some of the perks that will be provided to new mothers by Momentum Health Solutions and BabyYumYum, South Africa’s most popular parenting website.
👉 Members of Momentum Health and Momentum Health4Me can get immunisations without leaving the comfort of their own homes and have access to medical advice whenever they need it.
👉 Months of research into postpartum moms’ needs and preferences informed the enhancements to the maternity benefits programme.
👉 According to a survey of BabyYumYum’s more than 150,00 followers, the top five things respondents wanted from their medical insurance were midwife homecare visits, father support, at-home immunisations, access to assistance at all hours, and reliable 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.
Momentum Medical Scheme has a Momentum Multiply Rewards Program and also the following medical aid plans:
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
Cornubia
Blackburn
PO Box 2338
Durban
5. Fedhealth
Overview
👉 Fedhealth was established in 1936 to meet the healthcare requirements of South Africans. Their dedication to offering top treatment at reasonable prices has endured through the years.
👉 Since Fedhealth is still a cooperative managed for the benefit of its members, it is always exploring new approaches to healthcare delivery in order to keep up with the evolving needs of its clientele.
👉 As a member of Fedhealth, you can tailor your healthcare coverage to meet your specific needs. Fedhealth is a membership organisation, hence it prioritises the needs of its members above all else.
👉 Because of the Scheme’s strong financial status, it has been able to retain an AA- Global Credit Rating for the past 14 years and set aside more than the minimum 25% of members’ contributions as a reserve for when times are tough.
👉 Members of Fedhealth are able to make their normal benefits stretch even further thanks to the program’s innovative Risk-based rewards system.
👉 You can see any doctor in the network as often as you like without incurring any additional costs, and you are eligible for a free upgrade once a year, provided you request it within 30 days of a significant life event.
Fedhealth Medical Aid Option Plans Suitable for Pregnant Women
👉 Fedhealth offers excellent maternity benefits suitable for pregnant women.
Fedhealth maternity benefit
👉 The goal of Fedhealth’s Baby Programme is to ensure that all pregnant women receive the highest quality prenatal care possible, including professional counselling, emotional support, and individualised medical treatment.
👉 The purpose of Fedhealth Baby is to make becoming a mother less stressful and more joyful by providing new parents with expert assistance. It has a tonne of great bonuses like free stuff, discounts, training, and support.
👉 Doula care during pregnancy and after birth is supported by Fedhealth with an R3,000 payment. A doula is a trained professional who helps mothers in many different ways, both emotionally and physically, as they give birth. Throughout the mother’s nine months of pregnancy, she would visit her often to offer both mental and physical support in preparation for the birth.
👉 Fedhealth Baby members receive phone calls on the member’s estimated due date to check on her progress, a health profile at the beginning of each trimester, financial support for a doula (labour support) during a natural birth and a new birth card, and a follow-up on the birth within a week after the due date.
👉 In addition, the Fedhealth Family Room online member portal features a Baby Bumps community where members can sign up to receive helpful information and support from other expectant mothers.
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 from 13 122 per month per the main member.
What Is the Waiting Period for Fedhealth Benefits?
👉 The general waiting period for Fedhealth benefits are usually three months, depending on the medical aid scheme you join. The waiting period for pre-existing conditions is 12 months.
How to Claim for Benefits from Fedhealth Medical Scheme
👉 Members can submit claims using one of the following:
➡️ On 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
Florida Glen
Johannesburg
Phone: 0861 116 016
Learn more about 5 Best Hospital Plans for Pregnancy Coverage in South Africa
Frequently Asked Questions
Can I join a medical aid scheme if I am already pregnant?
Yes, but you will have to undergo a waiting period before the benefits become active as per the particular medical aid scheme.
How do I choose a medical aid if I am already pregnant?
Check the fine print of your health insurance policy. Expectant mothers should choose a comprehensive health care plan that either pays for all of their medical costs or prioritises hospitalisation (complicated or not).
How do I choose a medical aid if I am planning to become pregnant?
If you are pregnant and apply for medical aid, you may have to wait anywhere from three months to a year before obtaining any benefits, depending on your coverage history.
That’s why it’s a good idea to enrol in a health plan that provides coverage for your regular medical expenses, not just emergencies.
Why do I need medical aid for pregnancy?
Prenatal care is expensive, even with medical aid cover. Medical Aid may provide benefits for diagnostic procedures including ultrasounds, blood work, and pregnancy tests, in addition to covering consultations with a gynaecologist, general practitioner, or midwife (at medical aid rates).
What will a medical aid cover for pregnancy?
A medical aid plan that provides comprehensive coverage would pay for all of your prenatal care visits and your hospital birth. Also included are prenatal visits (at Medical Aid rates).
