20 November 2012

Pregnancy and your medical scheme

Here's how to make the best medical scheme choice for your healthcare needs. It will also show what you're covered for.


The last thing you want to be worrying about when you are pregnant  is medical bills. A good quality medical scheme plan is essential, and it will relieve you of the burden of paying for medical costs at a time when you’d rather be focusing on your family.

So how do you go about choosing the right medical scheme plan to cover your pregnancy? The advice below will help you to make the best medical scheme choice for your healthcare needs, and will also help you to understand what you’re covered for.

Choosing a scheme for your pregnancy

The first and most important step in choosing medical scheme for your pregnancy is planning ahead. Just as you planned your pregnancy, you need to plan ahead for medical cover, because most South African medical schemes won’t cover you if you’re already pregnant when you join.

Even for those who didn’t plan their pregnancies, it’s likely that they were hoping to have a child in the future – and it’s always a good idea to take your future healthcare needs into account when choosing a medical scheme.

If you weren’t a medical scheme member when you fell pregnant, the onus will be on you to cover all your pregnancy-related expenses. Join a medical scheme well in advance to minimise the significant costs associated with pregnancy and childbirth.

Your pregnancy benefits

Assuming that you were already a member when you fell pregnant, your medical scheme plan will cover many of the basic costs associated with pregnancy and childbirth, such as hospitalisation, and, depending on the type of plan you have, may even offer certain antenatal benefits.

Whether you have a hospital plan or a day-to-day medical plan, the costs of your confinement will be covered (they may be subject to co-payments), and some medical scheme plans will contribute to the cost of foetal scans and certain antenatal blood tests even if you’re only on a hospital plan. Day-to-day plans may also cover antenatal visits, additional growth scans and in some cases, a certain number of paediatrician visits following the birth.

Some medical schemes offer cover for antenatal classes up to a set amount, and may also provide cover for home births, provided that a registered midwife is present.

Regardless of whether or not your pregnancy was covered by your medical scheme, your baby will be covered from birth if you are a medical scheme member and have registered the baby’s birth.

Maternity support

Many medical schemes offer their pregnant members maternity support in the form of advice, guidance and information throughout their pregnancies. The best thing to do is to familiarise yourself with the medical scheme plans available to you, and to discuss these plans with a medical scheme consultant. This will help you to make the best choice when selecting a medical scheme plan for your mid to long-term healthcare needs.

This article was provided by Selfmed Medical Scheme.

Visit the Medical Schemes Centre


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