Questions to raise with your medical aid before and during pregnancy

Being pregnant is a blessing that many women crave to have in their lives. It brings with it joy, excitement as well as some discomfort and emotion. There is a lot of planning that goes into a pregnancy, the most important of which includes your medical aid. You could compare the options of the top 5 medical aid schemes in South Africa, or you could set out a list of questions to ask your current medical aid. Below are the questions you need to ask your medical aid before planning your pregnancy.

Do I have to use a specific hospital or doctor?

This is an important question as it relates directly to both the early and late phases of your pregnancy. Having to go to a specific doctor or hospital could mean that you have to travel

far from your home for delivery or that doctor’s appointments are in another suburb.

Of course, most medical aid and hospital plans restrict their coverage to certain hospitals and doctors within their network. It is important that you find out if you are able to go to a doctor of your choosing, who you feel comfortable with and who will not incur any exorbitant fees. With the hospital, you will have to ask them about the protocol during an emergency situation where you might have to go to a hospital outside of your network.

What is the waiting period for pregnancy?

Unfortunately, common practice is to have a waiting period for pregnant mothers who want to join. This is because, while pregnancy is not a disease, it is still a pre-existing medical condition.

Medical aids differ in their waiting periods for pregnancy, and this is due to the fact that many women do not disclose their pregnancy when signing up for a medical aid. Pregnancy and childbirth before 12 months of membership will not be covered, which is an important fact to consider if you are planning on starting a family. It is better to be upfront with your medical aid, so that there are no discrepancies later.

What is covered during pregnancy?

This is one of the most important questions to ask your medical aid. All private medical aids will cover a specific number of prenatal check-ups with a gynaecologist, as well as ultrasound scans. But the number of these visits will differ according to which of the top 5 medical aid schemes in South Africa you choose.

Some schemes also cover the cost of antenatal classes while others only pay a contribution towards them. If you are considered to have an “at-risk” pregnancy (that is, if you are older or are carrying twins or triplets) you might need more specialised care. Check with your medical aid that these needs are covered and to what extent they are before you start planning on getting pregnant.

What is covered for the birth?

The birth is the most exciting, nerve wracking, scary and joyful part of your pregnancy. It is vital to know what your medical aid will cover during birth, especially if you are planning on having a home birth or an out-of-hospital birth. Another important thing to find out is if you are covered only for an emergency C-section or if you are allowed an elective C-section.

You should also ask whether or not you are covered to have a midwife or doula with you during the birth. Finding out what is covered during the birth is an important factor in deciding when and if you should start a family. Medical costs can become debilitating for young parents, so you should always be sure that you are covered for what you need on your journey to parenthood.

What about post-natal consultations?

Postnatal consultations are important in helping young parents deal with their life, as well as giving much needed medical advice after giving birth. Some medical aid schemes do pay for these consultations while others ask for a co-payment as it is a “specialist” visit.

Having extra help when you need it most is vital for new mothers, so you should definitely be certain that you are able to get this help when you need it. Postnatal consultations help doctors to ascertain how healthy both the mother and baby are. They are important in gauging how your baby is developing. If your medical aid does not cover these visits, they can become costly so be sure to ask about these visits when you start planning your pregnancy.

Be prepared for your bundle of joy

Planning to have a child is not to be taken lightly. You have to change your entire lifestyle, including how you spend money and your health choices. One of the most important aspects of becoming pregnant is to ensure that your medical aid covers you for all the necessities, even the unseen ones. Ask your medical the above questions, and any others that you can think of, so that you are fully prepared to become a parent.

 

Advice on Pregnancy and Safe Driving https://t.co/USuGPJVVjr #ArriveAlive pic.twitter.com/EfkB8jI2S7

— Arrive Alive (@_ArriveAlive) May 21, 2015