Already Pregnant & Need Medical Aid? Tips & Advice




Pregnancy is a beautiful journey, but it is also an expensive one. There are several prenatal checkups and tests that need to be done to ensure a safe pregnancy. While some may bear the cost with cash, what happens when the money runs out? Will you have enough to pay for the medical procedures even after childbirth?

Finding out you’re pregnant before getting medical aid can lead to stress, which is a feeling you should do your best to prevent while pregnant. Pregnancy health insurance or medical aid is essential, given that it will pay for these medical expenses so that you can focus entirely on the new addition to the family.

There are a plethora of companies on the market, all offering great pregnancy benefits. However, the challenge comes when choosing the one that best suits your personal and financial needs.

Fortunately, we have composed this insightful guide to help simplify your research. Read on to discover the top insurance brokers and commonly asked questions regarding insurance for pregnant women.

Next Read: Learn the difference between medical aid and medical insurance

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Commonly Asked Questions Regarding Pregnancy Health Insurance

Is Pregnancy Considered a Pre-Existing Condition?

Yes, when you sign up for maternity insurance or medical aid while you are pregnant, it is considered a pre-existing condition. In South Africa, pre-existing conditions are excluded from insurance benefits for up to 12 months or the period leading up to the birth.

So, women are expected to either bear the expense of prenatal treatment and delivery or pay a higher premium to have it covered—depending on the insurance providers’ offering. The good news is that most insurance companies offer coverage for your infant and postpartum costs.

What Do I Do If I’m Pregnant With No Insurance Cover?

A common misconception is that if you’re pregnant with no insurance, you don’t qualify for medical aid. The reality is that no insurance provider can refuse you coverage; however, they can charge you more if you sign up with a pre-existing condition. People who join medical schemes only when they need treatment are often referred to as “anti-selective.”

The Council for Medical Schemes (CMS) of South Africa established a regulation requiring the implementation of late joiner fees and extended waiting periods for pre-existing conditions. This legislation was enacted to reduce the number of anti-selection cases.

So, getting medical aid or insurance coverage for pregnancy is a better option, even though you’ll be required to pay a little extra or wait a little longer. Without insurance, you and/or your family will pay thousands of rands to cover prenatal and delivery costs.

How Do I Apply for Medical Aid While Pregnant?

Medical aid or pregnancy health insurance providers in South Africa usually require a few documents to start your application process. Here are some documents they may request:

  1. A certified copy of your South African ID
  2. Bank statements or a confirmation letter from your local bank
  3. Pay slips or a letter of employment from your employer
  4. Marriage or birth certificates of your dependants (if any)

With these supporting documents, insurance providers will require you to fill out an application form with your personal details.

Does Insurance Cover Childbirth?

Depending on the provider and scheme, medical insurance may or may not cover childbirth. Therefore, it is essential to consult with your broker before choosing a plan so that you can prepare in advance.

Best Health Insurance for Pregnancy

Here are a few South African companies that offer the best insurance that covers pregnancy:

Discovery Health

The Discovery Health Medical Scheme offers comprehensive maternity insurance covering you and your baby during pregnancy, childbirth, and early childhood. Some benefits include, but are not limited to:

  • Antenatal consultations
  • Prenatal screening
  • Ultrasound scans
  • Postnatal care
  • Lactation consultations


Bonitas offers benefits and support for maternity and child care that starts from the initial stages of pregnancy and extends to when the baby is born. The maternity programme includes antenatal classes, hearing screening for newborns, ultrasound scans, and amniocentesis, as well as:

  • Clinical care advisors
  • 24/7 line for maternity health advice
  • Weekly SMSs regarding the stage of pregnancy
  • Emails and live webinars on maternity and baby care
  • And a beautiful baby bag as a gift


As a Bestmed member, you will enjoy a 100% Scheme tariff on all maternity benefits without deducting costs from your savings account. The Bestmed Maternity care programme offers consultations, ultrasounds, and maternity supplements throughout your pregnancy. With this programme, you will also receive:

  • A welcome pack containing information on the 5 phases of pregnancy
  • A baby gift after 12 weeks
  • Access to a 24-hour medical advice line

Switching Health Insurance While Pregnant

Switching your pregnancy health insurance plan or provider is not forbidden. However, depending on the scheme or company you’re switching to, you will be subject to waiting periods or extra costs.

The best option is to read the fine print of these plans to ensure you’re making the right choice. Speaking with your financial advisor about the implications of switching plans or insurance providers is also important.

Final Thoughts

A comprehensive insurance or medical aid plan is the best bet if you want your pregnancy journey to be fully covered. However, suppose you haven’t yet found a suitable medical scheme. In that case, it is never too late to contact your financial advisor and set up meetings or calls with the different South African insurance providers according to your budget.

Expectant parents typically make the mistake of choosing a cover that is the cheapest, but there is a lot more that comes with finding the right insurance or medical aid. You have to determine the out-of-pocket costs for each medical procedure and consider the percentage of hospital fees and regular consultation costs that the benefits cover.

Although Discovery, Bonitas, and Bestmed are the top 3 insurance providers in South Africa, there is a myriad of other companies that offer similar benefits for maternity and child care.

You can compare and review the best medical aid companies to help fuel your decision.

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