Having adequate financial cover for pregnancy and childbirth is important if you want to afford quality healthcare for both mother and child. With the host of complications that can arise during pregnancy and childbirth, proper cover can at times make the difference between a viable pregnancy and the birth of a healthy baby or not. Even without pregnancy complications, childbirth in particular can be expensive if you wish to have your baby in a South African private hospital. Most people cannot afford to pay cash and private hospitals do not offer credit facilities. It is either cash upfront or a medical aid hospital plan at the very least.
Ideally the public health sector would be offering quality medical care and none of us in South Africa would even bother with private hospitalisation. However, this is far from the case. Many of us often fear being admitted into a government hospital and when we are aware of the upcoming need for hospitalisation, like with pregnancy and childbirth, we can take the necessary measures to secure our place in a private hospital. If you are pregnant, you should inform your medical aid about your pregnancy well before your due date. Your medical aid will provide you with an authorisation number which can save you time during hospital admission.
South African medical aids provide maternity benefits at different levels. If you have a full medical aid with comprehensive cover then you can rest assured of cover for prenatal care. This includes your regular gynaecology check ups and scans, necessary bloods tests and other relevant pregnancy procedures and treatment. Hospital care is also covered. However, if you only have a medical aid hospital plan then your outpatient prenatal care is up to you – you will have to pay cash to visit a private gynaecologist and for all the related procedures and treatments.
Hospital cash back cover does not provide benefits for prenatal care. You will only receive a cash payout once you are hospitalised for childbirth and it is important to clarify whether you will be paid out at this time. Since hospital cash back cover only pays out after a deferred period of 2 to 3 days, you may not qualify for benefits for childbirth without complications as you are usually discharged by day two after giving birth.
The most expensive part of having a child in terms of healthcare costs is the actual childbirth. It does not make a major difference whether you are in labour for a few hours or days. The cost lies largely in the birthing process and subsequent care of the newborn baby, especially if there are complications at the time of birth. While you medical aid hospital plan will cover you for the hospital costs, baby’s stay in nursery and neonatal ICU if necessary, you may have to pay out of your own pocket for the gynaecologist and obstetrician and paediatrician for your baby.
Most medical specialists in South Africa charge private rates these days. This is a rate above the NHRPL (National Health Reference Price List) according to which the medical pays out, either to practitioner or patient. A higher rate means you will have to pay the difference to your doctor out of your own pocket. Hospital cash back cover is helpful in funding the difference for medical bills but this is only if you receive a payout for childbirth. Otherwise its cash from your pocket or the assistance of medical aid gap cover which is above and beyond your medical aid.
Childbirth in South Africa can start from about R15,000 in total for private hospital births. It is slightly high for a Caesarean section (C-section) as compared to natural vaginal birth. Should your baby need hospitalisation in a neonatal intensive care unit then you can expect to pay anywhere between R6,000 to R11,000 per day for your baby’s care. It all depends on how serious the birth complications are and what level of care your baby needs. It can be just for a few days or even extend into weeks in a neonatal ICU.