Pregnancy and Gap Cover for Medical Aid

    July 14, 2019

    Let’s say you are pregnant when you take out gap cover for medical aid. And let’s assume you have to undergo surgery during the confinement and run up a high hospital bill. Unfortunately gap cover will not cover co-payments resulting from medical expenses linked to pregnancy.

    Essentially, there is a waiting period of nine months before your new gap cover policy covers you. That applies to hospital, specialist, medication and procedure costs linked to the birth of your baby.

    When does gap cover apply to pregnant women?

    Check with your specialised short-term insurance company for gap cover when you take out gap insurance. But as a rule of thumb it is best to take out gap cover a year before you plan to get pregnant. That’s just to make sure you enjoy full co-payment benefits.

    Pregnancy and Gap Cover

    Why does gap cover not cover pregnancy?

    Well, actually they do cover patients who are expecting but not moms who take out gap cover just because they are pregnant. You should be an established customer of a gap cover firm to get cover for shortfalls in your medical aid cover.

    The take-away is that expectant moms should have had gap cover in place long before they fell pregnant.

    Is gap cover really necessary for expectant mums?

    Yes it is. Remember that gap insurance is for medical aid members only. It’s an important add-on that you dare not be without – pregnant or not.

    That’s because medical aids rarely pay entire hospital and specialist bills that members present to them. Instead they pay a portion of the bill according to internal tariff scales.

    So if there is a R100 000 hospital bill, for instance, your medical aid might pay only R60 000, leaving you to find R40 000 in cash to settle the account.

    You really do not want that.

    So act now. Protect your pocket by signing up for gap cover. Complete and submit the form on this page so we can get in touch with you for a quote and to take you through the signing up process.

    All info was correct at time of publishing