MEDICAL AID: PREGGY WOMAN

Thanks Wildcat for clarifying that because i was almost certain that you can join GEMS while preggis.

Hi ladies,i know Vamo u'v already been assisted but just wanted to clarify the Gems issue,i joines Gems when i was 3months pregs,the day i was admitted in hospital with complication,was the day the cover started,"wat a relief "and i was covered 100%,from my scans,vitamins,gynae visits,my c-section and it's not forced on you,there are other options if you dont want to join Gems,the thing is with gems the gov subsidy is almost 100%.And i was not on a ma prio to that.

<BUMPITY BUMP>

Thanks RM

This really make sense!

I saw this article and thought of this thread:

Medical aids usually do not cover any procedure or treatment for a pre-existing condition within the first year of joining a scheme. This applies to pregnancy as well and almost all medical aid schemes will not cover the pregnancy and delivery costs for a new member who joins the scheme when pregnant.



While it may be argued that pregnancy is a normal physiological process and not a disease, medical aids have to weigh out the risks associated with covering a person compared to the total contributions. There has been a trend in South Africa for pregnant women to join a medical aid, stay on it throughout pregnancy and a month or two after childbirth, only to then leave the scheme. The total payout for pregnancy and childbirth costs may be more than the member’s total contributions meaning that the scheme has to fund these costs from the pool. Ultimately it is the other long standing and loyal medical aid members who essentially bear the cost of this practice.

Most medical aids in South Africa in South Africa now do not accept pregnant women. However there are a handful of medical aids with a select member base that may cover pregnant women and pay for the childbirth costs. This is changing almost on a daily basis with even these select few schemes now refusing pregnant women.

These schemes are usually restricted meaning that it is not open to the general public. Only workers in selected industries or professionals with university degrees may be allowed to join the scheme. These schemes may either be partly subsidised by a professional body or related organisation or the member is considered as a low risk client who is unlikely to quit the scheme immediately after childbirth. Refer to the List of Medical Aids and Medical Aid for Professionals for information on restricted (closed) medical aid schemes

There is a link with the various medical aids on it;

www.vitacare.co.za/joining-a-medical-aid...-pregnant/#more-1294

Try Topmed. They took my sister a few weeks ago... She was not that far along though, but worth a try!

Thanks Gals