MEDICAL AID: PREGGY WOMAN

Hi I'm with Gems and they is a 12 month waiting period for pregnancy unfortunately. Try Fedhealth or Bonitas.

My cousin just joined Medihelp. When she sent in her application forms, she was not aware of the fact that she was pregnant. Well, technically, she wasn't pregnant yet as she was about 2 weeks preggies when she sent in the forms, meaning, she was propably only ovulating when she sent in the forms...

Medihelp took a month to process the forms, by the time she was accepted, she was 6 weeks pregnant and had known about it for a week but didn't say anything.

After being accepted without any waiting period for anything (they where on another fund previously) she waited a week, went to her GP and "found out" that she was about 7 weeks pregnant.

Medihelp is now investigating wheter it would have been possible for her to have known that she was pregnant when she applied for cover before they are going to cover her pregnancy. She had to write a motivation of why she didn't know that she was pregnant when she applied etc. If they find that its legit that she could not have known that she was pregnant, they are covering the full pregnancy, delivery everything.

She was stil breastfeeding when she fell pregnant, and she was not planning on falling pregnant. So she added this to her motivation, and the person who is dealing with her case told her that this is just a formality, and that they are most likely going to cover everything.

Profmed still accepts pregnant women with no waiting period, but like I said they need a person to have a 4 yr degree in order to become a member.

Just for interest's sake: We got our hospital account last night - I was admitted at 32 weeks with premature contractions, which cost R 5000. The medical aid covered it entirely. Nicole was in NICU which cost R 29 000 - and they covered everything except her eyedrops, which cost R 37. The birth was R 16 000, which was covered.

Anyway DH and I worked out last night how much they have paid towards our medical expenses vs how much we have paid in contributions. They have covered more than R 50K, and we have only paid half of that (if that even). But they will make it up from us within a year of our contributions.

So the question arose of the risk medical aids take in accepting pregnant women, and apparently Profmed "assume" that those they accept are less likely to cancel the medical aid once baby is born, since their members are apparent "professionals". Just something interesting that I have always wondered about

This subject has come up about 3 dozen times on this site.

Out of interest the last time I saw our insurance guy I asked him if there is an insurer/medical who would take on a pregnant woman and contribute towards the pregnancy.


The answer is no.

Any MA who takes on someone who is pregnany will exclude the pregnancy and birth from any medical cover. They usually have a 12 month clause on this issue so you can't even go"what a shock, I am 6 weeks pregnant and I just signed up with you..."

Really there is no MA who will.

There is no benefit to the MA and bearing in mind that even if a pregnant woman contributed R1500.00 - R3 000.00 a month for the 8/9 months it would not cover the cost to insure her, so this would always be an excluded issue.

Sorry!

It is super sh&t to be pregnant and not have MA, but really there is no MA who she can join who will cover these costs as a new member.

<as indicated if the person has joined a company and the company has a MA, say GEMS, I am pretty sure this would also be an excluded "condition" in their very fine print>

Really? Shoo i was not aware of this. I joined Bonitas when i was around 2 and a half months but then again that was 5 years ago....

profmed will take her if either her or her husband have a 4 year degree. When I fell pregnant with Nicole in August, we were not on a medical aid and they were the only ones who accepted me - no questions asked. Good luck!

As far as I know there isn't a medical aid that will accept a preggy lady these days. Like Hasie says if she is changing then possibly, but I still recon she would have a waiting period.

They will accept a pregnant woman, but obviously the birth and antenatal consults wouldn't be covered.