Every Medical Scheme includes maternity benefits.If you are not already pregnant before applying for your medical aid, you can enjoy maternity benefits when you fall pregnant. This article will focus on Discovery Medical aid company. If your medical insurance is Momentum, Bonitas, Fedhealth or Profmed, please contact us for your maternity benefits. Benefits will be activated when your pregnancy or baby profile is created on the My Pregnancy or My Baby programme on the Discovery app, or on website www.discovery.co.za or when you register your baby onto the Scheme. You can also activate the programmes by calling 0860 99 88 77 and following the voice prompts. These benefits are available per pregnancy per child up to two years after birth. Once these limits are depleted, you will have to pay for out-of-hospital healthcare expenses related to your pregnancy. Benefits Overview During Your Pregnancy For Two Years After Birth Benefits Details
Antenatal consultations You are covered for up to 8 consultations at your gynaecologist, GP or midwife covered from the Maternity Benefit at the Discovery Health Rate. Pre- and postnatal care You have cover for up to five pre- or postnatal classes (including online classes) or post-birth consultations with a registered nurse, up until two years after birth. Once these have been used, we pay antenatal classes from the available funds allocated to your Medical Savings Account. Prenatal screening You are covered for one non-invasive prenatal testing (NIPT) or one T21 chromosome test subject to clinical entry criteria and/or amniocentesis or chorionic villis sampling (CVS) from the Maternity Benefit at the Discovery Health Rate. Blood tests Cover for a defined basket of blood tests per pregnancy from the Maternity Benefit at the Discovery Health Rate. Ultrasound scans You are covered for up to two 2D ultrasound scans including one nuchal translucency test from the Maternity Benefit at the Discovery Health Rate. 3D and 4D scans are paid up to the rate we pay for 2D scans. Medicines for morning sickness, iron supplements and folic acid (Medical Savings required) Discovery pays for medicines and supplements that are taken during your pregnancy from the available funds allocated to your Medical Savings Account. If these accounts are more than the money you have available in your Medical Savings Account, you will have to pay these costs. GP and specialist care after birth Your baby under the age of two years is covered for two visits to a GP, paediatrician or an ear, nose and throat specialist from the Maternity Benefit at the Discovery Health Rate. Other healthcare services You are covered for one flu vaccination during your pregnancy. You also have access to postnatal care which includes a postnatal consultation within six-weeks post-birth for complications postdelivery, a nutritional assessment with a dietitian and two mental healthcare consultations with a counsellor or psychologist. You are also covered for one breastfeeding consultation with a registered nurse or breastfeeding specialist from the Maternity Benefit at the Discovery Health Rate (DHR). Point-of-care devices (Medical Savings required) If you are registered on the My Pregnancy or My Baby Programmes, you also have access to the latest remote monitoring medical examination device called TytoHome until your youngest child turns six. Discovery pays up to 75% of the Discovery Health Rate for one device per family every five years. You will need to pay 25% of the cost of the device. For more information, refer to the Connected Care for healthcare at home guide available on www.discovery.co.za under Medical Aid > Manage your health plan > Find important documents and certificates. Discovery covers normal deliveries or home births or birthing home delivery with a registered midwife If you choose to have a water birth or normal delivery at home or birthing home, Discovery will pay for care from a midwife for your approved delivery from your Hospital Benefit. The midwife must be registered with a valid practice number. For a water birth at home, Discovery will pay for the cost of the hire of a birthing pool from your Hospital Benefit at the Discovery Health Rate. This must be hired from a registered provider who has a valid practice number. If you use a midwife within our network, the birthing pool is included in the amount we pay. Hospitalisation for your delivery You have cover for hospitalisation for your delivery from the Hospital Benefit, if approved. We pay the hospital account from your Hospital Benefit up to the Discovery Health Rate. You have cover for a water birth in hospital. The midwife must be registered with a valid practice number. Treatment for neonatal jaundice If your baby needs phototherapy due to neonatal jaundice, Discovery will pay for the phototherapy lights from the Hospital Benefit as long as you call for authorization. Please consult the treating doctor for the treatment codes so that we can provide you with the authorization number of the treatment. Is Baby Immunization Covered? Baby immunization is paid from your available Medical Aid Savings, if you are on a hospital plan (Core Plan) then you need to pay for it from your own pocket. The suggestion we would provide, whether you have Medical Aid Savings, is that you should call the Dischem near you, ask them if they have stock for government/public immunization shots, this would not only save your time from queuing at a Public Clinic, but also save you money, as the price difference between the private and public immunization shots can be huge. If you would like to know more about your Maternity Benefits, please contact Jo or Namhla in our Health Department email: service@daberistic.com Tel: (011)658-1333
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AuthorKevin Yeh Archives
January 2025
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