“Pregnancy and childbirth are usually occasions of great joy, but the medical expense shortfalls that go along with it can add a lot of stress,” Tony Singleton, CEO at Turnberry Risk Management Solutions reminds parents-to-be. “The best solution is to plan your financial future carefully and have medical aid and gap cover in place well before falling pregnant so that waiting periods are not an issue.
According to Singleton, parents-to-be should know that it’s never too late to get gap cover, even though waiting periods may exclude the actual birthing process if they’re already pregnant. “Babies will be covered on their parents’ gap cover policy from the moment they are born, provided they are registered within 90 days of birth.
Why do I need gap cover BEFORE I get pregnant?
Gap cover provides additional protection for medical expense shortfalls that are not covered by medical aid. These shortfalls include co-payments, making use of providers outside of the scheme’s network, and doctors charging more than the scheme rate.
If you decide to give birth at a hospital that falls outside of the specified network, or your gynaecologist is not a network doctor, you will be left with out-of-pocket medical expense shortfalls. If you make the decision to have an out-of-hospital birth or have support from a doula, this may result in additional expenses. Should you be transferred to a hospital, the gynae may not be part of the network. The immediate emergency treatment will be covered, but the additional hospital stay may not be covered in full if you are out of network. There’s also the matter of the anaesthetist – should you decide to have an epidural or a caesarean section, even if your doctor and hospital are in network, you may not know who your anaesthetist is until the day of the procedure.
Gap cover providers impose a 10-month exclusionary waiting period on pregnancy and childbirth, which means that these will not be covered by the policy until this period has elapsed.
Why should I get gap cover if I’m already pregnant?
As much as pregnancy is a time of joy, childbirth can also be fraught with complications, from congenital defects to jaundice to the need for baby to stay in the Neonatal Intensive Care Unit (NICU). Some problems like cleft palates, club foot and heart defects require extensive surgery after birth, which may not be fully covered by medical schemes. The result? Medical expense shortfalls that you will be responsible for paying.
One example was a young family whose newborn baby was diagnosed with hyperostosis of the skull, a rare condition which causes thickening of the skull. The baby later on underwent extremely complex surgery, under the care of both a neurosurgeon and an Ear, Nose and Throat (ENT) surgeon, which attracted a shortfall in excess of R110,000. This amount was covered by their gap cover policy.
Turnberry’s Synergy Gap Cover Product will increase the medical aid rate up to 500% helping you cover medical expense shortfalls for in and out of hospital childbirth from R312 /family/month – 2022 rates. Terms and Conditions apply.
Turnberry will navigate the way and ensure peace of mind.
Turnberry Management Risk Solutions (Pty) Ltd is an authorised Financial Services Provider (FSP no. 36571). Underwritten by Lombard Insurance Company, an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.
www.turnberry.co.za +27 11 677-9891