How gap cover with no waiting period for pregnancy works
For people who can afford medical aid in South Africa, they often face high premiums. According to the World Health Organisation (WHO) South Africa has one of the most expensive private healthcare systems in the world.
Private hospital prices in South Africa are on par with prices in countries with much higher GDP levels.
Many medical aid companies have also created gap cover which gives medical aid members an alternative when medical aid schemes aren’t willing to pay in full.
More about gap cover:
No-one is allowed to buy gap cover unless they are already a member of a registered medical aid scheme.
Gap cover essentially protects medical aid members, by covering their medical aid scheme’s payment shortfall during hospitalisation.
Is it possible to get gap cover with no waiting period for pregnancy?
Most gap cover providers exclude pre-existing conditions such as pregnancy for up to 12 months. Waiting periods may be waived in cases where the employer makes it compulsory for the employees to take gap cover.
Under the new regulations gap cover providers have to be fully transparent.
There are generally 2 types of waiting periods for maternity benefits.
3 month: this generally applies to all members
12 month: this is for any pre-existing benefits (such as pregnancy)
Pregnancy usually falls within the pre-existing conditions waiting period. This is because many insurance providers have had to contend with women who have signed up for insurance then stopped contributing premiums after delivery of their babies.
If you fall pregnant within a few days of cover then the medical aid may still dispute cover for childbirth even after you pass the 3 month waiting period.
This indicates that getting gap cover with no waiting period for pregnancy is quite unlikely.