Having a baby is a time of joy and excitement but have you considered the healthcare costs that may be incurred by a newborn? Nobody likes to equate such a joyous time in life with money and expenses, but the reality is that if you do not have medical aid, you may have to leave your newborn in a government hospital. Newborn babies are fragile – leaving the protection of their mother’s womb to face the harsh environment filled with bugs, allergens and irritants. As their system is still maturing, they may be prone to repeated illnesses in the first few months of life. This means repeated visits to the paediatrician, blood tests, scans and even hospital stays. Without medical aid, it can be difficult to afford having a newborn baby and offering him or her quality health care.
Immediate Cover for Baby
If the mother is a medical aid member then the newborn baby is immediately covered at birth. There is no immediate paperwork necessary for this instant cover to take effect but you should have notified your medical aid about your pregnancy. In this way the scheme was prepared for a new member to join your scheme in the coming months, even though you cannot be sure of the exact date of delivery.
Once your baby is born, you should notify your scheme as soon as possible although the medical aid cover took effect immediately. Medical aids allow the main member of the scheme anywhere between 30 to 60 days to register the newborn on their cover, failing which the baby’s benefit will fall away. Your medical aid will then inform you about the added premium to your medical aid for baby’s cover. Some schemes have benefits where if 3 of your child are covered, your other children will be covered for free.
Neonatal Baby Care
Some of the largest expenses you may incur in hospital these days related to your pregnancy and childbirth are the costs accrued by your newborn. Should you baby be premature, have breathing difficulties, be born with birth (congenital defects) or there were complications at the time of delivery, then your newborn baby will have to be admitted to the neonatal ICU (intensive care unit for newborns). Without specialist care, your baby’s chance of survival may be slim. It is not necessarily an overnight stay. Your newborn baby can be in hospital anywhere from a few days to several weeks and even months in some instances.
It is not a matter of choice – it is mandatory for the obstetrician and paediatrician to do so if the baby needs this high level of medical care. Although your medical scheme will cover these expenses, you should realise that without medical aid you can prepare to pay as much a R9,000 per day for each day that your newborn is in the neonatal ICU within a private hospital. These cash rates can be higher or lower depending on the private hospital in question, the facilities and equipment that your baby requires for their specific needs and does not include the paediatrician’s consultation fees.
Paediatrician and Vaccinations
Even if your baby is healthy at birth and discharged within 2 to 3 days, there is still the ongoing need for specialist care. A paediatrician should ideally be managing your baby for at the very minimum of 2 years. Paediatricians are medical specialists and their consultation rates are significantly higher than your general practitioner (GP). Most paediatricians charge private rates meaning they are contracted out of medical aid and charge higher than the National Health Reference Price List (NHRPL) which medical aids pay. In other words, you have to settle them in cash and claim back the amount from your medical aid.
At least with medical aid you can rest assured of reimbursement of a significant portion of the paediatricians fee. If you have medical aid gap cover then you can be assured of complete reimbursement in most cases. You cannot argue that your newborn baby will never need medical care. Even a healthy baby has certain medical needs like regular checks to ensure that he or she is reaching their development milestones and having the required vaccinations. Unless you want to opt for a government facility, you will have to pay cash without the protection of a medical aid for your newborn baby.