Cover for maternity

You may have many questions about your pregnancy, one of them being “How does my medical aid cover my maternity benefits?”.

You can read this page to find out more about how we cover pregnancy and childbirth claims on each plan type.

Executive Plan

Day-to-day benefits

Antenatal Classes

We cover antenatal classes up to a limit of R1000 for each family for each year as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit.

Scans

We cover two 2D scans for each pregnancy as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit.

We pay for 3D scans up to the cost of 2D scans.

Other benefits

We pay for gynaecologist consultations, blood tests, non-stress tests and amniocentesis as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit.

Hospital Cover

Cover for having a baby

Before you go to hospital for any planned procedure, you must:

  • see your doctor
  • authorise your hospital admission with us beforehand as hospital cover is not automatic.

You must authorise your admission to hospital at least 48 hours before you go in.

We need to know so we can manage your costs in the best way, and give you information that is relevant to how we will cover your hospital stay. If you do not authorise your admission we will only pay 70% of the costs that we would normally cover.

Costs related to childbirth

We cover childbirth from your Hospital Benefit. Your Hospital Benefit covers your hospital account, internal medical devices and emergency medical services.

Hospital cover includes home births done by midwives with valid practice numbers and who are registered with the Board of Healthcare Funders. You must let us know 48 hours before your hospital stay.

Caesarian sections

We cover a stay of four days and three nights in hospital.

Normal vaginal deliveries

We cover a stay of three days and two nights.

Home births

We cover home births from the Hospital Benefit.

The midwife attending the birth must have a valid practice number and be registered appropriately with the Board of Healthcare Funders.

You must let us know if you choose to have a home birth.

The midwife charges a global fee for the confinement (the birth of the baby) and this includes any follow-up care needed for three days after the delivery.

Water births

In-hospital

If you have a water delivery in hospital, the cost of hiring a birthing pool is included in the global costs related to the confinement (birth of the baby). If you want to hire one, you will be responsible for paying for it.

Out-of-hospital

If you have a water delivery at home, Discovery Health will cover the cost of the hire of a birthing pool from the Hospital Benefit. This must be hired from a practitioner who has a registered practice number.

Lodging fees

We do not cover the lodging fees if your baby needs to stay in hospital after your discharge. If you choose to stay in hospital to be with your baby while he or she receives medical care, you will be responsible for the cost of your accommodation.

Comprehensive and Delta Plans

Day-to-day benefits

Antenatal Classes

We cover antenatal classes up to a limit of R1000 for each family for each year as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit.

Scans

We cover two 2D scans for each pregnancy as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit.

We pay for 3D scans up to the cost of 2D scans.

Other benefits

We pay for gynaecologist consultations, blood tests, non-stress tests and amniocentesis as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit.

Hospital Cover

The Delta Range

Please note that if you are on a plan in the Delta Range, you need to go to a hospital in the Delta Hospital Network for planned procedures. If you go to any other hospital you will need to pay a deductible of R4 150. The deductible does not apply in an emergency – once you are stabilised you may be transferred to one of the hospitals in your chosen network.

Cover for having a baby

Before you go to hospital for any planned procedure, you must:

  • see your doctor
  • authorise your hospital admission with us beforehand as hospital cover is not automatic.

You must authorise your admission to hospital at least 48 hours before you go in.

We need to know so we can manage your costs in the best way, and give you information that is relevant to how we will cover your hospital stay. If you do not authorise your admission we will only pay 70% of the costs that we would normally cover.

Costs related to childbirth

We cover childbirth from your Hospital Benefit. Your Hospital Benefit covers your hospital account, internal medical devices and emergency medical services.

Hospital cover includes home births done by midwives with valid practice numbers and who are registered with the Board of Healthcare Funders. You must let us know 48 hours before your hospital stay.

Caesarian sections

We cover a stay of four days and three nights in hospital.

Normal vaginal deliveries

We cover a stay of three days and two nights.

Home births

We cover home births from the Hospital Benefit.

The midwife attending the birth must have a valid practice number and be registered appropriately with the Board of Healthcare Funders.

You must let us know if you choose to have a home birth.

The midwife charges a global fee for the confinement (the birth of the baby) and this includes any follow-up care needed for three days after the delivery.

Water births

In-hospital

If you have a water delivery in hospital, the cost of hiring a birthing pool is included in the global costs related to the confinement (birth of the baby). If you want to hire one, you will be responsible for paying for it.

Out-of-hospital

If you have a water delivery at home, Discovery Health will cover the cost of the hire of a birthing pool from the Hospital Benefit. This must be hired from a practitioner who has a registered practice number.

Lodging fees

We do not cover the lodging fees if your baby needs to stay in hospital after your discharge. If you choose to stay in hospital to be with your baby while he or she receives medical care, you will be responsible for the cost of your accommodation.

Priority Series

Day-to-day benefits

Antenatal Classes

We cover antenatal classes up to a limit of R1000 for each family for each year as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit.

Scans

We cover two 2D scans for each pregnancy as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit. Your Above Threshold Benefit has an overall limit. Once this is reached, we will not pay for any further day-to-day claims.

We pay for 3D scans up to the cost of 2D scans.

Other benefits

We pay for gynaecologist consultations, blood tests, non-stress tests and amniocentesis as long as you have money in your Medical Savings Account or if you have reached your Above Threshold Benefit. Your Above Threshold Benefit has an overall limit. Once this is reached, we will not pay for any further day-to-day claims.

Hospital Cover

Cover for having a baby

Before you go to hospital for any planned procedure, you must:

  • see your doctor 
  • authorise your hospital admission with us beforehand as hospital cover is not automatic.

You must authorise your admission to hospital at least 48 hours before you go in.

We need to know so we can manage your costs in the best way, and give you information that is relevant to how we will cover your hospital stay. If you do not authorise your admission we will only pay 70% of the costs that we would normally cover.

Costs related to childbirth

We cover childbirth from your Hospital Benefit. Your Hospital Benefit covers your hospital account, internal medical devices and emergency medical services.

Hospital cover includes home births done by midwives with valid practice numbers and who are registered with the Board of Healthcare Funders. You must let us know 48 hours before your hospital stay.

Caesarian sections

We cover a stay of four days and three nights in hospital.

Normal vaginal deliveries

We cover a stay of three days and two nights.

Home births

We cover home births from the Hospital Benefit.

The midwife attending the birth must have a valid practice number and be registered appropriately with the Board of Healthcare Funders.

You must let us know if you choose to have a home birth.

The midwife charges a global fee for the confinement (the birth of the baby) and this includes any follow-up care needed for three days after the delivery.

Water births

In-hospital

If you have a water delivery in hospital, the cost of hiring a birthing pool is included in the global costs related to the confinement (birth of the baby). If you want to hire one, you will be responsible for paying for it.

Out-of-hospital

If you have a water delivery at home, Discovery Health will cover the cost of the hire of a birthing pool from the Hospital Benefit. This must be hired from a practitioner who has a registered practice number.

Lodging fees

We do not cover the lodging fees if your baby needs to stay in hospital after your discharge. If you choose to stay in hospital to be with your baby while he or she receives medical care, you will be responsible for the cost of your accommodation.

Saver and Delta Plans

Day-to-day benefits

Antenatal Classes

We cover antenatal classes as long as you have money in your Medical Savings Account.

Scans

We cover two 2D scans for each pregnancy as long as you have money in your Medical Savings Account.

We pay for 3D scans up to the cost of 2D scans.

Other benefits

We pay for gynaecologist consultations, blood tests, non-stress tests and amniocentesis as long as you have money in your Medical Savings Account.

Hospital Cover

The Delta Range

Please note that if you are on a plan in the Delta Range, you need to go to a hospital in the Delta Hospital Network for planned procedures. If you go to any other hospital you will need to pay a deductible of R4 150. The deductible does not apply in an emergency – once you are stabilised you may be transferred to one of the hospitals in your chosen network.

Coastal Plans

Please note that if you are on a Coastal Plan, you need to go to a hospital in the coastal network for planned procedures. If you don’t go to one of these hospitals we will pay up to a maximum of 70% of the hospital account and you will need to pay the difference. This does not apply in the coastal network. 

Cover for having a baby

Before you go to hospital for any planned procedure, you must:

  • see your doctor 
  • authorise your hospital admission with us beforehand as hospital cover is not automatic.

You must authorise your admission to hospital at least 48 hours before you go in.

We need to know so we can manage your costs in the best way, and give you information that is relevant to how we will cover your hospital stay. If you do not authorise your admission we will only pay 70% of the costs that we would normally cover.

Costs related to childbirth

We cover childbirth from your Hospital Benefit. Your Hospital Benefit covers your hospital account, internal medical devices and emergency medical services.

Hospital cover includes home births done by midwives with valid practice numbers and who are registered with the Board of Healthcare Funders. You must let us know 48 hours before your hospital stay.

Caesarian sections

We cover a stay of four days and three nights in hospital.

Normal vaginal deliveries

We cover a stay of three days and two nights.

Home births

We cover home births from the Hospital Benefit.

The midwife attending the birth must have a valid practice number and be registered appropriately with the Board of Healthcare Funders.

You must let us know if you choose to have a home birth.

The midwife charges a global fee for the confinement (the birth of the baby) and this includes any follow-up care needed for three days after the delivery.

Water births

In-hospital

If you have a water delivery in hospital, the cost of hiring a birthing pool is included in the global costs related to the confinement (birth of the baby). If you want to hire one, you will be responsible for paying for it.

Out-of-hospital

If you have a water delivery at home, Discovery Health will cover the cost of the hire of a birthing pool from the Hospital Benefit. This must be hired from a practitioner who has a registered practice number.

Lodging fees

We do not cover the lodging fees if your baby needs to stay in hospital after your discharge. If you choose to stay in hospital to be with your baby while he or she receives medical care, you will be responsible for the cost of your accommodation.

Core and Delta Plans

Day-to-day benefits

Antenatal Classes

Core plans do not have a Medical Savings Account to cover day-to-day medical expenses. 

You need to pay for your day-to-day claims from your own pocket.

Scans

Core plans do not have a Medical Savings Account to cover day-to-day medical expenses.

You need to pay for your day-to-day claims from your own pocket.

Hospital Cover

The Delta Range

Please note that if you are on a plan in the Delta Range, you need to go to a hospital in the Delta Hospital Network for planned procedures. If you go to any other hospital you will need to pay a deductible of R4 150. The deductible does not apply in an emergency – once you are stabilised you may be transferred to one of the hospitals in your chosen network.

Coastal Plans

Please note that if you are on a Coastal Plan, you need to go to a hospital in the coastal network for planned procedures. If you don’t go to one of these hospitals we will pay up to a maximum of 70% of the hospital account and you will need to pay the difference. This does not apply in the coastal network. 

Cover for having a baby

Before you go to hospital for any planned procedure, you must:

  • see your doctor 
  • authorise your hospital admission with us beforehand as hospital cover is not automatic.

You must authorise your admission to hospital at least 48 hours before you go in.

We need to know so we can manage your costs in the best way, and give you information that is relevant to how we will cover your hospital stay. If you do not authorise your admission we will only pay 70% of the costs that we would normally cover.

Costs related to childbirth

We cover childbirth from your Hospital Benefit. Your Hospital Benefit covers your hospital account, internal medical devices and emergency medical services.

Hospital cover includes home births done by midwives with valid practice numbers and who are registered with the Board of Healthcare Funders. You must let us know 48 hours before your hospital stay.

Caesarian sections

We cover a stay of four days and three nights in hospital.

Normal vaginal deliveries

We cover a stay of three days and two nights.

Home births

We cover home births from the Hospital Benefit.

The midwife attending the birth must have a valid practice number and be registered appropriately with the Board of Healthcare Funders.

You must let us know if you choose to have a home birth.

The midwife charges a global fee for the confinement (the birth of the baby) and this includes any follow-up care needed for three days after the delivery.

Water births

In-hospital

If you have a water delivery in hospital, the cost of hiring a birthing pool is included in the global costs related to the confinement (birth of the baby). If you want to hire one, you will be responsible for paying for it.

Out-of-hospital

If you have a water delivery at home, Discovery Health will cover the cost of the hire of a birthing pool from the Hospital Benefit. This must be hired from a practitioner who has a registered practice number.

We do not cover the lodging fees if your baby needs to stay in hospital after your discharge. If you choose to stay in hospital to be with your baby while he or she receives medical care, you will be responsible for the cost of your accommodation.

KeyCare Series

You need to go to a hospital in the KeyCare hospital network. If you go to any other hospital you will need to pay for cost of your admission. This does not apply in an emergency – once you are stabilised you may be transferred to one of the hospitals in the KeyCare hospital network.

Please note that elective caesarean sections for members on the KeyCare Series are not covered.

Day-to-day benefits

We cover:

  • Four visits to a gynaecologist in the KeyCare network hospital (KeyCare Plus members: your selected GP must refer you)
  • One routine scan (between 10 and 20 weeks of pregnancy)
  • Selected antenatal blood tests requested by your gynaecologist
  • Remember that you must get a reference number for your gynaecologist’s claims to be covered.

Antenatal Classes

The KeyCare Plans do not cover antenatal classes.

Hospital Cover

Cover for having a baby

Before you go to hospital for any planned procedure, you must:

  • see your doctor 
  • authorise your hospital admission with us beforehand as hospital cover is not automatic.

You must authorise your admission to hospital at least 48 hours before you go in.

We need to know so we can manage your costs in the best way, and give you information that is relevant to how we will cover your hospital stay. If you do not authorise your admission we will only pay 70% of the costs that we would normally cover.

Costs related to childbirth

We cover childbirth from your Hospital Benefit. Your Hospital Benefit covers your hospital account, internal medical devices and emergency medical services.

Hospital cover includes home births done by midwives with valid practice numbers and who are registered with the Board of Healthcare Funders. You must let us know 48 hours before your hospital stay.

Caesarian sections

We only cover emergency caesarian sections on the KeyCare Plans.

Normal vaginal deliveries

We cover a stay of three days and two nights.

Home births

We cover home births from the Hospital Benefit.

The midwife attending the birth must have a valid practice number and be registered appropriately with the Board of Healthcare Funders.

You must let us know if you choose to have a home birth.

The midwife charges a global fee for the confinement (the birth of the baby) and this includes any follow-up care needed for three days after the delivery.

Water births

In-hospital

If you have a water delivery in hospital, the cost of hiring a birthing pool is included in the global costs related to the confinement (birth of the baby). If you want to hire one, you will be responsible for paying for it.

Out-of-hospital

If you have a water delivery at home, Discovery Health will cover the cost of the hire of a birthing pool from the Hospital Benefit. This must be hired from a practitioner who has a registered practice number.

Lodging fees

We do not cover the lodging fees if your baby needs to stay in hospital after your discharge. If you choose to stay in hospital to be with your baby while he or she receives medical care, you will be responsible for the cost of your accommodation.

 

Make sure your baby is covered

The baby will be covered automatically for the calendar month of his/her birth. To continue cover, contributions for the baby must be paid from the first month following the baby's birth.

Example: A baby is born on 3 March. The mother is registered on Discovery Health. The baby is covered until 31 March. If the baby needs cover from 1 April onwards, it must be registered on Discovery Health.

The Medical Schemes Act allows 30 days from the date of birth for the parents to register the baby with the Medical Scheme. Parents must complete a newborn application form and submit it to Discovery Health to ensure that their baby is covered.

The baby may be subject to underwriting, if he/she is not registered within the 30-day period.

We may not pay for your treatment in full

Cover is subject to our rules

Once we authorise your hospital admission, we may not pay for the treatment in full. Your cover is according to our scheme rules, funding guidelines and clinical rules. There are some expenses you may incur while you are in hospital that the Hospital Benefit does not cover, for example private wards. Certain procedures, medicines or new technologies need extra authorisation while you are in hospital.

The following in-hospital expenses are not covered by the Maternity Programme: