Medical aid warning to new parents in South Africa
Many new parents in South Africa assume that because their medical aid covers the expecting mother’s pregnancy and maternity care, their newborn babies would be covered automatically after birth.
However, experts warn that the newborn baby will generally need to be registered with the medical scheme after birth, and there are deadlines for doing so.
“Pregnancy and childbirth involve a lot of planning, and medical scheme administration is easy to overlook among everything else parents are preparing for,” said Bonitas Principal Officer Lee Callakoppen.
“Understanding your maternity benefits and knowing what needs to happen once your baby is born can help parents avoid unnecessary stress during an already busy time.”
Callakoppen warned that while many newborns will only need routine examinations and follow-up appointments, some babies may require additional medical attention in their first hours, days or weeks.
A newborn could need treatment for conditions such as jaundice, feeding difficulties or breathing problems, or require investigations, specialist consultations or neonatal care.
He urged parents to enquire with their medical schemes before the birth to understand exactly how their policy works and what would happen if their newborn requires urgent medical treatment after delivery.
“When parents understand what their medical scheme covers and what they need to do to register their newborn, they can approach those first few weeks with greater confidence,” said Callakoppen.
He said that understanding the terms of their medical schemes can help them better focus on their child and their recovery, rather than trying to navigate the administration at the same time.
For Bonitas medical aid members, when a family welcomes a newborn baby, the child can be registered as a dependant on the principal member’s medical aid plan, subject to the Scheme’s rules and registration requirements.
Callakoppen said that the impact on the family’s monthly contribution will depend on the Bonitas plan selected, as each option has its own contribution structure for child dependents.
For example, on the 2026 Bonitas plans, the monthly contribution for a child dependant is R899 on BonStart Plus Select, while it’s R1,211 on BonSave.
Once registered, the newborn will have access to the benefits included in the chosen option, including the mother and child care benefit.
The Medical Schemes Act protects newborns during birth
The Medical Schemes Act 131 of 1998 is the main legislation governing private health financing in South Africa. Its purpose is to protect members’ interests and ensure fair access to healthcare.
While the Medical Schemes Act sets out regulations in South Africa, individual medical schemes can vary significantly in registration timelines, documentation deadlines, and additional maternity or baby benefits.
Every medical scheme automatically covers an infant’s immediate hospital care under the mother’s authorisation code at the time of delivery.
However, this coverage ends upon discharge unless the child is formally registered.
According to Section 29.1 of the Medical Schemes Act, if a child is registered within the specified grace period of 30 to 90 days, the scheme cannot impose waiting periods, late-joiner penalties, or exclusions for pre-existing conditions.
Most schemes allow the initiation of the registration process using the hospital’s birth notification slip.
To prevent the account from being frozen, parents must send the child’s official unabridged birth certificate from the Department of Home Affairs and their South African ID number within 30 to 60 days of receiving the notice.
Basic medical scheme policies in South Africa
| Medical Scheme | Grace period to register | Billing start date | Required initial document | Exclusions if registered late |
|---|---|---|---|---|
| Discovery Health | 90 days from birth | Date of birth | Hospital notification or birth certificate | Full medical underwriting (3-month general & 12-month condition exclusions) |
| Bonitas | 30 days from birth | 1st of the month following birth | Hospital birth notification | Loss of backdated cover; potential underwriting |
| GEMS (Public Sector) | 30 days from birth | Date of birth | Hospital notification / Home Affairs slip | Baby removed; non-refundable claims incurred post-birth |
| Momentum Health | 30 days from birth | Date of birth | Hospital birth registration slip | Standard 3-month waiting period applied |
| Bestmed | 30 days from birth | Date of birth | Hospital proof of birth | Subject to full underwriting rules |
| Medihelp | 30 days from birth | Date of birth | Hospital birth certificate / ID notification | Late-joiner underwriting rules apply |
| Fedhealth | 30 days from birth | Date of birth | Hospital proof of birth | Minimum 1-month general waiting period |
Loading ...