By Tony Singleton
We are living in an extremely stressful time, with uncertainty around COVID-19 causing many people a lot of anxiety. Pregnancy is a time already often fraught with concern, especially around medical expenses and medical expense shortfalls from medical aid, as these are often significant. The current climate is only making matters worse. Gap cover can help to ease some of the financial stress whilst dealing with a pandemic.
While experts seem to agree that pregnancy does not put women at greater risk of severe illness during this time, there are still many unknowns about the impact of the virus on unborn babies and pregnant women. If women test positive for the virus before giving birth, they are placed in isolation wards and are not permitted to have anyone besides medical personnel present at the birth. There is also the concern that being infected means women could pass the virus onto their new born baby, putting them at risk. Sadly, South Africa has already seen one neonatal death as a result of the virus.
Tony Singleton, CEO at Turnberry Management Risk Solutions says uncertainty is the “biggest cause of anxiety for many, added to financial and physical stress. Any complications could add further medical expense shortfalls to an already costly time, with long-term implications.”
Given the financial strain many people are facing due to pay cuts or even a complete lack of income, it may be tempting to cancel medical aid memberships. However, this could result in long-term financial difficulties.
“I understand that not everyone is able to afford medical aid, as it is expensive. However, if you can, I would strongly recommend taking at least a hospital plan. Pregnancy can be very stressful and having medical aid relieves a lot of that stress. For example, I knew that my labour would be covered with my first pregnancy (even if I had a C-section). In fact, the majority of our hospital costs were covered,” says Claries Roelofsz, who is currently 20 weeks pregnant with her second child.
Aside from expenses directly related to pregnancy or even COVID-19, accidents also happen, which can lead to financial distress due to lack of cover from medical schemes.
“I dislocated my shoulder in 2017 and needed to go to the emergency room. I was not admitted overnight, and the medical aid therefore did not cover the hospital costs. This was under the ‘fine print’ and I was not aware that I needed to be admitted overnight in order for them to cover the costs. If this happened during the lockdown as a result of medical requirements for my pregnancy, my husband would not have been allowed to come with me and the financial strain of having to pay cash would have put more pressure on us as a household,” Roelofsz adds.
Mind the gap
During pregnancy and childbirth, the list of medical expenses is extensive and medical expense shortfalls are an all-too-common occurrence. From the gynaecologist to midwives and doulas (and anaesthetists should a C-section be required), as well as paediatrician fees after the birth, there are many areas where medical aid may not cover the full amount. In addition, should a woman elect to give birth at a hospital outside of their Designated Service Provider (DSP) network, they will be liable for further medical expense shortfalls.
“Often, pregnancy and childbirth result in unanticipated medical expenses, which could leave young families in greater financial distress if they do not have medical aid. Even with medical aid, you are not guaranteed full cover,” adds Singleton.
“For example, at Turnberry we have seen shortfalls in cover of up to R28 000 for a C- section and up to R20 000 for spontaneous vertex deliveries. Without gap cover in place, young families are placed under heavy financial strain as they will need to find a way of paying for these medical expense shortfalls out of their own pocket. In normal circumstances this is challenging for a family just starting out, but in the current pandemic and economic crisis it could be catastrophic,” he adds.
Less worry, more joy
Welcoming a child into the world should be a joyful experience, but current circumstances are causing strain. In a world where women may have to give birth in isolation, and cannot introduce their new children to family and friends, the last thing they need is to worry about medical expense shortfalls.
“Gap cover can help to alleviate some of the strain by giving new mothers and young families peace of mind that their medical expenses will be taken care of. Amidst all of the other worry, this leaves a little more room to focus on the important things, like being a family and bonding with the new baby. However, parents trying for a child must understand that gap cover needs to be taken out before falling pregnant as waiting periods do apply. So, speak to your financial advisor today to ensure you are covered during trying times,” Singleton concludes.