Navigating Maternity Scans Cover: What Couples Need to Know

Planning for a child is an exciting journey for couples, and access to essential maternity healthcare is a top priority. Maternity scans, which include ultrasound imaging and screening during pregnancy, are vital for monitoring both maternal and fetal health. Reliable health insurance makes these important services accessible and affordable. For South African couples, it is crucial to understand what types of maternity scan cover exist, how they work within health insurance plans, and what to consider when selecting the best option for your unique needs.

What Are Maternity Scans?

Maternity scans are non-invasive procedures that use imaging technology to assess the development, growth, and general health of the fetus at different stages of pregnancy. These scans typically include:

• Early pregnancy scans (6-12 weeks)
• Mid-pregnancy anomaly scans (18-22 weeks)
• Growth scans (28-36 weeks)
• Specialised monitoring for multiple pregnancies or high-risk cases

Why Are Maternity Scans Important?

• Monitor fetal growth and wellbeing throughout pregnancy
• Identify developmental concerns early for best intervention
• Guide healthcare practitioners in providing evidence-based, individualised care

How Maternity Scans Are Covered Under Health Plans

Not all health insurance plans in South Africa provide automatic cover for maternity scans; coverage depends on the type of plan and its specific inclusions. Hospital and combined health plans often offer benefits for in-hospital maternity care-including approved scans performed during admission. Out-of-hospital or routine scans may be subject to separate rules or benefit limits under day-to-day cover products. Couples are encouraged to review the benefits offered by their chosen plan to ensure prenatal and postnatal needs are addressed.

Comparing Maternity Scan Cover: What Couples Should Look For

These example costs are based on 2024 rates from Affinity Health and provide perspective for comparing plan options. Always confirm the most up-to-date premium with the provider.

Key Features of Maternity Scans Cover for Couples

Choosing suitable cover involves looking beyond just cost: the level of inclusion, ease of access to providers, and type of network all impact the quality and convenience of care. For couples, planning for the necessary number of scans (usually 2-4 per pregnancy), and potential high-risk events, becomes important. Cover for hospitalisation, advanced scans, and support between appointments is essential for peace of mind throughout pregnancy.

Making the Most of Your Maternity Benefits

• Familiarise yourself with plan documentation and benefit limits for scans, blood work, and routine check-ups.
• Identify the nearest partnered clinics and hospitals-use the Find a Hospital Provider tool to see your local network.
• For out-of-hospital appointments, check if the approved provider list includes specialists who offer ultrasound services.
• Keep records of all scan appointments, reports, and bills to make the claims process easier.
• Ask your healthcare practitioner for advance approval where pre-authorisation may be needed.

Budgeting and Planning for Couples

Most couples will want a plan that covers both routine day-to-day medical care and potential hospital events, ensuring that no important maternity service is missed. Combined plans are specifically designed for this purpose-providing in-hospital and out-of-hospital scan cover within broadly affordable monthly ranges.

Tips for Couples New to Health Cover

• Review frequently asked questions in the Affinity Junior Cover page, which outlines what happens after birth and how newborn benefits can start.
• Discuss all maternity options with your healthcare practitioner to ensure your plan matches your specific medical needs.
• If working in a company setting, check for possible Group Cover benefits, which may improve price and service.

Sources

• Affinity Health - Combined Plan
• Affinity Health - 2024 Recommended Premiums
• Department of Health SA - Maternal & Child Health
• Statistics South Africa - Births and Healthcare Data