If you are considering giving birth at a private hospital in South Africa, the chances of you choosing from a list of private gynaecologists are much higher.
By private I mean, gynaecologists that don’t charge typical medical aid rates. Some private gynaecologists charge up to 400% of medical aid rates and most medical aids only cover up to 200% of medical aid rates – and that depends on your scheme.
The reason why gynaecologists charge a huge fee is because of the malpractice insurance amount they need to pay yearly.
Please note: Every medical aid works out their cover rate percentages differently so when you book with a private gynaecologist, don’t just assume that half of the amount due will be covered by your medical aid. Sometimes it’s a little less than that.
My medical aid scheme covers 200% and my gynaecologist charges 300%. During my last check-up, the bill came to R790 but only R371 was covered by my medical aid.
In South Africa, medical aids work with “networks”. So, if you want to get the best out of your medical aid and not pay a cent extra towards your pregnancy and delivery, you need to use the services/doctors provided within the network. Many first-time parents don’t understand how crucial this is for their pockets. The network you are on is decided by the type of medical scheme you take from your medical aid.
How much do Top Private Gynaecologists charge in South Africa?
These rates are to be used as a guideline and was set by a gynaecologist who charges 300% based in the Sandton area.
Antenatal visits and important scans:
8 weeks – R880.00
12 weeks – R1560.00
16 weeks – R790.00
20 weeks – R1560.00
24 weeks – R790.00
28 weeks – R790.00
30 weeks – R790.00
32 weeks – R1560.00
34 weeks – R790.00
36 weeks – R790.00
37 weeks – R790.00
38 weeks – R790.00
39 weeks – R790.00
Total amount for visits: R12670.00
Vaginal birth – R14,760.00
Caesarean section – R14,760.00
Emergency caesarean section – R16,260.00
Anaesthetic – R5450.00
Anaesthetic emergency – R7815.00
Paediatricians +/- R5000.00
Important fees to know:
First antenatal visit – R880.00
Follow up visit – R770.00
Ultrasound – R880.00
Cardio-tocogram – R450.00
Urine test – R20.00
Emergency visits after hours (includes consultation, ultrasound, and materials used) R2,000.00
What to expect during your antenatal visits:
- Your first visit will include a urine test, routine blood tests and an ultrasound examination to determine gestational age, the number of foetuses, site, foetal heart beats, and size.
- Next, follow up visit will be booked depending on the duration of pregnancy. Routinely every 4 weeks until 28 weeks of pregnancy then every 2 weeks until 36 weeks of pregnancy and weekly thereafter.
- Electronic foetal heart rate monitoring (Cardio-tocogram) may be required during certain visits.
- Around 20 weeks of pregnancy, your gynae will provide you a letter for booking your bed in the maternity unit. Private patients are requested to pay a deposit fee at that time.
- The post-natal visit is booked 6 weeks after delivery. A PAP smear is usually done during this visit and future family planning is discussed.
- The post-natal visit fee is included in the delivery fee.
What is considered an emergency visit?
- Vaginal bleeding
- Amniotic fluid drainage
- Absent foetal movements after 26 weeks of pregnancy
- Painful contractions or other severe pains.
Payment for visits is required immediately after consultation. You then need to submit your statement to your medical aid to receive back some money.
If you end up having an emergency operation, the prescribed minimum benefits kicks in which helps the patient avoid paying in a big fat amount for something she never asked for.
In terms of the Medical Schemes Act of 1998 (Act number 131 of 1998) and its regulations, all medical schemes have to cover the costs related to the diagnosis, treatment, and care of:
- any life-threatening emergency medical condition
- a defined set of 270 diagnoses and
- 27 chronic conditions.
These conditions and their treatments are known as the Prescribed Minimum Benefits (PMB).
All medical schemes in South Africa have to include the Prescribed Minimum Benefits in the health plans they offer to their members. There are, however, certain requirements that a member must meet before he or she can benefit from the Prescribed Minimum Benefits.
The three requirements are:
1. The condition must be part of the list of defined PMB conditions.
2. The treatment needed must match the treatments in the defined benefits on the PMB list.
3. Members must use the scheme’s designated healthcare service providers.
To find out more about PMB, visit www.medicalschemes.com.