Family planning is one way to celebrate world population day

Peter Jordan, Principal Officer of Fedhealth.

According to the United Nations, World Population day on 11 July aims to reaffirm the human right to plan for a family and to encourage events and information to make this right a reality throughout the world. It is also a time to embrace women's wellness

According to Peter Jordan, Principal Officer of Fedhealth, while pregnancy is an exciting time for expectant parents, it can be a costly exercise if not planned correctly and financial planning is the key to a happy event.

Jordan says co-payments are something that few members will escape completely during a pregnancy, adding that to keep co-payments to a minimum there are a few things to consider. "First and foremost I would suggest that members register their pregnancy with their scheme and obtain authorisation for the birth. Emergencies during a pregnancy will also require authorisation."

Statistics from Fedhealth's data warehouse over the last three years show that of all their deliveries in South Africa, nearly 80 percent are performed via c-section. C-section procedures and the resultant hospitalisation cost, is significantly more than a natural delivery. Jordan says on average, c-sections cost a scheme around R23 000 with hospital costs making up approximately 70 percent of the total cost. Natural deliveries, on the other hand, are significantly less, costing a scheme approximately R13,440.

Next Jordan urges members to ensure that their chosen specialist assisting them with their pregnancy and birth, typically a gynaecologist or obstetrician, is covered by their medical scheme option. "Many women choose to go by word of mouth when selecting a specialist but depending on what scheme or option they are on, it is not always guaranteed that consultations with the member's preferred specialist will automatically be covered," adds Jordan.

"Members ideally should make use of a network specialist or GP to ensure that consultations will be covered. Many schemes provide unlimited visits on most of their plan options provided a network specialist or GP is consulted.

The same applies to the facility or hospital that members will be making use of. In many cases only network hospitals or facilities are covered, or members may have to pay in 40% of the total cost depending on what option they are on," he advises.

This also applies to attending specialists during the birth. To avoid co-payments members must ensure that the delivery by a general practitioner or medical specialist and the services of the attending paediatrician and or anaesthetist fall within the scheme's specialist network. Members should also check whether the global obstetric fee covers post-natal care by a general practitioner and medical specialist up to and including the six-week post natal consultation.

As an alternative, Jordan says Fedhealth will cover the cost of deliveries by a midwife and the hire of a watering birthing unit. They also cover four post-natal visits by a midwife so that women are empowered to make the best decisions regarding their confinement. "It is unfortunate," says Jordan, "that in SA there has been little support for private independent midwives."

Jordan says co-payments can also be reduced by making use of Designated Service Providers when it comes to purchasing of medication. Again, this will depend on the various scheme options. "Members should stick to using medication that is within the formulary. This will decrease potential co-payments and will make sure that benefits last longer," he concludes.