FutureSA / Baby and Beyond – 13th January 2023
While it is not possible to predict a preterm birth, some risk factors can increase the chances of a baby being delivered before full term, and the parents of a premature infant should expect that their baby will more than likely need some form of medical intervention to survive.
Preterm birth is defined as the birth before 37 weeks of pregnancy, and it is estimated that about 15 million babies are born prematurely each year across the globe, with approximately 84 000 of these births occurring in South Africa.
Common causes of preterm birth include multiple pregnancies, infections, and chronic conditions such as diabetes and high blood pressure, or genetic influences; however, often no cause can be identified. Some of the most common health conditions that affect premature babies include apnoea of prematurity (temporary pauses in breathing during sleep), bronchopulmonary dysplasia (underdeveloped lungs), and intraventricular haemorrhage (bleeding in the brain).
As a result, premature babies often need special care after leaving the Neonatal Intensive Care Unit (NICU), sometimes in a high-risk new-born clinic or an early intervention programme. Depending on their health, they may need care from specialists, such as doctors who treat problems with the brain and nervous system (neurologists), eyes (ophthalmologists), and lungs (pulmonologists).
Post birth care
Premature babies must go to all doctor visits and receive the vaccines that all babies need to stay healthy and undergo routine hearing and eye exams. As the baby grows, doctors will check their growth development, including speech and language; learning and motor skills; muscle tone, strength, and reflexes.
Unfortunately, the treatment and interventions required for preterm babies can be costly. Depending on the baby’s condition, the cost of staying in a NICU could vary between R7 000 and R10 000, on top of which parents must also consider the costs of the specialists who will be treating their newborn.
A medical aid scheme will cover these costs, but only in line with the benefits that the scheme provides. This will depend on the type and option of the medial aid plan. However, medical specialists tend to charge over and above medical aid rates, meaning there could be a shortfall between the amount covered and the actual amount charged.
This is where gap cover, or medical expense shortfall cover, can help. Gap cover is a policy that covers predominantly in-hospital events and pays for the shortfall between what medical specialists charge and what a medical aid scheme will pay out.
Best medical care possible
It goes without saying that as a parent, when your baby needs medical attention, you want to be able to provide them with the best medical care available. Gap cover is invaluable in helping you achieve this, and if parents take out gap cover during the pregnancy, their baby will be covered for any medical expense shortfalls post the birth.
It is advisable that expectant parents look at their family’s financial needs holistically before picking a medical scheme and option that best suits them from a financial and benefits perspective. They should also look at supplementing their medical aid cover with a gap policy that will assist with the payment of specialists’ fees, co-payments, and any sublimit cover that the family might be exposed to.
Settling on the right choice of medical scheme and option is a very important decision and must be aligned with the applicable gap cover option to ensure that you are as comprehensively covered as you can afford. Consulting a financial advisor can be very useful to get insight into what is available on the market and what best suits your requirements.
About Turnberry Management Risk Solutions
Founded in 2001, Turnberry is a registered financial services provider (FSP no. 36571) that specialises in Accident and Health Insurance, Travel Insurance, and Funeral Cover.
With extensive experience across healthcare and insurance industries in South Africa, Turnberry offers unsurpassed service to Brokers and clients. Turnberry’s gap cover products are available to clients on all medical aid schemes, as they are independently provided and are therefore transferable in the event of a change in the client’s medical aid scheme. Turnberry is well represented nationally, with its Head Office based in Bedfordview, Johannesburg with Business Development Managers in Cape Town and Durban. The Turnberry Team’s focus on outstanding client service comes from having extensive knowledge and experience in the financial services sector and is underwritten by Lombard Insurance Company Limited. Lombard Insurance Company Limited is an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business
(011) 677-9891 firstname.lastname@example.org
What is Gap Cover?
We were able to use the best obstetrician in town to delivery our baby without having to worry about his rates exceeding medical aid rates. As a result my wife was able to leave hospital the day after giving birth to our son, and was able to move around freely, without much pain almost immediately upon returning home, Contrast to our first son’s delivery, where she was in a lot of pain and unable to move freely for almost a week. Our son was born during covid-19 lockdown so getting in and out of hospital quickly was vital.
It is definitely worth it. Medical costs, and in particular surgery and specialist costs can be excessive, and gap cover allows peace of mind, knowing that all costs will be taken care of.
As a parent when your child is sick, you want to be able to provide them with the best care. Gap Cover could be invaluable to help you achieve this as can be seen with one of our latest claims. After Monique and Hein had been to different specialists their Baby Amelie was diagnosed with Hyperostosis of the skull, a rare condition which causes thickening of the skull. At the end of November 2018 Brave Baby Amelie, under the care of a specialised Neurosurgeon and a specialised Ear, Nose and Throat Surgeon, underwent an extremely complex surgery.
The difference between what the highly trained Specialists charged and what the medical aid paid for Baby Amelies’ surgery was R110 448.13, which was paid by Turnberry.
Monique and Hein were able to focus on Baby Amelie and not worry about Medical Expense Shortfalls as they have a Turnberry policy. A policy that Monique and Hein says has provided them with peace of mind