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Gap Cover For Pregnancy: All You Need to Know

Gap cover for pregnancy

Navigating medical cover can be challenging, especially when you are preparing for your new addition to the family. One of the many considerations for expectant parents is gap cover.

Gap Cover is not a medical aid; it is supplementary insurance designed to cover the shortfall between what your medical aid pays and the actual cost of medical treatment.

This article will explore the significance of pregnancy coverage within gap cover. We hope to guide families in ensuring financial protection during this pivotal time, offering insights into TRA’s policies.

Understanding Gap Cover

Gap cover is an insurance policy that acts as a safety net for medical expenses exceeding the amounts paid out by your medical aid.

It is important to note that gap cover is not a substitute for medical aid. Therefore, in order to qualify for gap cover, you have to have a medical aid.

Gap Cover primarily addresses the difference in costs for authorised medical procedures, both in and out of the hospital, that medical aid schemes do not fully cover.

Pregnancy Cover Under Gap Cover

Pregnancy is a special time that requires proper care and attention. Regular check-ups and ultrasounds are necessary to ensure the health of both the mother and the baby. In some cases, more complex medical procedures are required depending on the circumstances of the birth. Gap cover policies can help cover the costs associated with pregnancy by paying for shortfalls arising from in-hospital specialist consultations with obstetricians, C-section surgery, and in-hospital treatments that are charged at more than the medical aid tariff.

These services can be exhaustive to your medical aid, but having pregnancy coverage through gap cover ensures that expectant mothers can receive the care they need without worrying about out-of-pocket expenses.

How Pregnancy Cover Fits Within TRA’s Gap Cover Policies

Pregnancy cover within gap cover offers tailored benefits that address the specific needs of pregnant women. These benefits cover a range of pregnancy-related medical procedures and hospital stays.

TRA’s Maternity Ward Benefit

As we mentioned, pregnancy-related healthcare can be extensive, ranging from prenatal check-ups to delivery and postnatal care.

TRA’s gap cover addresses the financial implications of these services, offering benefits such as the Maternity Private Ward Benefit. This specific benefit covers the shortfall between general and private ward rates for childbirth, capped at a daily limit for up to three consecutive days. It ensures a comfortable and stress-free hospital stay.

TRA’s Additional Benefits

In addition to direct pregnancy-related benefits, gap cover policies often include other perks that could be beneficial during pregnancy. 

Additional TRA Benefits for Pregnant Women

Beyond direct pregnancy-related benefits, TRA’s gap cover includes additional perks that can be beneficial during pregnancy. This includes oncology benefits for medical aid-approved treatment plans and emergency medical assistance, ensuring comprehensive coverage beyond maternity care.

Choosing TRA’s Cover

Selecting the right gap cover for pregnancy is comparing different plans to see which offers the most comprehensive benefits at a reasonable premium. It’s essential to look beyond the maternity benefits and consider other policy aspects that could affect your family’s health and financial well-being.

For instance, policies may differ in coverage levels for in-hospital procedures, co-payments, and sub-limits for specific treatments.

TRA Gap Cover Policy With Maternity Benefits

Expectant mothers must select the right gap cover provider and look at the policies and coverage levels.

TRA offers various plans with differing coverage levels, allowing families to choose the best option. For instance, the Super Cover Plus and Absolute Cover Plus plans offer extensive benefits, including coverage for co-payments and sub-limits, which can offer financial protection during pregnancy.

Using TRA Gap Cover When Your Baby Comes

Ensure you cover your newborn under your medical scheme and your gap cover policy to benefit from our Gap Cover.

In Hospital Newborn Coverage

TRA’s gap cover policies typically cover newborns from the moment of birth. This means that subject to the policy’s specific terms and conditions, any medical procedures or hospital stays required by the newborn are covered. This immediate coverage is invaluable in cases where infants require additional medical attention.

In Hospital Postnatal Care for Mothers

After giving birth, mothers need to recover and may require follow-up medical consultations, treatments, or even physical therapy whilst still hospitalised. TRA acknowledges the importance of comprehensive postnatal care and provides coverage that helps bridge the gap left by medical aid schemes, covering a portion of these additional expenses.

Extended Oncology Benefits

For mothers facing health challenges such as cancer, TRA offers extended oncology benefits. These benefits cover the shortfall for approved oncology treatment plans, ensuring that mothers receive the necessary care and support during this challenging time without worrying about the financial burden.

It is important to ensure your medical aid covers the neccessary in-hospital procedures, regarding pre and post natal care in order to qualify for gap cover to cover the shortfall.

In addition, view TRA’s out-of -hospital shortfall procedure list to understand your coverage entirely.

Families and new mothers are encouraged to review their TRA gap cover policy details to understand the extent of the after-birth coverage provided fully.

View our 2024 Coverage Brochure.

Gap Cover Policy Waiting Periods, Terms and Conditions

An essential aspect of understanding gap cover involves familiarising yourself with the policy’s conditions and waiting periods.

Most gap cover policies enforce a waiting period for pregnancy and childbirth claims. This means coverage for these events only becomes active after a specified period from the policy start date. These waiting periods ensure that coverage is provided fairly and sustainably.

TRA’s Waiting Period

No claims can be submitted for pregnancy and childbirth within the first 10 months of membership, highlighting the importance of securing gap cover before your pregnancy journey. However, if you are already pregnant, you can still join TRA and benefit from the costs related to the baby for in-hospital procedures.

Go into Your Pregnancy Covered With TRA

Pregnancy should be a time of excitement and joy. Throwing baby showers and choosing what to pack for that first day in the hospital should not be overshadowed by concerns over potential medical expenses. With the right gap cover, families can secure financial security and access to quality healthcare during this pivotal period.

Total Risk Administrators (TRA) offers gap cover options designed specifically for expectant mothers, providing peace of mind throughout this special journey.

We encourage you to consider TRA Gap Cover. With TRA, you can ensure you’re fully prepared for this exciting chapter of your life, backed by medical and financial coverage.

Secure the support you and your baby need during this special time and contact our team today if you would like to explore your options.

Note: All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on and matter relating to their health and well-being. The information and opinions expressed here are believed to be accurate, based on the best judgement available to the authors, and readers who fail to consult with appropriate health authorities assume the risk of any injuries. Errors and Omissions Excepted. Terms and Conditions Apply.


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