Cover for Pregnancy and Childbirth

Bankmed offers cover for in-hospital and out-of-hospital pregnancy and childbirth, subject to your selected Plan benefits. Preparing for your baby's arrival? Join the Baby and Me Programme.

Maternity Benefits

In-hospital Cover Guidelines

    
  • Hospitalisation and associated in-hospital services require pre-authorisation. Failure to obtain pre-authorisation may result in the loss of benefits or incurring co-payments.
  • You must use a DSP to ensure full coverage at the contracted rate. If you do not use a DSP, claims may not be paid in full. Prior authorisation for admission is essential, and you should contact us at 0800 BANKMED (0800 226 5633).

Maternity Benefits Covered by Bankmed

  • Midwife care and delivery
  • Birthing facilities as an alternative to hospitalisation
  • Cost of disposables are limited to R1 440 for each case
  • Out-of-hospital cover includes certain pregnancy-related expenses based on your Plan benefits
  • Antenatal and post-natal care includes services of GPs, specialist consultations, and procedures performed in the Healthcare Professional's rooms
  • Ultrasonic investigations are limited per Plan type
  • Pathology tests
  • Newborn screening test:
    • Available to all newborns to detect certain metabolic and endocrine disorders
    • Clinical entry criteria and Plan limitations apply
  • Newborn hearing test:
    • Funding only covers the test, provided by a registered Audiologist
    • Plan limitations apply
  • T21 chromosome test or non-invasive prenatal test (NIPT):
    • Clinical entry criteria and Plan limitations apply; applicable to high-risk beneficiaries aged 35 years and older at delivery
    • If a T21 test is positive, the Healthcare Professional may refer for NIPT, and Bankmed will fund both tests, subject to pre-authorisation
  • Amniocentesis:
    • Clinical entry criteria and Plan limitations apply
    • Any registered pathologist may perform the test, subject to gynaecologist referral

Items Not Covered

  • Mother and baby packs supplied by the hospital
  • Bed-booking fees required by certain hospitals
  • Lodger or boarder fees if your baby needs an extended stay in the hospital and you choose to stay on

IMPORTANT: Please refer to the Plan Tables for specific limitations and requirements pertaining to maternity benefits on your Plan.

Baby-and-Me Programme

Baby-and-Me is Bankmed's maternity programme that informs and empowers expectant parents during pregnancy.

Basic, Core Saver, Traditional, Comprehensive Plans

Bankmed's dedicated maternity programme, Baby-and-Me, offers enhanced coverage for pregnancy and childbirth. Access to this programme is exclusive to members on the Basic, Core Saver, Traditional, and Comprehensive Plans. Unfortunately, members on the Essential and Plus Plans are not eligible for the additional coverage provided by the Insured Benefit.

Key Benefits and Reasons to join

We provide additional coverage from the Insured Benefit during pregnancy for services such as ultrasounds and further consultations. A client relationship manager can help you to register on the programme and give you advice throughout your pregnancy and after the birth of your baby.

When you register, you receive:

  • A Bankmed baby hamper*, redeemable at any Toys R Us or Babies R Us store nationally.
  • Extra coverage beyond the standard benefits.
  • Regular communication at different milestones throughout your pregnancy.
  • Assistance with hospital pre-authorisation.
  • A comprehensive hospital checklist to prepare you for your hospital stay.
* Note: The contents of the Bankmed baby hamper are subject to change without notice based on stock availability.

Additional Insured Benefits

Additional Insured Benefits are subject to registration on the Bankmed Baby-and-Me Programme. All additional Insured Benefits require a referral from a GP within the Bankmed GP Network.

Access the 2025 Benefit & Contribution schedule for further detail relating to coverage for the Basic, Core Saver, Traditional, and Comprehensive Plans

How to join

Complete the Baby-and-Me application form below and send it via one of the below channels:

To complete the form, you will require:
  • Bankmed membership number
  • Details of parent-to-be
  • Details of parent-to-be's caregiver (Healthcare Professional)
  • Expected date of delivery
  • Details of medical history and previous pregnancies (if applicable)

Collection

You can collect your Bankmed Baby Hamper from any Toys R Us or Babies R Us store. All you need to do is open the link we send to you by SMS, click on REDEEM and present your code at the till point. If you have misplaced the SMS, contact us on 011 529 7227 and we will resend it to you.

Preparing for your baby's arrival

The 28th week marks the first phase of the final trimester of your pregnancy and you need to prepare for the baby's arrival. The preparation stage begins with booking your hospital admission. A hospital pre-authorisation number will be requested by the hospital when you book your hospital stay. This is a unique number that is provided to you by Bankmed. You may contact us on 0800 BANKMED (0800 226 5633) for additional information.

You have your hospital pre-authorisation number - What now?

To ensure payment of related hospital claims and that your baby is registered as a dependant, you must complete the dependant registration forms within 30 days of your baby/babies' date of birth.