Baby on the way – what do you need to do as a member of AMS?
When you fall pregnant, a million things go through your head. You already feel overwhelmed with questions about both your and your baby’s health, the financial implications of raising a child and the future of your family - so we do understand that medical aid matters might not be at the top of your list.
In terms of Scheme cover, the most important thing to remember is to call us on 0860 222 633 to:
- register your pregnancy between week 12 and 20;
- get authorisation for the confinement; and
- register your newborn within 30 days of birth.
Registration of your pregnancy - why?
If you don't register your pregnancy, the consultations with your GP or gynaecologist and ultrasound scans will be paid out of your normal day-to-day benefits or Medical Savings Account. If you do, however, register your pregnancy between week 12 and 20, you get access to additional maternity benefits. On the Standard Care Plan (SCP) you have access to eight prenatal and/or postnatal consultations and on the Managed Care Plan (MCP) you have 12 prenatal and/or postnatal consultations per pregnancy - either at your GP or gynaecologist. On the Value Care Plan (VCP), in addition to your GP consultations, two gynaecologist consultations per pregnancy are covered at the Prime Cure agreed rate. Two 2D ultrasound scans per pregnancy are covered on all three plans.
Authorisation for the confinement
As for any procedure or hospital admission, you need to get authorisation for the confinement. Every pregnancy is different and we do not know when your baby will be born. Call us as soon as your anticipated delivery date has been established. If the delivery comes sooner than anticipated, you can call us within 48 hours after admission to obtain authorisation. On the SCP and MCP, your confinement can take place in a hospital or, if preferred, in a low-risk maternity unit provided by a registered midwife. There is no hospital limit, but Scheme Reimbursement Rates apply - 100% on SCP and up to 230% on MCP. On VCP, the confinement in hospital is subject to the Overall Family Hospital Limit and the Prime Cure agreed rate.
Registration of your newborn 30 days after birth
As per the Scheme rules, you need to register your baby within 30 days of birth in order to ensure membership and prevent waiting periods. To register your baby, please submit the application form for the ‘Registration of a new-born baby’ (available on Info Centre > Downloads) to your HR department together with the baby’s birth certificate.
Did you know?
The ‘30-day registration deadline’ also applies to newly adopted children or if you want to add your new spouse and dependants to your membership.