Does Health Insurance Cover Pregnancy?

Yes! But make sure that your health insurance policy has maternity benefits. Because standard health insurance policy may not always cover pregnancy expenses. Therefore, in order to get coverage on normal delivery, cesarean, hospitalization, newborn care and other pregnancy-related expenses you need to buy Maternity Insurance policy or a health insurance policy that provides maternity coverage as an additional benefit. Besides, most of the time there is a waiting period for maternity claims, so it is better to go for a pregnancy plan in advance.

Planning a Baby Soon? Know One More Expense Involved

Making a new addition to the family is one of the most exciting times for any family. But along with happiness comes a huge responsibility, starting from regular medical checkups, diagnostic tests, medicines, hospitalization, delivery charges and post natal care for the newborn baby. In fact, maternity expenses in India have gone up exponentially in the last few years.

Depending on the city and hospital you choose, delivery charges might range from anywhere between Rs. 50,000 to more than Rs. 2,00,000.

That is where the Maternity Insurance plan comes to your rescue.

The biggest misconception about maternity benefits is that most of the health insurance plans provide maternity coverage as a part of the base policy. In reality it is not the case. Knowing how maternity benefits work will prevent you from huge expenses during one of the most crucial periods of life.

In this article, we will be discussing everything you need to know about pregnancy insurance, maternity benefits, things that are covered and not covered, the waiting period and other details that might help you while purchasing a maternity insurance policy.

What is Maternity Insurance?

Maternity Insurance is a special type of health insurance benefit provided to insure against medical expenses incurred due to childbirth. Instead of paying all the hospital bills from your own pocket, you can claim money from your maternity insurance company against pregnancy related expenses as per the terms and conditions of the policy.

Depending on your maternity insurance provider, your maternity benefits might consist of :

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  Doctor's consultation fees during the pregnancy

  
  


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  Hospitalization expenses during pregnancy

  
  


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  Normal delivery

  
  


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  Cesarean section (C-Section)

  
  


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  Expenses incurred due to pregnancy related complications

  
  


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  Pre and post hospitalization expenses

  
  


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  Newborn baby coverage for a certain period of time

  
  


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  Every insurer company provides maternity benefits differently. Hence, comparing various insurance plans is necessary in order to choose the best one available in the market.

  
  

What is Covered Under Maternity Insurance?

Although each insurance company defines its maternity cover differently, there are a handful of standard things that are covered by almost every Pregnancy Insurance Policy :

1. Hospitalization During Pregnancy  If hospitalization is necessary during pregnancy, your maternity insurance policy will cover eligible hospitalization expenses as per the terms and conditions mentioned in your policy document.

2. Expenses Incurred due to Normal Delivery  Almost all Pregnancy Insurance Policies covers normal delivery after the waiting period is over. Expenses that are usually covered under this segment includes:

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  Room rent

  
  


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  Nursing charges

  
  


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  Doctor's fees

  
  


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  Expense incurred during the delivery

  
  

3. Expenses Incurred due to Cesarean Section (C-Section)  If your doctor suggests C-Section due to any medical reasons, maternity insurance covers eligible hospitalization expenses as per your policy terms and conditions. Since, C-Section is costlier than normal vaginal delivery, having a maternity insurance plan will help reduce your out-of-pocket expenses.

4. Expenses Incurred due to Pregnancy Complications  Certain maternity insurance policies also cover expenses incurred due to pregnancy related complications, if any, as per your policy terms and conditions. For instance:

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  Treatment expenses for high-risk pregnancies

  
  


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  Treatment expenses for gestational diabetes

  
  


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  Treatment expenses for pregnancy-induced hypertension

  
  


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  Other pregnancy related complications, if any, as mentioned in your policy document.

  
  

5. Pre and Post-Hospitalization Expenses  Apart from the expenses incurred during the delivery, Maternity Insurance also covers eligible pre and post-hospitalization expenses. Some of the things that are covered under these segments are:

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  Diagnostic tests

  
  


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  Doctor's consultation fees

  
  


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  Medicines

  
  


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  Other expenses, if any, as mentioned in your policy document.

  
  

The number of days for which pre and post hospitalization expenses are covered depends on your insurer company.

Is Newborn Baby Covered Under Maternity Insurance?

Yes, newborn babies are covered under most of the comprehensive health insurance plans. Several insurance companies also provide limited newborn coverage for a certain period of time. Coverage can include:

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  Treatment expenses for certain medical conditions

  
  


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  Hospitalization expenses for certain medical conditions

  
  


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  Initial medical care for the newborn baby

  
  


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  Vaccination benefits for the newborn baby (if mentioned explicitly in your policy document)

  
  


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  After the baby is born, most of the insurance companies provide an option to add your newborn to your family floater health insurance policy in order to provide continuous health insurance coverage for the child.

  
  

Why is it Better to Buy Maternity Insurance in Advance?

One of the most common mistakes made by people is that they look for pregnancy insurance policies after they become pregnant. Unfortunately, it is too late to buy a maternity insurance policy after you become pregnant, since most of the maternity insurance policies have a waiting period that ranges from 9 months to 4 years. Therefore, in order to claim maternity benefit, you should buy a pregnancy insurance policy at least 4-5 years in advance.