A woman’s pregnancy can be emotionally and financially taxing, so it’s crucial to have the appropriate insurance coverage and enough of it. An individual health insurance policy with a maternity benefit cover will pay the total cost of pregnancy, whereas a standard health insurance policy might not. In this narrative, we will cover everything you need to know about health insurance plans that offer maternity benefits. We’ll examine the premium prices for these policies, what is and isn’t covered, and how claims are resolved. *
What is included?
Health insurance covers maternity and an expecting mothers and her child’s medical expenses. It covers all pregnancy-related costs, including hospital stays, medications, tests, check-ups, and unanticipated events. Which policies are excluded? Such a policy may not cover treatments from or related to fertility, sterilisation, birth control procedures, etc., or treatments received from someone, not a medical professional.*
Cashless System: Any hospital in the insurance company’s network that accepts cashless payments is available. In this case, the policy expressly pays for the administrative costs. In essence, during such a process, the insurer directly resolves all or a portion of the claim with the hospital. *
Method Of Reimbursement: In this case, you must pay the bills in full before requesting reimbursement. Does your employer offer coverage for maternity leave? With group medical insurance plans, maternity benefits are typically an add-on. Not all employers, though, use this facility. As a result, you need to ask your employer about this extra.
Additionally, there may be a nine-month or longer waiting period for the maternity benefit under some group policies. In this situation, the waiting period is calculated starting from the employee’s start date. Experts advise against choosing a standard/individual health policy with maternity benefits if your employer already offers a health plan with maternity benefits.*
What ought you to do? Examine the policy’s sub-limits before weighing your options. “The most important things to look for are the initial waiting period before you are covered with the maternity benefit, the amount of cover for standard and cesarean delivery, and the additional premium you are paying for the maternity benefit. Some policies that include maternity benefits also cover prenatal and postnatal Outpatient Department (OPD) expenses, such as OPD Doctor consult fees, scan charges, and so on. Others still offer money to cover the cost of the newborn’s hospitalisation for three months following birth. These might be advantageous characteristics for both the expectant mother and the newborn. *
We understand that a pure maternity policy won’t work because it’s anti-selective. Theoretically, a pure maternity policy will only work if consumers make purchases. In this case, it will be a case of many contributing and many claiming, defeating the principle of insurance, which is a contribution by many and a claim by few. Maternity coverage is an integral component of a health insurance policy rather than a typical add-on or standalone policy. *
* Standard T&C Apply
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.