What is Maternity Health Insurance & What Is Covered Under Maternity Health Insurance?
What is Maternity Health Insurance?
Health insurance with maternity coverage is a form of medical insurance that covers all pregnancy-related expenditures, including regular and C-section deliveries. Within these, several insurance providers give pregnancy coverage, including pre and post-natal expenditures and new born baby costs as well . Additionally, some corporations provide maternity insurance as part of their company policies.
All maternity health insurance policies in India include a wait time, which can range from 9 months to 6 years. During this time, insured women are unable to claim any pregnancy-related expenditures. Thus, women should consider purchasing maternity insurance at least a few years before they want to have a baby.
What is covered under the Maternity Health Insurance?
Coverages are instances in which a maternity benefit claim is payable. The health insurance benefit is available not just to the mother’s delivery and birthing expenditures, but also to the new-born infant. The following are the general benefits of a Maternity health insurance plan:
- Coverage for both pre- and post-hospitalization.
- Hospitalization costs
- The expense of a medically recommended pregnancy termination in a life-threatening circumstance.
- Cost of normal and caesarean deliveries.
- Cover for a new-born baby: A new-born infant is eligible for maternity benefits for up to 90 days after delivery at no extra cost. After 90 days, the new-born must be added as a covered individual to the basic plan.
- Vaccination protection: A new-born infant must be immunized at regular intervals. The price of usual and acceptable vaccines is covered by a health insurance plan’s maternity benefit.
Important Things to Consider While Buying Maternity Insurance
There are importance factors that need to be considered while choosing a maternity plan and they are:
- Inclusions
Maternal health spending has grown in tandem with other healthcare costs. Regular visits to the gynaecologist, testing, medications, and purchasing pregnancy-related products might be tough to handle if you do not have sufficient health insurance coverage. As a result, when purchasing a health plan with maternity care, make sure to review the inclusions to ensure maximum coverage.
- Sub-limits
Most maternity health insurance policies include sub-limits. This implies that even if you have a maternity insurance worth a few lakh rupees, you may not receive the entire amount during the payment, and therefore may have to compensate for some bills out of your own pocket. Some insurances, for example, may include a sub-limit of Rs. 15,000 to Rs. 25,000 for regular deliveries and Rs. 25,000 to Rs. 50,000 for caesarean deliveries. As a result, while purchasing Health insurance with maternity coverage, you must be aware of the sub-limits in order to prevent issues when submitting a claim.
- Waiting time
A maternity insurance coverage often has a lengthier waiting time, ranging from two to four years. This implies you won’t be able to submit a maternity-related claim for two to four years after acquiring the coverage. As a result, it is critical that you get a maternity coverage far before you want to have a kid in order to have the expenditures covered by the policy.
- Premium
Having an insurance with maximum coverage also implies paying a hefty premium. The majority of maternity insurance policies have hefty premiums. However, knowing your particular demands and conducting research on different policies from various insurance providers will assist you in finding the correct maternity insurance.
What is the claim process for Maternity Health Insurance?
The procedure for settlement of claims under the Maternity Health Insurance are as follows:
- The claim should be intimated, within 24 hours of emergency hospitalisation and 48 hours of hospitalisation which is planned.
- Cashless pre-authorisation consists of the following steps:
- Fill out the pre-authorization form, which is accessible at the TPA desk or may be downloaded online.
- After obtaining the pre-authorisation form, the insurance company’s claim management staff delivers a letter of permission.
- You can then make a reimbursement claim.
- The following steps are included in the reimbursement claim process:
- In addition to the documentation requested by the insurance company, you must fill out and submit the claim form.
- Upon receipt of the aforementioned form, the insurance company’s claim management team delivers a letter of acceptance.
Summing Up
You should always check that your maternity insurance covers your new-born as well when you are searching for the best health insurance for pregnancy. Pregnant women are eligible for health insurance plans that cover both their pregnancies and their babies. Under the Maternity Benefit, pregnancies medical expenses like diagnosis and medical visits are covered. Also covered are the post-delivery medical expenses for the new born and the mother to make sure they are both in good health.
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