The Core Coverage: Prenatal to Postnatal Care
A well-structured policy typically operates in three acts: before, during, and after delivery.
Prenatal Care: This is the foundation. You will need to find coverage for your gynecological visits, as well as for necessary diagnostic services (ultrasound and blood tests) performed during those visits, along with any medications your doctor prescribes. Many forward-thinking companies also cover the vaccinations that the mother receives at her gynecology visits (e.g., T-dap vaccine).
Hospitalization for Delivery: This is the centerpiece. Whether you have a normal vaginal delivery or a C-section, your insurance policy should provide coverage for room charges, surgeon and anaesthetist fees, nursing, and medical consumables while you are in the hospital. This is where your Mediclaim Insurance for Maternity serves to alleviate your financial responsibility when it comes to paying for hospital bills.
Postnatal Care: Coverage should not stop once you leave the hospital. The best maternity plans have coverage for the mother and baby for several weeks following birth. Coverage will provide necessary treatment and services for the baby, such as jaundice and/or any birth defects, and will cover necessary NICU expenses from day one. This coverage is non-negotiable.
Beyond the Basics: The Value-Added Protections
Often times, the difference between a good and great Pregnancy Medical Insurance Policy is primarily determined by the extras offered by the insurance company. Some examples of these extras include:
Complications Coverage – This is the most critical benefit. This would include coverage for medical expenses incurred when any complications related to pregnancy occur, such as ectopic pregnancy, gestational diabetes or pre-eclampsia.
Ambulance Charges – Most insurers will cover the emergency ambulance service for pregnancy-related emergencies.
Vaccination Cover for the Newborn – A number of insurance policies will cover the first set of vaccines received by your new baby.
Day Care Procedures – If your pregnancy-related medical treatment does not require an overnight stay, it may still be covered by your policy.
Crucial Considerations and Common Exclusions
When you work with a professional advisor on a Maternity Insurance Policy, I cannot stress enough how important reading through all of the details is. A Maternity Insurance Policy (also referred to as Medical Insurance for Maternity) almost always has a waiting period (which can be anywhere from 9-48 months). You will not be able to purchase a policy if you are pregnant; therefore, please make sure you plan in advance. Some of the major exclusions you will see on most maternity insurance policies include:
1. Cannot have any coverage for any Fertility Treatments (IVF, IUI, etc)
2. If the baby is born with a congenital disease and is discovered after birth, there may be limits to what the insurance covers for these types of costs
3. Insurance plans will almost always exclude non-allopathic treatments
As you compare different Mediclaim plans when looking to purchase Maternity Insurance, you will want to understand not only what the sum insured (premium payment) is, but you will also want to review the each plan’s sub-limits (for example: cap on room rent, cap on delivery procedure), co-payments (if applicable), and cashless network of hospitals). Ultimately, a plan with a higher sum insured but reasonable sub-limits would probably provide you with more value than a plan that limits you to a top-tier amount with high sub-limits.
Ultimately, if you choose to invest in a maternity insurance policy; it is an investment in not only the love of you and your partner as parents, but it also illustrates the responsibility you have purchased to insure that your child has the absolute best benefits available. Pregnancy Medical Insurance should not merely be considered a financial product, but also should be viewed as a business partner on your journey through parenthood. It provides you with peace of mind, so that your pregnancy and delivery will be filled with joy and love and not filled with unexpected bills after your baby arrives.
Disclaimer: This article is published in association with NivaBupa and not created by TNM Editorial.
