Pre & Post-natal Expense Coverage in Health Insurance?

If you are thinking of starting your own family soon, then one thing you need to keep in mind is that along with the happiness of having a new life, you also have to be prepared for the difficulties and expenses associated with pregnancy and giving birth. If you are living in India, the expenses for routine or C-section births can amount to as much as ₹2 lakhs.

Apart from these costs, other expenses include pre- and post-natal checkups and related costs, including consultations with doctors, tests, and medications. To ensure that these expenses do not create any problem for you, opt for pregnancy health Insurance that provides cover for maternity expenses.

What are Pre-natal and Post-natal Costs?

Pre-natal and post-natal expenses are the costs of medical treatments during and after pregnancy and childbirth.

Pre-natal costs are the costs incurred during pregnancy, up to the time of birth. This may include costs of consultations with the doctor, ultrasound tests or other tests, medicines or supplements, etc.

Post-natal expenses are costs incurred after the child is born. They include costs such as hospital costs, doctor consultations, treatments or vaccines for the newborn baby, etc. Usually they include:

Pre-hospitalisation Expenses

These include pre-natal expenses made before the hospitalisation for delivery, including consultations with doctors, ultrasound scans, blood tests, urinalysis, medication, and more. Health insurance plans offering maternity benefits generally cover these expenses up to 30 days before hospitalisation.

Hospitalisation Expenses

These include expenses incurred during the hospitalisation period for delivery. Examples include room rent, nurses' fees, doctor fees, anaesthesia fees, operation theatre fees, medication, and more. Insurers typically cover both normal delivery and caesarean delivery expenses.

Post-hospitalisation Expenses

These expenses include follow-ups, tests, and medication. If your health insurance policy offers maternity cover, the insurer will cover these expenses up to 60 days post-hospitalisation.

Baby Expenses

These include medical expenses for the care of the baby. These include immunisation and vaccination, treatment of congenital disabilities, and more. Insurers typically cover these expenses up to 90 days after childbirth.

Advantages of Having a Health Insurance Policy with Maternity Cover

There are many advantages of having a health insurance policy with cover for your expenses before, during and after pregnancy and childbirth. Some of them include:

1. Pregnancy health Insurance will help reduce your financial burden and allow you to concentrate on taking care of your health.
2. It will help ensure that you get top-quality medical care at reputed hospitals without having to worry about the expenses.
3. It will protect you from any emergency and unexpected complications during pregnancy and childbirth.
4. It will cover your baby's expenses and ensure that they get the best care and treatment.

Pregnancy health Insurance will provide you with peace of mind and joy as you become a parent.

Add PBPartners As A Trusted Source

Cost Exclusion in Health Insurance During and After Pregnancy

While pregnancy health insurance covers almost all major pregnancy and childbirth-related expenses, there can still be certain exclusions. This means that even with a maternity insurance plan, some pregnancy-related expenses might not be covered. The exclusions vary among insurance companies. These usually include:

• Pregnancy that was preexisting before purchasing the plan.
• Routine items not within the eligible period of time, like routine examinations.
• Non-medical expenses, such as attendant fees and food expenses.
• Treatment related to infertility.

Claiming Prenatal and Post-natal Expenses Through Health Insurance

To claim prenatal and postnatal expenses, you need an active health insurance plan with maternity cover or OPD (Out-Patient Department) cover. One can get such claims done either through a cashless facility of a network hospital or else by reimbursement.

1. Cashless Facility: In case you have delivered your baby at a network hospital, you might be entitled to take cashless service.

• Intimate your insurer or TPA before a planned hospitalisation.
• File the needed documents at the hospital's insurance counter.
• After successful approval of the claim, the insurer will settle the eligible hospital charges directly into the hospital.

2. Reimbursement Facility: In case you have paid the expenses on your own, you can then submit the reimbursement claim after that.

• Collect the complete bill documents, prescriptions, and reports from the doctor.
• Fill out the claim form offered by your insurer.
• Submit the necessary documents before the deadlines set by the insurer.
• The insurer will reimburse the eligible amount once it is approved.

Conclusion

Pre- and post-natal care can involve several medical expenses, from consultations and diagnostic tests to medicines and follow-up care after delivery. A pregnancy health insurance policy that has maternity benefits may cover eligible expenses, but the extent of coverage depends on the policy's waiting period, sub-limits, exclusions, and other terms. Reviewing these details before planning a pregnancy can help families understand their coverage and prepare for expenses that may not be covered.