Coverage Of Maternity Insurance Scheme And Exclusions Of Claim
Maternity insurance is an essential component of health insurance that covers the expenses related to childbirth and prenatal care. It is designed to offer financial support to expecting mothers and their newborns by covering medical expenses incurred during pregnancy, childbirth, and postnatal care. In this article, we will discuss the coverage of maternity insurance schemes and exclusions of claim in detail.
Coverage of Maternity Insurance Scheme
The coverage of maternity insurance schemes varies from one insurance provider to another. However, some of the common benefits covered by most maternity insurance policies include:
Prenatal Care: Maternity insurance covers the expenses incurred during regular check-ups, ultrasounds, and other diagnostic tests during pregnancy.
Hospitalization Expenses: Maternity insurance covers hospitalization expenses, including room rent, ICU charges, nursing charges, and consultation fees.
Delivery Expenses: Maternity insurance covers the expenses related to normal delivery or cesarean section delivery, including charges for delivery, anesthesia, and surgical charges.
Postnatal Care: Maternity insurance covers the expenses incurred during postnatal care, including doctor consultations, medication, and diagnostic tests.
Newborn Care: Maternity insurance covers the expenses incurred during newborn care, including vaccinations, pediatrician consultations, and hospitalization expenses in case of any medical emergency.
Ambulance Charges: Maternity insurance also covers the expenses incurred during ambulance services required for pregnant women during emergencies.
Coverage Of Maternity Insurance Scheme And Exclusions Of Claim
Exclusions of Claim in Maternity Insurance Scheme
While maternity insurance covers most of the expenses incurred during pregnancy, childbirth, and postnatal care, there are certain exclusions to the claim that one must be aware of before purchasing a maternity insurance policy. Some of the common exclusions are:
Pre-existing Medical Conditions: Maternity insurance policies do not cover expenses related to pre-existing medical conditions like diabetes, hypertension, and heart disease.
Waiting Period: Most maternity insurance policies have a waiting period of 9 months to 2 years before the coverage starts. Therefore, expenses incurred during this period are not covered.
Congenital Disabilities: Maternity insurance policies do not cover expenses related to congenital disabilities and birth defects.
Abortion Expenses: Maternity insurance policies do not cover expenses related to abortion, except in cases of medical emergencies.
Fertility Treatments: Maternity insurance policies do not cover expenses related to fertility treatments, including IVF and other assisted reproductive techniques.
Non-medical Expenses: Maternity insurance policies do not cover non-medical expenses like expenses incurred during childbirth classes, maternity clothes, and other non-medical expenses.
Conclusion
Maternity insurance is a crucial component of health insurance that provides financial protection to expecting mothers and their newborns. It covers the expenses incurred during pregnancy, childbirth, and postnatal care, including hospitalization expenses, delivery expenses, and postnatal care expenses. However, there are certain exclusions to the claim that one must be aware of before purchasing a maternity insurance policy. Therefore, it is essential to read the policy document carefully and understand the coverage and exclusions before making the purchase.
Coverage Of Maternity Insurance Scheme And Exclusions Of Claim
FAQs
Q1. I am already pregnant. Can I get maternity insurance?
Pre-existing conditions are often considered by insurance companies. If you are pregnant, coverage will not be provided.
Q2. What is a waiting period?
The waiting period is the time that an insured must wait before coverage begins. Some insurance companies have a waiting period of 3-6 years before the policyholder is eligible to claim benefits. For maternity coverage, group insurance policies require a waiting period of 9 months.
Q3.What happens if a baby is born with a birth defect?
Congenital conditions are defined as a child born with a deformity, critical illness, or disease. The maternity insurance plan provides coverage for newborns, where the policyholder can make claims for treatment costs.
Q4.What is the minimum amount that can be guaranteed under maternity insurance
Different insurance companies have different minimum amounts. Before purchasing maternity insurance, individuals should carefully read the policy document.
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