Having access to the best healthcare services is crucial for any expecting woman. Having this access through your employer group health insurance policy makes it easier for you. However, maternity coverage under group health insurance is subject to the employer’s discretion and thus needs to be understood more carefully.
But if your employer does buy a group health insurance policy with maternity cover, you will get several benefits under it.
What is Maternity Cover in Group Health Insurance?
Maternity coverage in a group health insurance policy is an optional add-on for the policyholder. Having this add-on coverage helps employees obtain maternity benefits, which typically cover all their medical expenses related to pregnancy and childbirth.
If some employees choose to add this optional coverage to their group health insurance, then their employers must purchase it on their behalf. Including a maternity add-on also increases the policy premium for employers and might change some terms and conditions.
When to Buy Maternity Cover in a Group Health Insurance Policy
You may opt for maternity cover for yourself or your partner under the group health insurance policy. However, understanding the scope of coverage is necessary here. Suppose you or your partner is already expecting a baby; in such a case, insurers do not provide maternity cover because it is considered a pre-existing condition.
That is why it is suggested to apply for maternity coverage well in advance before you plan to expand your family. As insurance companies also have long waiting periods for such events, these waiting periods provide sufficient time for family planning.
Group Health Insurance Maternity Coverage
Pre and Postnatal Cover
The pre and postnatal periods of pregnancy are equally crucial and require their own set of medical attention. With maternity cover, expecting mothers can get pre- and postnatal coverage for expenses such as diagnostic tests, regular check-ups, vaccinations and doctor’s consultations before and after delivery.
In-patient Treatment
The maternity coverage under the group health insurance policy also covers the inpatient treatment expenses. Inpatient treatment includes all hospitalisation expenses for delivery, such as nursing charges, room rent, doctor’s fees, canteen charges, medical treatment and other related expenses.
Delivery Expenses
The maternity group health insurance policy also covers the cost of both types of deliveries. The first type is vaginal birth, and the second is C-section. Both of these delivery methods have their unique medical procedures and treatments to ensure a safe delivery. All charges incurred through any delivery method are covered under maternity cover.
Lawful Pregnancy Termination
Pregnancy is a very sensitive stage in any woman’s life and on several occasions, things can get complicated. In situations like medical emergencies and pregnancy complications, procedures like lawful termination of pregnancy are done. The maternity cover provides for the expenses incurred in the procedure.
Vaccination Cost
Vaccination of the mother during pregnancy and the child after delivery is crucial for their safety. The maternity coverage in the group health insurance policy covers the cost of vaccination for both the mother and newborn child, providing protection against any illness for both.
Newborn Care Cover
The maternity cover also provides coverage for the newborn baby care that they might need within a few days of being born. It includes regular checkups and medical treatment, such as operations, due to any medical complications.
Miscellaneous Expenses Cover
The maternity coverage under the group health insurance policy also covers the cost of miscellaneous medical expenses, such as other delivery-related expenses, prescriptions, additional tests, and other expenses related to the mother and childcare.
Exclusion of Maternity Cover in Group Insurance
Although the maternity cover has a broad scope of coverage, there are still some exclusions to the policy. These exclusions should be noted to avoid any claim rejection or inconvenience during the process.
- Coverage for any fertility expenses is excluded from the maternity cover
- Coverage exclusions for pre-existing pregnancy
- The expense for the unlawful termination of pregnancy is excluded from the policy
- Voluntary termination of pregnancy
- Pregnancy termination before 12 weeks of pregnancy
- Surrogacy pregnancy
- Expense for birth control treatments
- Non-allopathic treatment
- Complications due to substance abuse
- Pregnancy costs exceeding the coverage limit
Summing Up
Providing maternity coverage under a group health insurance policy is an initiative that companies should consider, especially now that more women are joining the workforce. Welcoming a new member into the family and navigating the whole pregnancy period is a sensitive time for the entire family of an employee. Providing maternity cover allows them financial reassurance.
Especially when employees get coverage from a trusted insurer like TATA AIG, they do not have to worry about medical expenses and can welcome the new happiness with a smile. They also provide a wide range of other insurance options, including workers’ compensation, fire and burglary insurance, and marine insurance. Any organisation can buy business insurance online with them as per the business’s coverage needs.