Health Insurance with Pre- and Post-Natal Expenses Cover

Pre- and post-natal expenses refer to pregnancy-related medical expenses incurred before and after childbirth.

Pre-natal expenses include gynaecologist consultations, diagnostic tests, and ultrasounds, while post-natal expenses include follow-up gynecologist consultations and lactation consultations. Post-natal expenses can also refer to medical expenses incurred for the newborn baby.

While pregnancy-related hospitalisation expenses are significant, these pre- and post-natal expenses can also add considerably to the overall cost.

Generally, when we seek health insurance coverage for pregnancy-related expenses, we get maternity insurance cover.

Are pre- and post-natal expenses covered under maternity insurance? Let us explore.

Yes, maternity insurance plans cover pre- and post-natal expenses. However, the type of expenses covered can vary from one plan to another.

What is Covered Under Maternity Insurance?

Maternity insurance covers medical expenses incurred towards childbirth. This includes:

• Hospitalisation expenses: Doctor consultation fees, nursing charges, room rent, etc.

• **Labour and delivery expenses:**Expenses incurred for normal and caesarean birth.

• Delivery complications: For complications related to delivery, the medical treatment expenses of the newborn baby incurred during the hospitalisation are covered.

• First-year vaccinations for the newborn baby: Under first-year vaccinations, the vaccination expenses for the child up to their first birthday are covered.

Maternity cover can be built into a health insurance plan or available as an optional add-on. For instance, maternity cover benefits are offered as an inbuilt feature under TATA AIG’s MediCare Premier health insurance policy.

They are available as an optional cover under the TATA AIG MediCare Select policy.

The TATA AIG Advantage for Pre- & Post-natal Expenses

TATA AIG offers various optional add-ons under the ‘EmpowerHer’ rider for women’s health insurance plans with maternity coverage.

It has a Maternity Protect rider that includes coverage for Pre-Natal and Post-Natal expenses. Pre-natal and post-natal check-ups are arranged on an outpatient basis.

Just like the varying set of benefits and inclusions under a health insurance plan, the exclusions of a maternity insurance policy depend on the specific policy you choose. Checking the exclusions of a health cover is as important as verifying the inclusions.

Here are some common exclusions of a maternity cover policy:

• Non-admissible Childbirths: The coverage for pre-natal and post-natal expenses is applicable only when the childbirth is admissible under the maternity cover included in the health plan.

• Expenses during the Waiting Period: Pre- and post-natal expenses incurred during the waiting period applicable to maternity insurance coverage are excluded.

• Investigation and Evaluation: Expenses primarily for diagnostics and evaluation purposes only, and not related to pregnancy, are not covered.

• Break-in Policy: Coverage benefits are applicable only when the medical insurance plan is renewed continuously without any break.

• Other Pregnancy-related Expenses: Any other pregnancy-related expenses not covered under pre- and post-natal care, such as medications and supplements, are excluded.

• Unauthorised Expenses: Expenses not supported by a prescription of a Medical Practitioner are not covered.

These are some of the common exclusions. Make sure you refer to your policy document for the complete list of exclusions and policy conditions before purchasing the policy.

Covers High Maternity Expenses

With rising medical inflation, the cost of maternity care, including pre- & post-natal expenses and hospitalisation, continues to increase. A maternity insurance policy with adequate coverage helps you manage these expenses more conveniently.

360-degree Protection for the Mother and the Child

With coverage of pre and post-natal expenses, along with labour and delivery charges, a maternity cover policy ensures all-around protection for the mother and the baby. The mother can access timely and appropriate care prior to and after childbirth.

Cashless Benefit

By including the coverage for pre- and post-natal expenses, you can benefit from cashless consultations. You can visit your gynaecologist for regular check-ups without making any upfront payments.

Get High Quality Medical Services

With adequate coverage under the medical insurance policy, you can access timely and quality maternity care services for both you and your baby, including gynaecologist consultations and diagnostic tests.

Tax Advantage

Premiums paid for health insurance plans qualify for a tax deduction benefit under Section 80D. This advantage applies to a policy that includes maternity cover for pre- and post-natal expenses.

Health insurance with maternity cover comes with a waiting period clause. That means there is a fixed time period from the date of policy purchase for which you cannot claim any benefits of the maternity cover policy.

The waiting period for maternity cover is generally 2 - 3 years. It varies across different plan options.

With the TATA AIG health insurance add-on for reducing the waiting period for maternity cover, you can shorten this duration. For example, you can reduce it from 2 to 1 year.

So, if you are planning to have a child, it is important to buy medical insurance with maternity cover well in advance to ensure the financial support when you need it the most.

Also Read: Waiting Period in Maternity Health Insurance

While choosing a maternity health insurance plan for pre- and post-natal expenses, it is important to evaluate a few aspects. Here are the factors to keep in mind:

• Assess your Requirements: Consider maternity-related expenses, including pre- and post-natal expenses at hospitals in your locality. This helps in determining the type of coverage and sum insured required.

• Compare Health Insurance Plans: Now, based on your requirements, compare health insurance plans to choose policy options that satisfy your needs for pre- and post-natal expenses.

• Check the Waiting Period: Choose a maternity health insurance plan with a waiting period that aligns with your requirements.

• Check Sub-limits: Make sure to check if the plan has any sublimits or caps on certain consultations, pregnancy-related expenses, or procedures.

• Check Policy Conditions and Exclusions: Read the policy document carefully to understand the policy conditions and exclusions that apply.

• Compare Premium Quotes: Compare the premiums of policy options that you have shortlisted and choose the best health plan that provides adequate coverage at an affordable premium.

You can claim pre- and post-natal expenses either on a cashless or reimbursement basis. While cashless claims are available in both network and non-network hospitals, the process is relatively simpler in network hospitals. TATA AIG has a network of over 12,000 hospitals across India.

For Cashless Claims

• Inform TATA AIG: Notify TATA AIG about your need to claim pre- and post-natal expenses. You can initiate the claim online through our website or the TATA AIG app. Contact us if you need any further clarification.

• Get Pre-authorisation: Coordinate with the TPA at the hospital to obtain pre-authorisation for consultations or diagnostic tests.

• Get the Necessary Medical Care: Once pre-authorisation is approved, proceed with the required assessments and consultations.

• Submit the Bills at the Hospital: After the procedure, submit the bills at the hospital.

• Claim Settlement: We will settle the bills directly with the hospital.

For Reimbursement Claims

• Inform TATA AIG: Inform TATA AIG and initiate the claim online through our website or the TATA AIG app. For any further clarifications, you can contact us.

• Visit a Hospital and Get the Medical Services: Visit any authorised hospital and undergo the required consultations or diagnostics tests.

• Pay the Bills: Pay the applicable medical expenses and collect all payment receipts.

• Submit the Documents: Submit the claim settlement form and the supporting documents, including the medical reports, bills, and payment receipts.

• Claim Settlement: We will review your claim and reimburse the applicable expenses.

With rising healthcare inflation, having a medical insurance policy becomes crucial for everyone. However, if you are planning to start a family, then medical insurance with maternity cover, including pre and post-natal expenses coverage, is essential. It ensures that you and your baby get the necessary medical care during such a sensitive period.

Explore TATA AIG family health insurance plans with customisable features at a budget-friendly price. With round-the-clock customer support, you can expect a reliable and smooth insurance experience.

Also Read: Maternity Cover in Group Health Insurance

Disclaimer - The information provided above is subject to change. Policy coverage and claim eligibility are subject to the terms and conditions of the policy.

Please refer to your policy document for complete details. For further clarification regarding your exact coverage, claim and policy inclusions and exclusions, kindly refer to your policy document and contact our claim representative.