Yes, but with limitations.

In India, abortion may be covered under health insurance policies, particularly under maternity benefits, but only under specific circumstances.

Abortion is typically covered under a maternity insurance rider or as part of a comprehensive health insurance plan if:

• The abortion is medically necessary to save the mother’s life.

• There is a pregnancy complication that affects the health of the mother or the fetus.

• The abortion is performed within the gestational limit as defined by law (typically up to 20 or 24 weeks, based on the Medical Termination of Pregnancy Act).

It is important to note that elective abortions (for non-medical reasons) are usually not covered.

• Unintended pregnancy

• Fetal abnormalities (e.g., Down syndrome)

• Risk to the mother’s health

• Pregnancy due to sexual assault

• Financial, emotional or personal reasons (Note: not all covered under insurance)

While some abortion procedures are covered, mediclaim policies typically do not cover:

• Elective or voluntary abortions not tied to medical emergencies

• Abortions done in unregistered or non-network facilities

• Complications from self-administered abortion pills

• Pre-existing pregnancy at the time of policy purchase

• Infertility or IVF-related terminations

The extent of coverage depends on your insurer and plan type. Some plans, like TATA AIG Medicare Premier, may provide limited coverage for abortions under maternity benefits if the procedure is medically required and all policy terms are met.

Typical inclusions under plans that cover abortion:

• Surgical abortion costs

• Hospitalisation charges

• Pre- and post-procedure consultations

• Diagnostic tests like ultrasounds

• Abortion pill cost (on doctor’s recommendation)

Always confirm with your insurer whether the plan qualifies as health insurance that covers abortion and what documents are required to claim it.

TATA AIG’s Women-Specific Rider: EmpowerHer

As women’s healthcare needs change and continue to evolve through the different stages of their lives, health insurance coverage limited to emergency and maternity care may no longer be enough.

Recognising this need, TATA AIG offers a women-specific rider, EmpowerHer, that can be added to your base health insurance plan. Its key features include:

• She Care+: Provides access to Gynaecologist and Dermatologist Consultations and Counselling for conditions like Premenstrual Syndrome, Menarche, Menopause, and more.

• Polycystic Ovarian Cover: Covers consultations, diagnostic tests and treatment costs related to Polycystic Ovarian Disease/ Syndrome (PCOD/PCOS).

• Women+ Screening and Vaccination Cover: Covers screening for breast, ovarian cancer, and cervical cancer, and also covers cervical cancer vaccination.

• Maternity Protect: Covers medically prescribed infertility treatments, voluntary sterilisation treatments and both ante-natal and post-natal care.

Most policies have a maternity waiting period ranging from 9 months to 3 years. This means:

• Abortion claims will be accepted only after the waiting period is over.

• Pre-existing conditions may further extend the waiting period for certain maternity or abortion-related claims.

The cost of an abortion varies based on city, hospital, and procedure type. Here’s a general breakdown:

• Medical abortion (abortion pill): ₹5,000 to ₹10,000

• Ultrasound scans: ₹1,500 to ₹3,000

• Surgical abortion: ₹15,000 to ₹35,000

• Anaesthesia charges: ₹2,000 to ₹2,500

• Hospital stay and consultation: ₹5,000 to ₹10,000

Does insurance cover abortion pills? Coverage of pills or other services depends on the insurer and health policy clauses.

Yes, abortion is free in many government hospitals under the Reproductive and Child Health Programme. However, access and quality may vary by region. Patients may still incur incidental costs like lab tests or follow-up care.

Abortion in India is governed by the Medical Termination of Pregnancy (MTP) Act, 1971, amended in 2021.

• Abortion is legal up to 20 weeks of gestation with the approval of one doctor.

• In special cases (rape, fetal anomalies), abortion is allowed up to 24 weeks with two doctors’ approval.

• Abortion is permitted for unmarried women under the same legal framework.

• The confidentiality of the woman undergoing an abortion is legally protected.

MTP Act Guidelines: What Is the Limit for Medical Abortion in India?

• Medical abortion using pills is legally permitted up to 7 weeks (49 days) of pregnancy.

• After that, surgical procedures may be required.

• MTP law permits abortion up to 20 weeks in general cases and 24 weeks for special categories.

Understanding whether abortion is covered by health insurance in India is vital for planning both reproductive and financial decisions. While abortion insurance may be included under maternity benefits in select health insurance plans, it comes with conditions like medical necessity, waiting periods and exclusions. Elective abortions are rarely covered, and coverage varies by insurer. It’s essential to review your health policy and consult your provider for clarity.

If you’re looking for a comprehensive plan with maternity add-ons, explore TATA AIG health insurance for affordable premiums, extensive coverage and reliable support tailored to your family’s needs.