Maternity Cover In Group Health Insurance Policy

A group health policy is when a group of people, usually employees, are insured by their employer under an insurance plan for their health security. This is a financial security provided by an insurance company with the help of the premium paid by the employer and employees in part.

Now, when some employees choose to add the feature of pregnancy insurance coverage in their group health policy, it is called group mediclaim with maternity cover. This coverage provides the employees with financial assistance at the time of pregnancy and its treatments.

Both male and female employees can enjoy the perks of this cover. The male employees can avail of this feature for their wives, and the female employees can add it for themselves.

Let us understand the coverage provided by this cover in order to make informed choices.

Prenatal and Postnatal Expenses

The pregnancy period is divided into two parts: prenatal and postnatal. Prenatal refers to the part before delivering the baby, and postnatal refers to after the delivery of the child. The doctors carry out various procedures in both these periods. There are regular checkups, vaccinations, diagnostic tests, and consultations before and after the delivery.

The maternity insurance plans or the group mediclaim maternity cover provides financial reimbursement and cashless treatment in both of these parts.

In-Patient Treatment

In-patient treatment refers to the hospitalisation of the employee for delivery. The group health policy’s maternity covers all the mentioned expenses associated with hospitalisation during childbirth. This includes the nursing charges, doctor’s fees, room charges, canteen charges, medical procedures, and other expenses.

Termination Of Pregnancy (Abortion)

Numerous things can result in a lawful termination of pregnancy, a medical emergency, a difficult pregnancy, complications, etc. Pregnancy health insurance provides coverage for these treatments as well. This ensures that the employee receives support and coverage in this situation.

Both Types Of Deliveries

There are two types of deliveries: vaginal birth and C-section delivery. The group health insurance maternity cover caters to both of these types of deliveries. Various treatments and surgeries go into making these deliveries a success. The charges related to these surgeries are included in the maternity cover.

Vaccination Costs

Before and after giving birth to a baby, the mother is supposed to be vaccinated for safety and health reasons. These vaccination costs are included in the maternity coverage as well. Apart from that, the coverage includes vaccination related to the newborn baby as well. The newborn is supposed to be vaccinated on various occasions to ensure health and wellness. These vaccinations are included in the maternity cover powered by the group medical insurance.

Newborn Care

As mentioned above, the newborn baby needs vaccinations. Along with that, it also needs other healthcare facilities like regular checkups and unforeseen medical requirements; for example, there can be an unexpected surgery required. All of the above medical requirements can be covered with the help of maternity cover if chosen.

Miscellaneous Expenses

Maternity cover encompasses all the other expenses related to delivery, the mother’s healthcare, and the child’s welfare. This can include additional tests, prescriptions, or unexpected emergencies.

Every health insurance policy has exclusions mentioned in the policy papers. Exclusions include the conditions or situations that the insurance policy cannot financially cover. One needs to pay keen attention to this list of exclusions in order to avoid untimely inconvenience.

• Pre-existing pregnancy

• Fertility treatment

• Unlawful termination of pregnancy

• Voluntary termination of pregnancy

• Termination of pregnancy before 12 months

• Cost exceeding the insured amount

• Complications due to substance abuse

• Birth control treatments

• Surrogacy pregnancy

• Non-allopathic treatments

As a manager or employer of numerous employees, including employee benefits in the form of business insurance in India can make a significant impact. With corporate health insurance policies provided by Tata AIG under SME insurance, you can safeguard the financial future of your company’s employees and secure their health.

With a commitment to holistic well-being, Tata AIG’s group health insurance offers numerous benefits that will ensure that every aspect of your healthcare experience (in this case, motherhood) is covered. It offers peace of mind and reinforces and promotes health over other things!

Maternity cover is a valuable provision arranged and designed by insurance companies. Adding this coverage option to the employee medical plan can be a smart move since the number of women in the workforce has increased significantly and will keep on increasing in the far future as well.

Since pregnancy can be mostly overwhelming, financial support will go a long way for women in the workforce. Ensure to add this feature to your group health insurance to maximise the advantages of your group health insurance.

How can employees raise a claim for maternity cover in a group policy setting?

To raise a claim for maternity cover in the group health policy, the concerned employee will have to submit relevant documents like hospitalisation bills, medical bills, and other paperwork.

Can male employees benefit from maternity cover?

Yes! Male employees can definitely benefit from maternity coverage powered by group health insurance. This is because the policies usually extend their coverage to the insured employees’ families. This means the coverage would extend to their wives, as well.

Is maternity coverage included in all group health insurance policies?

No! The insured must verify the inclusion of maternity coverage in order to enjoy the benefits. However, most group health policies include maternity coverage, but not all!