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Cesarean Delivery Under Health Insurance Plans

By Juhi Walia
19 October 2022, 12:42 PM

For a woman, being pregnant is a journey that changes her life in numerous ways. The cost of birth has increased due to rising medical inflation and total spending. Lack of preparation could lead to burning a hole in your wallet, which might outweigh the joy of having a child. Considering that maternity health insurance policies frequently include a lengthy waiting period, which may prove challenging for most consumers, experts advise making your plans well in advance. 

Private hospitals charge extra for caesarean deliveries. However, most mothers opt for a caesarean section because they don't want to endure the wait for the due date and labour discomfort. The adverse effects of a caesarean section include more commonly, body aches, back pain, etc. When we consider the costs or the fees at the private hospitals, the mental suffering will be worse than the physical pain. However, we can effortlessly go through this discomfort with the aid of maternity insurance.

Maternity Insurance

Maternity insurance is a form of health coverage that pays for pregnancy-related medical expenses. The costs of both routine and caesarean deliveries, as well as pre-and postnatal care, ambulance fees, immunizations for the newborn, and other services, are all covered by this insurance policy. Pregnant women have two options for coverage: a standalone maternity insurance policy or an additional premium add-on to their health insurance.

Opting for a C-Section

Cesarean deliveries are more frequent in today's world, and many people opt for them because they don't want to experience labour pains. Therefore, health insurance for childbirth is more important as it covers both vaginal and caesarean births. The greatest relief for parents is provided by maternity insurance, thus we must praise it. Maternity insurance has a waiting period of at least 9 months and offers coverage from INR 35,000 to INR 5 lakhs.

It would be financially easier for you if your health insurance covered the cesarean delivery. There are a few things to keep in mind even though some insurance plans cover caesarean deliveries.

The Waiting Period

After a waiting period, every health plan that covers maternity expenses would cover it. Before purchasing the plan, you should think about this time, which might be anywhere between 2 and 6 years. Although the waiting period may be shorter for specialised maternity plans, the premise is the same for all plans that offer maternity coverage. For instance, the Niva Bupa (Formerly Max Bupa) Heartbeat Gold Plan covers caesarean births after a 2-year waiting time, whereas the Care Health 'Joy' maternity plan covers it after a 9-month waiting period.

Read more - Waiting Period Clause in Health Insurance

Consider the Cap on the Coverage 

The maximum amount that can be used to cover a caesarean delivery is capped. This capping is determined by the plan variant and the amount of sum insured chosen. The payment often falls between INR 40,000 and INR 1 lakh. In order to know the amount of the cost, your health plan will pay before having a baby, verify the permissible limit before purchasing the plan.

Other Coverages

Some health insurance policies cover difficulties during childbirth, prenatal and postnatal expenditures, and ambulance costs in addition to your caesarean delivery. Additionally, the newborn infant and any associated immunisation costs may be covered by the coverage until it is renewed.

Taking the Premium into Account

The cost of the plans that will pay for your caesarean delivery will obviously be higher. Maternity insurance premiums are always higher for plans that offer the benefit. The insurers charge a higher premium for these policies since there is an absolute certainty that a claim will be made under the policy. It is advised that you conduct a thorough cost-benefit analysis of the various plans provided by various insurance providers before you decide to get such coverage.

Side Effects of Cesarean Delivery

Watch out for indications of infection and other complications if you recently had a c-section. These indicators include:

A temperature of 100.4° F or higher, leaking urine, significant vaginal bleeding,  large blood clots, foul-smelling discharge, persistent bleeding from the incision, swelling around the incision site, pain or swelling in the lower legs, pain when urinating, nausea, vomiting, or diarrhoea. In addition, one may feel symptoms similar to the flu, anxiety, despair, panic, and an acute headache that appears out of nowhere and persists.

Things to Consider Before Purchasing Maternity Insurance Benefits

If you're all ready to purchase maternity insurance, be sure to keep the following factors over and above the c-section in mind to make a wise choice:

  • Pre and post-hospitalisation cost coverage
  • Pre and postnatal expenses coverage
  • Inpatient hospitalization & delivery costs
  • Newborn baby expenses cover 
  • Vaccination expenses for the newborn baby

Conclusion

Financial protection throughout pregnancy and after childbirth depends on having health insurance with maternity coverage. To ensure that the waiting period is over by the time the kid is conceived, you must purchase the coverage in advance. 

The cost of a c-section delivery inflates the hospital bill. Therefore, obtaining a plan with maternity insurance coverage is crucial. Cesarean deliveries are covered by a few health insurance policies, including those indicated above. Finding a good health insurance plan with maternity coverage should not be difficult because there are many of them in India. Buy them today to increase your level of maternal bliss.

Read more -

FAQs

1. When is the best time to purchase maternity insurance?

When it comes to the waiting period for maternity benefits under health insurance, one should consult with the insurance provider. Ideally, maternity coverage should be purchased at the same time as adding your spouse to the health insurance plan, or shortly after the wedding.

2. Can a pregnant woman be covered by maternity health insurance?

While you are pregnant, you can purchase health insurance. However, until the waiting period is finished, your health plan won't pay for your maternity expenses. You must prepare and enroll in maternity health insurance earlier to take advantage of the benefits if you become pregnant because the waiting time might range from 9 months to 4 years.

3. Does health insurance consider pregnancy a pre-existing condition?

If you are already pregnant, the majority of insurance providers do not offer maternity insurance. This is due to the fact that your pregnancy is considered a pre-existing condition and is not covered by your insurance.

4. What does maternity insurance not cover?

Pre-existing conditions that impair pregnancy. Congenital ailments. Costs associated with infertility treatment.

5. Is it possible to claim insurance for delivery?

Maternity insurance pays for all costs related to your delivery up to a certain maximum. Both conventional and c-section births are covered by the policy. Some insurance plans might additionally cover the expense of a termination owing to problems.

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