Group health insurance is one of India's best and most popular health coverage options. Group insurance is usually provided to the employees of an organisation by the employer, as an employment bonus.
The coverage extends to the employee as well as her/his family members. Many helpful covers are available under a group health plan, including the all-important maternity cover. How does this coverage work and why is it so beneficial? Let’s find out in the article below.
Inclusions
Young couples nowadays are very planned in their approach and also take financial responsibility quite seriously. Therefore, an important decision like starting a family is usually taken after much deliberation. A lot of couples rely on their group health insurance policy to take care of maternity expenses, as that helps them effectively plan their finances during and immediately after childbirth. A group health plan includes the following covers:
1). Delivery expenses
Normal deliveries, as well as caesarean deliveries, are covered under maternity coverage. You can claim the expenses incurred when delivering your baby, provided it happens at a registered medical centre, under the supervision of qualified medical professionals. Most group health policies have a limit on the delivery overhead and you can expect a compensation amount ranging between INR 25,000 and INR 1 lakh.
2). In-patient care
Apart from the delivery expenses, you will also get coverage for all hospital-related expenses such as your room rent, nursing and doctor charges, ICU charges (if any) and other in-patient needs. This is very handy coverage as you can get the best treatment at the best hospital knowing your bills will be taken care of.
3). Postnatal complications
If due to any unfortunate reason your newborn baby develops any complications, the medical expenses will be taken care of. This includes NICU charges, special medical procedures and emergency medical expenses. Most of the maternity facilities under the group health plans offer extended coverage to your baby for a period of about 90 days post-birth.
There are several other covers available under a group health insurance plan. Since the different insurance providers offer different features, you will have to read the policy wording to be fully aware of the extent of the maternity coverage available under your group health plan.
Exclusions
While the maternity covers available under a group health insurance plan are very beneficial, there are some exclusions that you must be aware of. They are:
1). Infertility treatment
Any form of infertility treatment is not included in a standard group health policy. You cannot seek coverage for treatments such as IFV, IUI, freezing of eggs, etc.
2). Surrogate pregnancy
If you have a surrogate pregnancy, you will have to bear the expenses yourself as surrogacy is not covered under the standard group health insurance policies.
3). Voluntary termination of pregnancy
In some cases, termination of the pregnancy is a medical requirement and advised by the doctor. However, at times, the decision to terminate the pregnancy may be voluntary. In such cases, you cannot expect to get a claim under the maternity benefits of your group health insurance plan.
4). Regular pregnancy checkups
You will have to go for regular checkups all through your pregnancy. Your doctor will also ask you to undergo scans, blood tests, etc at regular intervals to ensure your baby and you, both are healthy. These expenses are not included in your group health plan’s maternity benefits.
It helps to be aware of the exclusions beforehand so you can make a proper claim and get the sum insured smoothly. Read the policy wording very carefully to know what exactly is covered and what is not.
Benefits
A lot of people rely on group health insurance maternity coverage because of its practicality and benefits which are:
1). Comprehensive medical cover
The birth of a child is one of the most momentous events in a person’s life. This is why you take every precaution to ensure the birth goes smoothly and you and your baby get the best medical care at the best hospital. When you have a group health cover in place, you can rest assured that you will be able to be at the best place and ensure nothing goes wrong. Healthcare is very expensive these days, but when the expenses are covered, you don't have to cut any edges and can get the full benefit of modern healthcare.
2). Newborn cover
Your baby is the most precious person in your family and you will not want any harm to come over her/him. With a maternity cover in place, your baby stays protected too and it is a tremendously beneficial assurance. The first 90 days of your baby’s life are very crucial and stay covered under the policy. This helps to keep the little one healthy and well taken care of.
3). No waiting period
Most of the regular health insurance plans offer maternity coverage, but they do so along with a waiting-period clause. This prevents you from claiming unless you complete a specific period in the plan, commonly two or three years. This is a huge drawback as many pregnancies are unplanned or are planned within the waiting period. The group health plans do not have a waiting period and you are covered from day one. This is another big advantage of availing the maternity coverage under an employer-provided group health insurance policy.
Speak to your employer and get a sound understanding of the benefits of this coverage. Once you have a good idea, you will be able to put all the benefits to proper use.
Conclusion
As you can see, there are several benefits of the group health plans, especially when it comes to maternity coverage. If you have a group health plan as part of your employment perks, make use of it if you are about to start a family. Keep all the points mentioned above in mind and make the most of this wonderful health insurance benefit.
