Motherhood can be quite an experience - a full roller coaster ride with sleepless nights and other challenges along with a whole new leap of happiness. It is important to warm up and prepare yourself emotionally. Also, you must be prepared financially as you do not want to be stuck in a situation that demands huge financial assistance during childbirth. Here, maternity insurance can be of great support and is a boon during your pregnancy.
In this blog, we discuss what maternity insurance is and how to claim it.
What is maternity insurance?
Maternity insurance is insurance that offers financial support against all pregnancy-related complications. A maternity plan can be bought as an add-on along with the basic health insurance plan or a standalone medical insurance plan. You will be covered for hospitalization expenses related to normal and cesarean delivery. Also, the vaccination charges for the newborn are included in it.
A maternity health insurance plan also covers pre and post-natal and pre and post-hospitalization expenses. Insurance providers cover the pre-hospitalization costs for up to 30 days before the date of admission. Also, buying a maternity health plan ensures you get treatment in a high-quality hospital. However, it is important to understand and know how to file a claim at the time of need. This is because a small miss can cause rejection of the claim.
How to file a claim for maternity insurance?
With the proper process, you can easily avail the benefit of maternity insurance. The claim will be settled immediately if you are admitted to a network hospital. However, if you choose a non-network hospital, the reimbursement process takes 2-3 weeks.
Below are the two ways of raising maternity plan claim -
Cashless claim process: The cashless claim process is only available when you opt for a network hospital with tie-ups with the insurance provider. To avail of the cashless claim, you must inform the health insurance provider before the planned admission. Here’s how you can file for a cashless claim for planned admission -
- Talk to the doctor and inform the insurance provider about the admission.
- Ensure you are getting admitted to a network hospital.
- On the day of admission, inform the hospital personnel about the cashless insurance facility.
- Provide your health card number or policy number.
- Fill out the pre-authorization form with all your details.
- The network hospital will connect with the insurance provider about the cashless claim, which will be settled between the insurance company and the hospital.
In case of an emergency admission, follow the steps below -
- Get admitted to a network hospital.
- Fill in the pre-authorized form and provide the attending staff with your policy number or health card.
- The network hospital will connect with the insurance provider about the cashless claim, and the claim will be settled between the insurance company and the hospital upon verification.
Note: Remember to verify and sign all the documents and medical bills upon discharge and keep a copy of your medical bills for future use.
Reimbursement claim process
A reimbursement claim means you will have to bear the expenses, and upon submitting the documents, such as bills, prescriptions, etc., the insurance provider will verify it. Once verified, the amount will be credited back to your bank account. Here’s how you can raise a reimbursement claim -
- Once you are out of the hospital, you can submit a claim form and the required documents per the policy terms and conditions.
- Once the document is verified, an approval letter is sent by the claim management team.
- The claim management team will ask a few questions for cross-verification. Do not misguide or lie while processing the claim.
- Once done, your claim will be processed.
Note: In case of a reimbursement claim, you can get admitted to any hospital of your choice, as there is no restriction of availing the network hospital.
What are the documents required to raise maternity health insurance claims?
To raise a claim, you must always have the required documents handy. The following documents are required to raise a maternity insurance claim -
- Duly filled claim form.
- Policy documents
- Consultation bills
- Prescriptions
- Discharge certificate
- Fitness certificate
- Admission bill
- Pharmacy bill
Ensure to check the policy document or connect with the health insurance provider to understand if you need to submit any additional documents. Confirming these with the insurer will help minimize the chances of claim rejection.
When is not covered under maternity insurance?
Remember to go through the policy's exclusion when buying a maternity health plan. Below are some of the exclusions of the policy -
- Regular doctor visits and check-ups
- Expenses on vitamins and tonics
- Doctor’s consultation charges along with tests during pregnancy.
- Treatment expenses for infertility treatment
As healthcare costs are rising in India, maternity healthcare costs are no different. Maternity health insurance will give you peace of mind and make things easier by reducing your financial burden. It ensures your child has a smooth and stress-free childhood, and you can treasure the moment instead of worrying about your finances. Taking care of yourself during pregnancy is important, and maternity insurance helps you do that. Also, while buying maternity health insurance, you must understand and be aware of the inclusion and exclusion of the policy to ensure the claim is processed smoothly. If you are buying maternity insurance as an add-on, chances are the premium might spike a little - but it is worth it.
Disclaimer - The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.
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