Pre and post-natal expenses for 60 days prior to hospitalization and 90 days post-hospitalization are usually covered in the GMC policy.
However, it is best to check the specific terms and conditions of the policy to see what is covered and what is not.
Are there any sub-limits to Maternity benefits?Yes, there can be sub-limits for Maternity benefits in a Group Mediclaim policy. Sub-limits refer to a specific maximum amount that the insurance company will pay for a particular type of expense or service. For example, a policy may have a sub-limit for the cost of delivery (normal or cesarean also known as C-section), or for pre-natal and post-natal care.
It's important to note that sub-limits can vary depending on the specific policy and the insurance company. Some policies may have sub-limits for certain type of expenses like room rent, ICU charges and so on. It's important to check the policy carefully and understand the specific sub-limits that apply to the maternity benefits under the policy.
It's also important to keep in mind that having sub-limits could mean that the policyholder would have to bear some of the expenses from their own pocket if the sub-limit is exhausted and the expenses incurred are higher.
Does the GMC policy cover abortion expenses?
Abortion is a procedure to end a pregnancy, it is also known as termination of pregnancy. The Group Mediclaim policies may cover the cost of Lawful Termination of pregnancy. In India, the Medical Termination of Pregnancy Act, 1971 (MTP) regulates and governs the termination of pregnancy. According to the act, a lawful termination of pregnancy can be done by a registered medical practitioner in a registered facility, under certain conditions and circumstances.
However, it is best to check the specific terms and conditions of the policy to see what is covered and what is not.
What is not covered under the maternity benefits in a GMC policy?
Exclusions are a standard feature of all health insurance policies. These are the circumstances under which you cannot make a claim on your Maternity Cover. Here is a list of exclusions for your reference:
- The cost of obtaining and/or storing stem cells.
- Ectopic conception
- Medical expenses incurred as a result of an assisted conception complication
- Birth control methods
- Hormone replacement therapy (HRT)
- Voluntary termination of pregnancy.
- Vicarious or surrogate pregnancy
- Routine check-ups
- Costs of non-allopathic treatment
- Pregnancy termination before 12 weeks
- Treatments for infertility
It is best to check the specific terms and conditions of the policy to see what is covered and what is not.