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Is family planning operation covered in Mediclaim?

Learn about does our health insurance covers family planning operation expenses or not below:

  • 30 Mar 2023
  • min read
  • 5625 views

Bringing a new life into the world is one of the most beautiful experiences for any family, but it can also come with its own set of challenges. Medical expenses related to pregnancy and abortion can be significant, and it is natural for individuals to seek financial protection through health insurance policies. However, it is crucial to understand that health insurance policies typically do not cover such expenses.

Health insurance plans usually do not consider pregnancy as a condition for providing coverage. That means the medical treatment expenses related to pregnancy and childbirth, including caesarean sections and complications arising from pregnancy, are part of the health insurance policy's exclusion. Moreover, voluntary abortion is generally not covered under health insurance policies.

However, in some cases where abortion is necessary to save the mother's life, some insurance providers may offer financial protection. In such instances, the insurance company would require certification from a medical practitioner before approving the claim.

Besides that, the insurer may offer additional maternity covers, providing financial protection for certain pregnancy-related expenses. It is crucial to understand the extent of coverage provided by the health insurance policy and explore other options for financial protection if needed.

Also read:

Add-on for covering Family Planning Expenses

In order to include family planning expenses, you may consider adding a maternity rider. This add-on includes the following.

  • Doctor consultations and medical tests: Maternity add-ons may cover the cost of doctor consultations and medical tests during the prenatal period, such as ultrasounds and blood tests.
  • Hospitalisation expenses: The cost of hospitalisation during delivery, including room charges, operation theatre charges, and nursing charges, may be covered under the maternity add-on.
  • Delivery expenses: Costs related to normal or caesarean delivery, such as anaesthesia charges and surgeon's fees, may be covered.
  • Pre- and post-natal expenses: Costs related to pre- and post-natal care, including regular check-ups, medications, and diagnostic tests, may be covered.
  • Newborn baby care: This is related to newborn baby care, including vaccinations and neonatal intensive care unit (NICU) charges.

It is important to note that the maternity add-on's coverage and benefits can vary depending on the insurance provider and policy. Some policies may have a waiting period before the coverage for maternity benefits starts, and there may be limits on the coverage amount. 

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