How to Raise a Claim for Maternity Health Insurance Policy?

Embracing parenthood can bring some of the most incredible and beautiful experiences. Creating a new life and welcoming your baby can be overwhelming. Along with pregnancy joy, taking sufficient care for both the baby and the mother is equally essential. Health insurance plans with maternity cover can be an excellent investment to secure your journey of pregnancy. 

While planning insurance, gather all the required knowledge regarding raising maternity claims. Health Insurance plans with maternity cover aim to cover the pregnancy and delivery-related expenses of the mother and the baby. It is vital to know the details of the claim process to make a hassle-free claim when the time comes.

This article will focus on mediclaim with maternity cover offered by Care Health Insurance and how to raise a claim. Read on to understand the claim process for maternity insurance in detail.

What is a Maternity Health Insurance Plan?

Before moving any further with claim process discussions, let's first understand insurance for pregnancy coverage. Parenthood includes a range of responsibilities alongside the tsunami of happiness and joy. The coming expenses of delivery, the pregnancy journey, medical expenses, medical needs of the newborn and the expectant mother, etc., are all a part of parenthood. To have a financial cushion to fall back on, health insurance plans with maternity coverage can be a great decision.

Medical costs are on a constant rise, and amid hefty medical expenses, managing pregnancy expenses can be challenging at times. Not just the delivery of the baby but the newborn may also require special medical care that again involves hefty expenses. Investing in the best maternity cover health insurance means you no longer have to worry about such expenses. Your healthcare provider, Care Health Insurance, is there to cover all such expenses without any hassle.

Claims Process for Maternity Health Insurance

The purpose of investing in a policy with maternity coverage is to avail of the benefits in times of need. You must know the claim process to avoid an eleventh-hour rush, confusion, and unnecessary back and forth. The maternity health insurance claim process may differ from usual health insurance plans. Check out the pointers below to understand the step-by-step process to raise a claim.

Reimbursement Claim Process

A reimbursement claim process is one where the insurer must pay all the bills and then raise a reimbursement claim. There is no compulsion to choose a network hospital in case of reimbursement claims in maternity health insurance. Here are the processes involved:

• Step 1: Intimate Your Insurer - The first step is to inform your insurer about your hospitalisation needs. In case of emergency hospitalisation, intimation must be sent within 24 hours, and for a planned hospitalisation, one must inform Care Health Insurance 48 hours before seeking medical aid.
• Step 2: Hospitalisation - You can seek medical attention from any of your preferred hospitals in a reimbursement claim.
• Step 3: Bill Submission - During discharge, the insured has to clear all the bills. After discharge, all the bills have to be submitted to the insurer.
• Step 4: Verification - Care Health Insurance will quickly verify and approve the claim.
• Step 5: Reimbursement - After the verification, Care Health Insurance will reimburse the admissible amount to your registered bank account.

Cashless Claim Process:

As the name suggests, cashless claims are the ones where the insured has to make no admissible payments from their end. The insurance company settles the bills. For a cashless treatment, one has to seek medical attention from one of the 28400+ network hospitals of Care. Here is the claim process for a policy with maternity coverage:

• Step 1: Information to the Insurer - In cashless treatment, the insured must also inform the insurance company within 24 hours in emergency cases and 48 hours before a planned hospitalisation.
• Step 2: Pre-authorisation form - The insured person must duly fill out the pre-authorisation form and submit it to the insurance company. The insurance company will quickly verify and approve cashless treatment.
• Step 3: Hospitalisation - Insured can begin with the pregnancy-related medical processes at one of the network hospitals of Care Health Insurance.
• Step 4: Claim Settlement - At discharge, the insurer will settle all the admissible bills directly with the hospital.

Maternity Health Insurance: Care Joy

Care Joy is a specially designed comprehensive maternity health insurance plan. Targeting all expectant mothers and newborns, Care Joy aims to cover the otherwise shooting medical expenses associated with pregnancy. The plan offers lifetime renewal. Care Joy health insurance has two types of sub-plans from which to choose. These are:

1. Care Joy Today

The features of Care Joy Today health plan are as follows:

• There is a waiting period of 9 months for maternity expenses
• The sum insured ranges from ₹3 lakhs to ₹5 lakhs
• Newborn defects are not covered under Care Joy Today
• The plan includes 30 days of pre-hospitalisation coverage and 60 days of post-hospitalisation expenses
• Other coverages include in-patient treatment, ICU and ambulance charges cover, room rent cover and no claim bonanza
• The newborn baby is covered for up to ₹50,000 for 90 days from birth.

2. Care Joy Tomorrow

Check out the features of the another variant, Care Joy Tomorrow:

• The waiting period for Care Joy Tomorrow is 24 months for pregnancy-related claims
• The newborn baby is covered for up to ₹50,000 for 90 days after birth 
• The plan also covers newborn defects for up to 50,000
• The sum insured ranges from ₹3 lakhs to ₹5 lakhs
• Pre and post-hospitalisation expenses are covered for 30 and 60 days, respectively
• ICU, room rent, ambulance charges, and no-claim bonanza, along with in-patient expenses, are covered.

The Waiting Period Clause in Maternity Health Insurance

As you plan to invest in insurance for pregnancy coverage, there are a few things you must know about it, and the waiting period is one of these. If you are purchasing maternity coverage for the first time, here are some insights on the waiting period in health insurance plans with maternity cover.

The waiting period for a maternity cover is one of the crucial elements. With Care Joy, the maternity waiting period under Care Today is nine months, and that of Care Tomorrow is 24 months.

Apart from maternity, there is an initial waiting period of 30 days. For named ailments, the waiting period is 24 months; for pre-existing diseases, the waiting tenure is 48 months. So, before you raise a claim, make sure to know the details of the waiting period of your chosen maternity health insurance.

In a Nutshell

Owing to rising medical expenses and the zeal to do the best for your kid, investing in maternity insurance can be a wise choice. Health insurance plans with maternity cover, like those offered by Care Health Insurance, are comprehensive plans. They cover not only maternity expenses but also named ailments and pre-existing diseases (if any). You can secure the best medical treatment for the mother and baby at affordable premium rates.

>> Also Read: What is Maternity Coverage with Minimum Waiting Period?

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.