Group Health Insurance

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Contrary to individual health policies, the following maternity benefits are available under the group health insurance plans:

  • Age related complications in delivery
  • No waiting period for covering pregnancy
  • Hypertension due to pregnancy and gestational diabetes
  • Pre-existing diabetes or hypertension
  • Higher chances of Cesarean delivery due to uterine inertia
  • Miscarriage occurring in the 2nd or 3rd semester

Other benefits: 

  1. Late pregnancy – In case there is late pregnancy (35 years or above) this is covered under the group health policy. Even in cases where there is excessive vomiting in the first trimester (hyperemesis gravidarum), it is covered. Late pregnancy is becoming the norm nowadays and to be covered under the group health policy is more advantageous since almost all expenses will be refundable.
  1. New born covered – The new born can be covered under the group health policy. The employer should fix the sum assured for the new born for a period from 0 – 90 days. The higher the sum assured, the higher the chance that the maternity sum insured would be enough for both the pregnancy related expenses and the expenses for the new born.

Given the expenses and complications that women with late pregnancy may face, it is useful to be covered under a group health insurance and enjoy maternity benefits.

Case: 1 

After working for two years in I.S Tech Solutions, 25-year old Radhika left the company and joined J.N IT in Pune. Along with the high salary, the new employer also offered a group health insurance with maternity benefits. Ruchika was quite excited to know that the employer will cover maternity expenses up to Rs 50,000.

In a few months of joining J.N IT, Ruchika got married to a businessman. After a one year of the customary honeymoon, the couple decided to start a family, and in a two month of time, she successfully conceived.

While the news of the pregnancy brought happiness in the couple’s life, they also had to start their financial planning in order to bear the expenses that may arise after the birth of a child.

Read More: Should You Include Dependent Parents of Employees in Group Health Insurance?

While they both decided to invest some money in fixed deposits and recurring deposits, the couple decided to buy an individual health insurance with maternity benefits to cover any expenses which were not covered by Radhika’s group health insurance.

However, they got a big shock when they came to know that there was a waiting period of 3 years before which the insurer will not cover maternity.

They heaved a sigh of relief as Ruchika’s corporate health insurance was offering maternity benefits as well.  Finally, that day came when the couple welcomed their little angel in this world.

Her group health insurance not only covered her normal delivery expenses which were Rs 45,000 approximately but also covered vaccination and consultation charges of her little daughter as well.

As her daughter was underweight, she was kept in the hospital and her group, health insurance policy, covered expenses related to this as well.

Thankfully, the group health insurance policy helped in saving the money for the couple by covering the maternity expenses.

Case: 2 

Unfortunately, Meghna lost her father when she was only eight years old. Her mother had to work as a maid in different houses to bring up Meghna and her one-year old brother. Since childhood, Meghna was a bright student who always got scholarships from her school and college.

It was in 1999 when Meghna joined N.S Software Company. Now she took up the entire responsibilities of her house, including higher education of her younger brother.

Meghna’s salary brought financial stability to her family’s life which was now their only source of income. It was the hard work of Meghna that she bought a new house for her family and also sent her younger brother to Australia for higher studies.

When everything was settled, her mother urged her to get married and settled down. The family found a good match for Meghna, and by the time she got married, she was 36. In a year or so, she conceived her first child. The couple was excited to start a new chapter in their life.

Read More: How Many Times can you update the Employee List in Group Health Insurance?

She shared this news with her company’s manager who has been mentoring her since she joined N.S Software Company in 1999. Her manager advised her to ask the HR department about maternity benefits offered by the company.

Being an employee-centric company, N.S Software was offering various maternity benefits like flexible working hours, paid vacation, free pick & drop, etc. The company also assured Meghna that she would get maternity coverage under a group health insurance policy.

Since Meghna had a late pregnancy, she was sceptical about the maternity coverage. However, her HR department told her that she was covered under a maternity cover of a group health insurance policy which extended cover to all employees, irrespective of their age. In addition to covering her delivery expenses, the group health insurance will cover her baby as well.

When the final day came when Meghna gave birth to a boy, her group health insurance provider covered all her maternity expenses and her husband did not pay anything to the hospital as the expenses were directly settled by the insurer. Her son was also covered under the group health policy for the next three months.

Thankfully, the maternity cover saved Meghna from spending thousands of rupees on her delivery.

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