MATERNITY INSURANCE COVERAGE

MEANING OF MATERNITY

Maternity is the period between pregnancy and immediately after delivery. It covers a period of 26 weeks after child birth or delivery. And it is this period of time that enjoys maternity Insurance Coverage.

A couple of Insurers do not make provision for maternity insurance coverage for women already pregnant. The singular reason is that they consider the pregnancy as a pre-existing condition. And as such is beyond the policy cover.

 And the reason is against the backdrop that insurance cover affects non- existent and uncertain conditions. In other words, these insurance companies view insurance cover from the standpoint of making provision for protection for uncertain probabilities of loss. And this is for the fact that the time and the level of loss at every of such event is always not certain.

Similarly, for the fact that some insurers consider pregnancy as a pre-existing condition, they most times insist that you undergo a waiting period 3-4years to avail you of their insurance coverage under the maternity policy.

Maternity Insurance coverage represents one of the essential plans that guarantee the health benefits of mother and child. It is apt to buy this policy so   that you enjoy coverage from all health insurance plans from insurance companies to individuals, families, and small groups etc.

One cannot ignore the importance of maternity care for the health of women, as well as that of the unborn child.

Maternity insurance coverage makes provision for ease to prenatal medical checks which improve health outcomes for women. And this is done through identifying preventable complications, as gestational diabetes, preeclampsia, and ectopic pregnancies. It also includes postnatal care checks for postpartum infection as well as depression. In a situation where a woman does not buy insurance maternity coverage, there is a possibility that she may avoid prenatal and postnatal care that will identify risks of preventable life-threatening maternity complications.

 Health insurance for maternity, labor, delivery, and newborn baby care are mandatory in some countries while they are optional in others. We shall examine few of these countries.

MATERNITY INSURANCE COVERAGE IN THE UNITED STATES OF AMERICA

 Prior to 2014 in USA, Maternity insurance coverage was not a sure benefit. And only a few Health Insurance Plans had coverage for maternity. Furthermore, people whose insurance Plans contains coverage for maternity were made to pay more insurance premiums.

However, as at 2014, there was a change in the narrative. And this was as a result of the coming into law of the Affordable Care Act (ACA) which is Legislation signed into law by President Barack Obama in the month of March 2010. The ACA represents a step towards a comprehensive healthcare reform by President Barack Obama administration in March 2010. The intendment of the ACA is to broaden access of Americans to health insurance plans. Most especially the ones who were yet to get insurance cover.

The coming into effect of the ACA marks the first time in the history of the USA health insurance that women will have a sure access to maternity coverage services which enjoys the protection of the ACA include:

1. Services, such as prenatal and postnatal doctor visits, Outpatient gestational diabetes screenings, lab studies, medications, etc.
2. Inpatient services, such as hospitalization, physician fees, etc.

3. Newborn baby care
4. Lactation counselling and breast pump rental and anyone willing to enrol in or change to a different health plan must do this during the Open Enrolment Period, which begins on November 15 every year for coverage starting in the next calendar year.

OTHERS ARE

1. Ambulatory patient services

2. Breastfeeding
3. Emergency services
4. Family planning
5. Hospitalization
6. Laboratory services
7. Mental health and substance use disorder services
8. Pregnancy, maternity,
9. Prescription medications
10. Preventive and wellness services and chronic disease management
11. Pediatric services
12. Rehabilitative and habilitative service

OTHER WORTHY PROVISIONS OF THE ACA

 The ACA also requires individuals and small group plans to incorporate maternity care as essential health care benefits. However, Small Employers (up to 49 employees) are not required to offer coverage, but if they do, it has to include maternity care.

And anyone who does not have insurance coverage from an Employer is at liberty to purchase an individual market plan. But the fact is that insurance coverage for maternity care is now mandatory for all insurance plans in every state.

 Similarly, all persons who are not grandfathers or grandmothers must enjoy maternity coverage on all individual and small group plans postdating January 1, 2014. In other words, If you’ve retained your grandmother’s or grandfather’s plan, your plan may not cover maternity care.

Equally, Lower-income families are eligible for subsidies for policies bought through the Marketplace.

Therefore, If you’re buying a plan that’s not backed up by ACA, there’s a good chance that it won’t cover maternity. And there is a possibility that your application will be rejected if you’re already pregnant when you apply for coverage.

MATERNITY COVERAGE IN INDIA

Most insurance companies do not provide maternity insurance in India if you are already pregnant. This is because they consider pregnancy as a pre-existing condition and is beyond the policy cover.

In India, maternity insurance policies provide wide range of benefits and coverage. It comes with wide areas of coverage and usually include wide hospitalization benefits (both pre and post-natal) . The costs of hospitalization right from the first day of hospital admission. As well as additional costs of ambulance, nursing, and surgical consultation, etc.

  It is noteworthy that these benefits are available for both a normal delivery and also for caesarian section. Additionally, it covers circumstances where a newborn suffers from any congenital disease. In which case, coverage may be available for up to ninety days.

Notwithstanding the fact that the benefits under maternity coverage in India are enormous, there are certain limitations in place. For example, the upper age capping is of 45 years for seeking the benefits.  There is equally an upper capping in place for expenditure on caesarian sections.  And also no benefits are available for any abortion within 12 weeks from conception.

Similarly, maternity insurance plans in India come with high premium rates. And as a result are costlier in comparison with other health insurance plans.

Also, there is always a waiting period that the insurers include in the policy terms, before the actual benefits of the plan can be claimed. This period ranges from anywhere between 2-6 years, depending on the insurer. Therefore, it is advisable and essential that you buy maternity plan in time.

 As stated above, taking a timely decision is very imperative to purchasing a maternity insurance plan in India. Maternity benefits can be claimed under certain health care plans as well. However, it is always advisable to purchase a different and specific maternity plan

MATERNITY INSURANCE COVERAGE IN NIGERIA

In Nigeria, maternity insurance is not compulsory except in some states while it is not in others. Examples of such state where it is mandatory is lagos state

Even though the health insurance scheme became a law in lagos state 2017 after its passage by the house of assembly.

The scheme covers public servants in the state and their spouses and a maximum of four children of less than eighteen years of age. The state government is to pay 75% of the family insurance premium per annum for every public servant while the balance of 25% will be borne by the public servant through a period of twelve months.

Consequently, every Enrolee into the scheme would enjoy services and benefits ranging from enrolment and consultation, treatment of common ailments such as malaria, hypertension, family planning services, dental care, diabetes, ultrasound scan, child welfare services, radiological investigations, care of childhood illnesses, neonatal services, gynaecological prenatal care and delivery.

 MATERNITY INSURANCE IN UNITED KINGDOM.

There exists universal health coverage in the United Kingdom since their creation of national health insurance scheme (NHS) in 1948 under the National Health Service Act of 1948. The act is to enable free health care as one aspect of welfare reformation meant to eliminate unemployment, poverty, illness and to improve education.

In the United Kingdom, the health minister has a duty to make provision for a comprehensive, free health services thus replacing voluntary insurance and out of pocket payments during medical attention.

Consequently, all ordinary residents in United Kingdom are entitled to free NHS medical care. Also, non residents with an European health insurance card is equally largely free. However, non Europeans visitors and undocumented immigrants enjoy free medical care in an emergency department and for certain infectious diseases.

In essence, the NHS provides and pays for the following services.

1. Maternity care
   1. Preventive services, including screenings, immunizations, and vaccination programs
   2. Inpatient and outpatient hospital care
   3. Physician services
   4. Dental care
   5. Eye care
   6. Mental health care including learning disabilities
   7. Palliative care
   8. Some long term care
   9. Rehabilitation, including physiotherapy
   10. Home visits by community nurses
   11. Wheelchairs, hearing aids and other assistive devices for those needing them.

ADVANTAGES OF MATERNITY INSURANCE

Maternity is one of the most blissful experiences in life and no words can ever describe the exact emotions that make it such an important milestone. In the old times, maternity meant the traditionally acclaimed methods of ensuring the safety of the mother and the child. However, the predominant thrust today is on hospitalization. And in many cases, owing to the complications, surgical methods and post-natal recuperation becomes a necessity. This obviously means a lot of financial stress for the couple and their savings are directly impacted because of this. This operates as the major importance of maternity insurance plan. Having a maternity insurance plan in place allows you to save your hard earned finances from unwanted hassles and provides due coverage benefits ranging from hospitalization, any surgical procedures required, medications and even post-natal recovery and lots more.