Can Company Health Insurance cover newborn baby 2023?

Can Company Good Health Insurance cover newborn baby 2023?

If you are a young couple thinking of having children, whether or not you should go for maternity insurance with your personal health insurance policy is an important decision. If the policy is taken with maternity cover, the premium will be higher. If you go without maternity cover, you will have to bear the entire cost yourself unless you have a corporate health policy for maternity. However, the most important issue is newborn coverage, which you should check beforehand.

Best value corporate health plans do not offer maternity benefit. Even those that do, may not provide coverage for newborns or the coverage they provide may not be adequate. Even if you have an individual health insurance policy without maternity benefit, it will not cover the newborn.

If you want to buy a new personal health plan for newborns, you will have to wait as most insurance companies offer financial protection to newborns only when they are older.

Family floater plans without maternity cover have a facility to add a new member. But that doesn’t help either. These plans usually allow a new member to be added only after 90 days of delivery within the same sum assured, but for an additional premium.

Hence, you need to check whether you need an individual health insurance plan with maternity benefit that provides coverage for the newborn. Does maternity insurance ensure health coverage before 90 days of birth?

There are two types of health insurance plans with maternity cover in the retail policy. One is that the insurance company pays the delivery expenses and the other covers the delivery expenses and the new born baby is covered from 1st day to 90th day at no extra cost. This scheme covers the cost of post-natal care for any kind of complications. , ICU charges etc. are recommended. Any personal health insurance policy that provides maternity insurance usually covers childbirth and all related complications.

Maternity insurance provides cover for expenses related to pregnancy and childbirth, such as hospitalization, ante/postnatal, room rental charges and birth/birth complications for the mother and her baby. Expectant mothers can avail these benefits whether the delivery is a cesarean section or a natural delivery.

Maternity cover in a retail health insurance policy usually comes with a substantial waiting period. So, check the fine print of the policy before buying it. “The usual waiting time for such policies starts at 4 years, but companies are now reducing it to 9 months. Getting a maternity insurance policy early is always advisable,” says Indraneel Chatterjee, co-founder, RenewBuy.

Individual health insurance plans also provide additional coverage. In some schemes, as recommended by the Indian Pediatric Society, vaccinations are mandatory for newborns up to 90 days of age.

Premium and Benefits 10L Sum Assured for 2 adults aged 27 years (Male) and 25 years (Female) and in Delhi,
*Mother and child care rider has been added which is only available on 3 year policy so the premium mentioned is 3 years inclusive of 1 year waiting period and 1 lakh sum assured of maternity cover.

Or 27 year old male and 25 year old female, non-smokers, urban resident Rs. 10 Lakh Sum Assured How to evaluate your corporate health plan for maternity cover If an individual has a corporate health insurance policy with adequate maternity cover, it is better to avoid duplication by purchasing an individual or family floater plan.

However, not all corporate plans tick all the right boxes. In many cases, purchasing an individual health insurance policy may be the best option. If you have a corporate plan, evaluate it before taking the call.

Check if the corporate plan has maternity coverage: Employees with corporate health insurance coverage are likely to have maternity coverage; However, before taking a decision, it should be checked thoroughly. “Maternity benefits are generally available at the discretion of employers. They may or may not opt ​​to include it in their corporate health plan,” says Nerurkar.

Corporate plans have sub-limit restrictions:

Even if a corporate plan has maternity coverage, it may provide very limited coverage due to restrictions. “Usually, the insured has sub-limits and co-payments. Hence the plan may not meet one’s medical needs. It is always important to check the coverage limits under the corporate health plan based on one’s need.” Nerurkar says. Check the features of the corporate health plan and ensure that there is adequate coverage. “Generally, a corporate health plan provides Rs 25,000-35,000 as delivery cost.

Whereas, in a retail health insurance plan that you can buy yourself, the sum assured is Rs. 2 lakh,” says Singhal. A personal health plan can offer more maternity coverage to cover any eventuality. “A retail health insurance plan has no sub-limits and is lifetime and renewable,” says Singhal.

Better to add coverage to your own plan:

A personal health plan can be helpful when a corporate plan doesn’t seem to have enough maternity coverage. “Corporate policies may have limits or restrictions on maternity cover, so you may want to add this to an individual or family float plan,” says Singhal.

This will ensure that you are best prepared to deal with any complications that may arise during labor. “A retail health policy, individual or family floater, can always act as a shield in case of any complications or medical conditions in the family.

Accumulation of No Claim Benefit helps:
If a person avails a corporate plan and not an individual plan, it may lead to accumulation of no-claim benefits.

Consumers who hold both family floater and corporate policies and continue to claim settlements from their corporate policy can avail the no-claim benefit from the family floater scheme.

Provide continuity of coverage during job transitions:

Corporate plans don’t work when someone leaves the company. If a person changes a job, he or she is covered by a family floatation policy during the transition period. The only major difference is the premium, which has to be borne by the policyholder at the time of family float.

Which policy should be used first if both spouses have corporate health cover:

If husband and wife have separate corporate plans, which should be used first? Search for information based on higher claim amount, higher benefits, lower coverage limits, deductibles and any exclusions.

This will help you decide which plan to use first. One should definitely go for a plan that has no limit on room rent. And there is no specific sub-limit on maternity.

Adding more cost to the two corporate policies:

Can these plans be combined for delivery or post-delivery treatment if the cost exceeds the coverage of a corporate health policy?

If the costs are high, these two plans can be combined. From a policy, the policyholder can make cashless payments. The remaining amount can be paid through the spouse’s corporate scheme through repayment.

Individual and Family Floater Plan:

Which Maternity Insurance Works Best?
Individual health plans come with maternity cover, but a family floater plan usually offers more coverage for a similar premium. Particularly beneficial for maternity coverage. Family floats are comfortable and include the entire family, including maternity expenses. Premiums are also cheaper than taking out two individual policies. If one is planning to start a family soon, a family floater with maternity benefits is a great plan that provides comprehensive coverage.

A family float plan’s high coverage can help during an event. Maternity insurance in Family Float provides adequate cover to take care of pregnancy, hospitalization and newborn expenses. One should carefully understand his family needs and financial capacity before opting for any scheme.

If you are value conscious, a family float plan works best. “Whenever a couple plans to start a family, it’s important to consider the overall cost of maternity care, which can be substantial. If you compare the premium costs of family float plans with the cost of an individual plan with maternity coverage and the out-of-pocket costs associated with maternity care, the family float plan is definitely Provides excellent value.

Some plans offer maternity coverage only when you purchase a family floater plan. “Many health insurance companies offer maternity benefits only if you and your spouse are covered by the same insurance plan

Should I buy add-on maternity insurance even with a corporate health policy?
Avoid having a private health plan with maternity insurance if one has a stable job with a corporate health insurance with maternity benefit that covers the newborn. Otherwise, it is better to have an individual health insurance plan along with maternity insurance plan for better protection.

An important thing to understand here is that corporate insurance policies can only act as a backup plan. Because the coverage amount is limited and the employer can change the terms and conditions at any time.

There is also the risk of the policy being forfeited if the policyholder changes jobs or loses a job, as the policy lasts only until the date of employment. Therefore, it is always recommended to have a personal health insurance policy to protect your financial well-being.

Additional information :

Company health insurance plans are designed to provide coverage for employees and their immediate family members. While these plans typically cover spouses and dependent children, many individuals wonder whether company health insurance can also cover a newborn baby. In this article, we will explore the factors that determine whether your company health insurance can extend coverage to a newly born child.

Understanding Company Health Insurance:
Company health insurance, often offered as part of an employee benefits package, provides essential medical coverage to employees and their families. These plans typically cover hospitalization, doctor visits, prescription medications, and various other medical expenses. However, the coverage for newborn babies can vary depending on the specific terms and conditions of the insurance policy.

Can Company GoodHealth Insurance cover newborn baby 2023?

Key Factors to Consider:

  1. Enrollment Period: Most company health insurance plans have a specific enrollment period during which you can add or make changes to your coverage. If your baby is born during this enrollment period, adding them to your policy is usually straightforward.
  2. Special Enrollment Events: In some cases, the birth of a child is considered a “qualifying life event” that allows you to make changes to your insurance coverage outside of the regular enrollment period. This means you can add your newborn to your policy shortly after their birth.
  3. Notification and Documentation: It’s crucial to notify your employer and the insurance provider about the birth of your child as soon as possible. They may require certain documentation, such as a birth certificate, to add the newborn to your policy.
  4. Costs and Coverage: The costs associated with adding a newborn to your company health insurance plan can vary. Some plans may cover the baby at no additional cost, while others may require you to pay an increased premium. Be sure to review your policy’s terms and conditions to understand the financial implications.
  5. Limits and Restrictions: It’s essential to be aware of any limitations or restrictions on coverage for newborns. Some policies may have waiting periods before covering certain medical expenses for the baby.

In most cases, company health insurance can cover a newborn baby, provided you follow the necessary procedures and meet the enrollment requirements. However, it’s crucial to review your specific insurance policy and consult with your employer’s HR department or the insurance provider to ensure that your newborn receives the required medical coverage. Understanding the terms and conditions of your company health insurance plan is essential to providing the best healthcare for your growing family.

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By Karthik

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