Cesarean Delivery - Is It Covered by a Health Policy?

When Preeti found out she was pregnant with her first child, she was filled with joy and excitement. She imagined a perfect birth—soft music playing in the background, her partner holding her hand as she welcomed her baby into the world. However, at her 36-week check-up, her doctor told her the baby was in a breech position. A cesarean delivery (C-section) was now the safest option. That’s when another worry came up: Would her health insurance cover the procedure, or would she have to bear the financial burden herself? Health insurance plays a major role in every aspect of life and it will help you when you are single and your family after you get married. Once you get married there will be huge expenses that will knock on your door out of which one of the life-changing ones will be maternity.

What is Cesarean Delivery?

Cesarean delivery is known as C-section delivery and it is done when normal vaginal delivery can’t be done due to some issues. It is done to deliver the baby through surgical incisions made in the abdomen and uterus. 

The need for cesarean delivery arises due to these reasons:

• When a baby's health is in danger or the baby is not getting enough oxygen.
• The position of the baby is not in the way it should be.
• The placenta covers the cervix or there are other issues with the placenta.
• The health problem of the mother.
• The mother is carrying more than one baby.

Health Insurance Plans for Maternity

There are different types of health insurance plans available from various insurers that give coverage for cesarean delivery. Go through the below-listed plans that give coverage for maternity.  

Cesarean Delivery Covered by Health Insurance Waiting Period

Cesarean delivery or any normal delivery is covered by health insurance but there are certain waiting periods which one has to serve before getting coverage for it. So before buying a health plan or maternity plan kindly go through the waiting period for maternity coverage and go for the plan with less waiting period.

Maternity Coverage

Besides Cesarean delivery coverage, some other maternity coverage is also covered under the Health insurance policy. Generally, health insurance policies cover many complications during childbirth, such as pre-natal expenses, post-natal expenses, and ambulance costs. Apart from all these, some policies also provide coverage for the newborn baby till policy renewal along with the baby’s related vaccination expenses.

Policy Premium

To be precise, the premium paid for the health policies that cover Cesarean delivery is higher than the premium for non-maternity insurance. So, don’t get distressed about getting maternity insurance at a higher premium. However, make sure the product you are choosing covers everything that is needed during the treatment of maternity

Inclusions & Exclusions Under Maternity Coverage for Cesarean Delivery

There are certain exclusions and inclusions in the maternity plans which are available in the plan offered by the insurance companies. Go through the listed below table to learn about the exclusions and inclusions available in the plans of maternity:

Cost of Cesarean Delivery Without Insurance

Medical costs in India are rising daily, so the cost of cesarean delivery is increasing and it is not possible for everyone to afford such a high-cost operation. The cost of cesarean delivery depends on the city and the types of hospitals you are in and it may cost you between Rs.50,000 to Rs.2,00,000. 

Top Factors to Consider When Choosing a Health Insurance Policy for Cesarean Delivery

There are certain factors which should be considered before purchasing health insurance for maternity and what should be there in the plan. To get a better plan go through the listed below factors before purchasing health insurance for maternity:

• Maternity Sum Insured
• Waiting Periods
• Network Hospitals
• Premium
• Claim Settlement Process
• Pre & post hospitalization expenses cover
• Pre & post-natal expenses cover
• Inpatient hospitalization & delivery charges
• Newborn baby expenses cover
• Vaccination expenses of the newborn baby

FAQs

Ques 1. Is pregnancy covered in employee health insurance?

Ans. Yes pregnancy is covered in employee health insurance however, the specific coverage and terms can vary depending on the employer, insurer, and type of plan.

Ques 2. What is the cost of C section delivery?

Ans. The cost of cesarean delivery depends on the city and the types of hospitals you are in and it may cost you between Rs.50,000 to Rs.2,00,000.

Ques 3. Why is C-section expensive?

Ans. C-section is comparatively more expensive than normal delivery because the risk percentage is higher in performing Cesarean deliveries. Patients may incur higher costs as a result of longer hospital stays and longer recovery times.

Ques 4. How long are typical waiting periods for maternity benefits?

Ans. The waiting period for maternity is between 2-3 years and also there are plans that have less waiting periods. The waiting period also depends on the insurer and the medical condition of the insured person.

Ques 5. How can I find out if my policy covers a cesarean delivery?

Ans. You can review your policy’s documents of benefits or contact your insurance provider directly to confirm if cesarean deliveries are covered.