Evaluating maternity cover in insurance plans

dubai - The maternity cover in your health insurance saves you the trouble of having to pay out of your own pocket.

Giving birth in the UAE is an expensive affair. The whole experience can cost you anything between Dh20,000 and Dh30,000, which includes routine consultations, tests, ultrasounds and hospitalisation. The maternity cover in your health insurance saves you the trouble of having to pay out of your own pocket and assures that the expecting mother and her newborn are taken care of medically and financially.

The Dubai Health Insurance Law No. 11 of 2013 requires all employers to provide mandatory health insurance coverage to their employees, maternity benefit included. This insurance cover often extends to the employees' families. If dependants are not covered in the package, it is advisable to get a maternity cover for your spouse far in advance of a planned pregnancy since some insurers require that you pay for the policy at least 6 months before you can avail of the benefits.

We break down the maternity coverage being offered as part of health insurance plans in the UAE.

Waiting period
Insurance companies require you to wait a certain amount of time before you can make a maternity claim on your policy. This period is called the waiting period and its duration is usually 6 months but in some cases can even be up to 12 months. However, some insurers do provide immediate claim on maternity cover provided the insured is not pregnant at the time of applying for the policy.

Pregnant already?
Insurance companies work in their best interest. This means that they aim to collect more in insurance premiums than they pay out for medical expenses. For this reason, taking out an insurance policy during pregnancy results in a significant loading on to the insurance premium. This could even be as high as Dh25,000. Unless the insured is worried about pre-natal or post-natal complications, it does not make financial sense to apply for an insurance policy at this stage. In such a case, the expecting mother has other options like maternity packages with healthcare providers or government health cards that entitle you to a more economical treatment at public hospitals.

Benefits and their coverage limit
For a standard health insurance policy, the maternity cover extends over pre-natal, post-natal, childbirth and neo-natal care. Coverage is broken down into the following 2 services:

> Inpatient services: Inpatient maternity services include the hospital stay and child birth. These are covered with a maximum 10 per cent co-insurance payable by the insured. Prior approval from the insurance company is needed or should be claimed within 24 hours of emergency treatment. According to Dubai Health Authority ruling, the cover limit is a minimum of Dh7,000 for normal delivery and Dh10,000 for a medically necessary C-section, complications and medically necessary termination of pregnancy.

> Outpatient services: These services are also covered with a maximum 10 per cent co-insurance. Pre-natal outpatient services include 8 consultations with the OB-GYN, 3 ultrasound scans and a range of standard initial investigations. Post-natal outpatient services cover any complications that might occur in the 8 weeks following child birth. Neo-natal outpatient services or newborn care is covered up to a minimum of 30 days from the date of birth and includes BCG, Hepatitis B and neo-natal screening tests.
In the adverse case of a critical condition where the mother or the newborn are affected, medically necessary expenses are covered up to the annual aggregate limit.

Limitations and exclusions
Health insurance policies sometimes specify an upper age limit over which maternity cover is not granted. This is because risk of complications associated with pregnancy and delivery is greater above a certain age. Certain medications such as epidural, multi-vitamins and other pain relievers are usually not covered by insurance. In addition to this, voluntary C-section, multiple births and complications due to a previous voluntary termination of pregnancy are some general exclusions of maternity cover.
It should be noted that maternity benefits, coverage limit and exclusions vary significantly from one insurance company to another as well as between different health insurance plans.

The writer is the founder and CEO of souqalmal.com. Views expressed are her own and do not reflect the newspaper's policy.