Health Insurance Basics

Health Insurance Guide for Expectant Moms and Dads

March 17, 2015

One of our goals at insureafrika is to provide you with as much information as you need to help you make insurance decisions. One area in insurance that attracts many questions is maternal health. You see, once you are married, getting a baby cannot be considered an insurable risk because it is highly likely that you will get a baby. Compare this to car insurance where insurance companies actually provide services based on how low the chances are that you will actually need insurance. We have picked out eight of the most critical insurance questions every mom (and dad-especially dads), need to be aware of during maternity. 

1. Do insurance companies cover maternity costs?

Yes they do. Many insurance companies today offer maternity cover as an annex of the primary health cover. While this goes against the intuitive nature of insurance, companies have found a way to offer maternal health covers which pays your hospitalization bills before, during, and after childbirth.

2. Is the cover ceiling for natural birth the same as the cover for Caesarean section?

No. insurance companies have difference ceilings for natural birth and CS. The cost of CS in any hospital can be between three to five times the costs of natural birth. This is because CS involves the use of a theatre, and the mother also require post operative care. The number of days a new mom stays in hospital are usually more after CS than after natural childbirth. Health insurance companies therefore have different ceilings because they treat them as different procedures.

Related: Don’t get Caught in Health Insurance Fraud

3. I am already pregnant. Can I rush to buy health insurance?

Unfortunately, if you are already pregnant and you have not bought a cover that includes maternal care, then you are late. It is still advisable to buy some type of health cover because pregnancy can be very unpredictable. In case of any complications, you may be able to claim some money from your insurer, without the costs of actual delivery.

4. What if my baby is born with a disease or a birth defect?

Many times, a maternal health cover will also include a clause on congenital illnesses. This means that if your baby is born with a birth defect, or requires emergency care immediately after birth, you insurance company will step in and cover these costs of care. It is advisable to discuss with your insurer whether they have any exclusion in regards to the cover extended to your newborn. It is also important to know what the limit of that cover is.

5. How do I get the best rates for maternal care?

The quickest and most effective way of getting good quotes for maternal cover is by filling in the insureafrika health insurance quote form. This is a free service from insureafrika designed to give you all the information you need to make critical decisions regarding your cover. Please remember that maternal cover is usually bundled as part of your health insurance cover, and may not exist on its own. Fill our form to see which companies have the best rates.

6. Will my insurer pay for prenatal and post-natal care?

Yes, prenatal and postnatal care usually falls under the purview of your health cover. It helps to know whether your insurer has any exclusions and limits when it comes to maternal covers. For instance, you insurer may have a limit on the number of scans that they pay for during prenatal care, and may also have exclusions on which medicines they pay for. Many insurance companies do not pay for supplements or may insist on case-by-case approval for supplements when prescribed.

Related: Avoiding Medical Insurance Fraud

7. How soon can I buy insurance for my newborn child?

As soon as your child is born, it is important to get a health cover. The baby is a separate person, and is not covered except under the congenital illness clause. Therefore, do your best to get a cover for your baby as soon as reasonably possible to ensure that your baby is covered.

8. Is it possible to spend nothing during the entire delivery process?

Yes and no. Yes, the maternal cover can finance your entire stay in hospital and you will not need to pay any fees for healthcare in the hospital. This is especially possible if there are no complications during childbirth. No, because there are items that health insurance companies will not pay for. This include diapers, baby formula (if used), and personal care products for you and your baby. It is highly advisable to have some cash at hand to take care of any incidental costs and the cost of buying personal care products.

If you have any further questions or further information in these or other areas, please send them to us using our social media pages, our email address or in the comments section below. 

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One comment


joseph muita says:

May 11, 2015 at 07:28 am
thanks nice article

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