How Maternity Cover works on Health Insurance

Episodic Health Insurance includes optional cover for maternity. Find out how the benefits work for you for both prenatal healthcare and delivery in hospital.

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When you start planning a family, the journey of parenthood is filled with both joy and moments of uncertainty. One of the important parts of navigating this exciting time with peace of mind is understanding how your health insurance coverage can assist you with maternity care.

This article aims to show you how you can use Episodic's Health Insurance benefits during your pregnancy and for the birth of your child.

Prenatal Benefits

During your pregnancy, it is a great comfort to know that your body and your baby are doing well and that things are going according to plan. There are a number of prenatal benefits on the Day-to-Day plan that you can use during this phase.

Day-to-Day cover is an optional suite of benefits that you can choose to include on your plan. If you do, here are the benefits that might assist you during your pregnancy:

  • GP Visits: the GP benefit lets you see a network doctor as often as is medically necessary. Get checkups and medical advice on the progress of your growing baby from a private medical practitioner.
  • Medication: the Acute Medication benefit gives you access to unlimited formulary medication as well as limited Over-the-Counter medication. Get prenatal vitamins and medication on your benefits.
  • Blood tests: the Pathology benefit gives you access to basic blood tests that your network GP may require.
  • Prenatal scans: the Radiology benefit covers two prenatal growth scans, one each in the 1st and 2nd trimesters, as required by your network GP.
  • Specialists: the Specialist benefit offers a  stated amount of cover to see an Ob/Gyn specialist during your pregnancy.

When you look at all of these benefits together, there is quite a nice collection of cover items that you can use to monitor the progress of your growing baby.

All of these benefits above carry a one month waiting period (except for the specialist benefit which has a 3 month waiting period). This means that you can take out Day-to-Day cover and use it even if you are already pregnant.

Hospital Cover for the Birth

When it comes to the time of delivery, you really want to know how you can pay for the birth of your child in a private hospital.

This is where the Hospital Maternity Cover benefit comes in. The benefit is an optional benefit on the Hospital Plan and offers a stated amount to help cover the birth of your child in a private hospital. The cover applies regardless of the type of delivery, whether you have a natural birth or a C-section.

Pre-authorisation is required so it is important to keep the administrator up to date as to the expected delivery date of your baby.

The Maternity benefit does have a 12 month waiting period so you won't be able to use this benefit if you are already pregnant. The benefit is designed to assist members who are starting to plan a family with a long term view on health cover for themselves and their families.

Maternity Cover is Optional

Hospital Maternity Cover on an Episodic Health Insurance plan is an optional benefit. This means that if you are not planning to get pregnant and don't want to pay for this benefit then you simply don't have to include it on your policy.

Episodic benefits are flexible and this is one of those optional benefits that you don't have to pay for if you don't need it.

Similarly, the Day-to-Day plan is optional as well, if you don't want these benefits (whether for prenatal care or for general primary healthcare) then you don't have to include it on your plan.

With Episodic, you control your own budget.

Embrace the Journey with Confidence

By understanding your maternity benefits and taking proactive steps to ensure you have adequate cover, you can start your parenting journey with greater confidence and focus on the joy and wonder of welcoming your little one into the world.

Disclaimer: This blog post describes the benefits included on Episodic's Health Insurance for Individuals plans (provided by EssentialMED) at the time of writing. Group cover for employers may differ slightly. Please consult the current benefit guides for exact and up-to-date coverage information. This article is also for informational purposes only and should not be construed as medical or financial advice.

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