Health Insurance for New Born Baby: What to Keep in Mind

As new parents, the safety and well-being of your newborn are paramount. There are several things you need to ensure, from medical treatments and regular check-ups to vaccinations, to ensure that your child's initial few months and following years are healthy and joyful.While frequent trips to the doctor can get expensive, a smart way to protect yourself from the expenses is to purchase Health Insurance . Bearing in mind the medical needs of infants, many insurance companies have started to offer policies specifically designed to cover expenses related to a newborn. Let's understand these policies better.

The Insurance Regulatory Development Authority of India ( IRDAI ) defines a newborn as a 'baby born within the policy term and aged up to 90 days.Health Insurance for a newborn can encompass expenses related to neonatal complications, infant care, medical check-ups, and vaccinations. Due to your child's vulnerable immune system at birth, they are more prone to illnesses. Thus, with a suitable plan for your newborn, you can focus on providing the extra care and attention your child needs.There are no individual Health Insurance policies in India that cover newborns. However, you can add coverage for your newborns within a Maternity Insurance plan . You can also choose the Family Floater Insurance plan. If your child is born while your existing Family Floater policy is active, you can add the baby to your plan once it is 90 days old.Some insurance companies extend coverage for newborn children under the Family Health Insurance plan at no additional cost, while others may require you to pay an extra premium. Also Read: Health Insurance Plans With Maternity Cover – Is it the Right Choice?

Let's delve deeper into the benefits and importance of a Health Insurance policy for a newborn baby:

Access to quality medical treatment

A Health Insurance plan provides you access to quality medical care for your baby from day one until they are 90 days old. It covers expenses related to hospital stays, specialist consultations, diagnostic tests, vaccinations, and medications.

Preventive care

The rising pollution levels and environmental degradation make your newborn susceptible to various infections or other health conditions. As per UNICEF, the first 28 days of a newborn's life is a critical window of opportunity for preventing and managing maternal and newborn complications, which can otherwise prove fatal. Newborn baby Health Insurance gives you access to regular check-ups and screenings, which can help detect and prevent potential health issues early on. Timely intervention can significantly improve health outcomes and reduce the risk of long-term complications.

Neonatal care

Your child may require specialised care in neonatal units due to premature birth, low birth weight, or other complications. UNICEF points out that nearly 3.5 million babies in India are born too early, and one million require Special Newborn Care Units (SNCUs). Many Health Insurance policies for newborns cover expenses arising from the need for specialised equipment, treatments, and round-the-clock medical supervision. Also Read: Top 4 Factors to Consider When You Buy Maternity Insurance It is essential to review the terms and conditions of the insurance policy thoroughly so that you will be clear about the specific exclusions applicable to your newborn Health Insurance plan that you are considering. The exclusions in your plan may vary, so it is important to clarify any doubts and seek clarification from the insurance company executive regarding coverage and exclusions in your plan.

Plan type

You can cover your newborn's medical expenses under your Maternity Insurance. If you are employed, and your employer provides Health Insurance with maternity benefits, check if it covers your newborn as well. The other option is to add your newborn to the Family Floater Insurance once they are 90 days old. Each plan has its advantages and disadvantages, so it's important that you carefully consider which one suits your child's needs.

Overall coverage

Check for the policy coverage regarding pre-and post-hospitalisation expenses, Critical Illness benefits, regular check-ups, vaccinations, room rent limits etc.

Postnatal care

Remember to check the terms for postnatal care, including expenses related to vaccinations and immunisations after your child's birth. Not all Health Insurance plans automatically cover newborns, so look for maternity add-on covers, including coverage for newborns and postnatal care.

Waiting period

There may be a waiting period before certain treatments or benefits in your plan become eligible for coverage. This waiting period can differ depending on your insurance plan and may apply to specific procedures or conditions.

You need to understand the limitations and scope of your policy to make informed decisions. Following are some exclusions you need to be careful about:

Congenital conditions

Your Health Insurance plan may exclude coverage for certain congenital conditions, i.e., medical conditions or abnormalities present at birth. However, some plans may cover specific congenital conditions after a waiting period.

Experimental or unproven treatments

Health insurance plans typically do not cover experimental or unproven treatments that doctors do not widely accept or recognise.

Non-medical expenses

Health Insurance plans generally do not cover non-medical expenses such as cosmetic procedures, alternative therapies, or non-essential treatments. Also Read: What Aspects are Excluded in Health Insurance Plan?

The documents needed to include your newborn in a Health Insurance plan may vary depending on the insurance company and the type of plan. However, the following documents are commonly required:

Birth certificate

You need to provide a copy of the newborn's birth certificate as proof of the child's age and identity.

Identity proof

Identity proof documents of the parents or guardians, such as an Aadhaar card, PAN card, or passport, may be required to establish their relationship with the child.

Address proof

Documents verifying your residential address, such as rental agreement or utility bills, may be necessary.

Photographs

You may need to provide a recent passport-sized photograph of your child for record-keeping and identification purposes.

Medical reports

Medical reports related to your newborn's health or any pre-existing conditions may sometimes be required. It could include discharge summaries from the hospital, vaccination records, or diagnostic test reports.

KYC(Know Your Customer) documents

KYC documents, such as PAN card, Aadhaar card, or passport of the parents or guardians, may be necessary as per regulatory requirements.It is important to note that these are general documents, and the specific requirements can vary between insurers. It is best to contact the insurance company directly or consult an insurance agent to get the precise documents needed to purchase a newborn health insurance plan. Also Read: What Should You Do If You Lose Your Health Insurance Documents?

For cashless facility:

• Enquire with your insurer about network hospitals that offer cashless facilities for newborns. Choose a hospital from the network for medical treatment.
• At the hospital, inform the insurance desk about the newborn's Health Insurance policy. Submit the necessary documents and fill out the cashless claim request form.
• Once your claim is approved, the hospital can provide medical treatment under the cashless facility, where your insurer will settle the bills with the hospital directly.

For reimbursement facility:

• Select a hospital of your choice for the newborn's medical treatment and pay for the medical expenses during the newborn's treatment.
• Gather all the required documents, including hospital bills, medical reports, and discharge summary, post-treatment.
• Fill out the reimbursement claim form provided by the insurance company and attach all the necessary documents. Get the completed form signed by your consulting doctor.
• Once the claim is approved, your insurance company will reimburse the eligible expenses per the policy terms.

• Inform the insurance company about the newborn's birth.
• Provide necessary documents like birth certificate and discharge summary.
• Add the newborn during the grace period (15 to 30 days) to avoid waiting periods.
• Check for premium changes and coverage for congenital illnesses.
• Confirm cashless facilities at network hospitals for the baby.

• Health Insurance protects you, as new parents, from the burden of heavy medical bills and ensures that your baby receives necessary treatments promptly.
• Through Health Insurance for newborns, you can provide early intervention and preventive care for your baby, addressing any health concerns proactively. Regular check-ups and vaccinations can help prevent illnesses and ensure your baby's well-being.
• If your Maternity Insurance extends to your newborn, you can get coverage for all the medical expenses you incur on your baby starting from day 1 to up to 90 days. You can add your baby to your Family Floater plan once they are 90 days old.
• If you choose Health Insurance plans that cover congenital conditions, you need not worry about any medical conditions your baby may be born with. This coverage supports the child's medical needs right from the early stages.
• Most health plans are customisable. You can choose the coverage and opt for add-ons as per your need.
• Ensure you keep the baby's birth certificate handy to submit to the insurer.