Under the multiple plans we offer, we include a number of different maternity-related benefits. These could be “Routine maternity”, “Complications of pregnancy”, “Complications of childbirth”, “Home delivery”, etc. Depending on the plans available to you, you may be covered for some or all of these benefits. It is therefore important that you refer to your Table of Benefits to confirm which maternity-related benefits are available to you and whether any benefit limits and/or waiting periods apply.
Below we provide you with a generic explanation of the most common maternity-related benefits which you may be covered for, depending on your plan. Please note that the terms (e.g. definitions and exclusions) related to the below benefits may be slightly different depending on the plan you have, so please check your Benefit Guide to confirm your cover.
You can access your Benefit Guide via MyHealth Digital Services. Simply login via your browser or use the Allianz MyHealth app, click on “My Policy” and select on the documents tab.
a. Routine maternity
Routine maternity refers to any medically necessary costs incurred during pregnancy and childbirth. This includes hospital charges, specialist fees, the mother's pre- and post-natal care, midwife fees (during labour only) as well as newborn care (read the definition of “Newborn care” to verify what we cover under this benefit and the in-patient treatment limits that apply to adopted and fostered children, all babies born by surrogacy and multiple birth babies born as a result of medically assisted reproduction).
We do not cover costs of complications of pregnancy and childbirth under the “Routine maternity” benefit. Caesarean sections that are not medically necessary are covered up to the cost of a routine delivery in the same hospital, subject to any benefit limits. Medically-necessary cesarean sections are paid for under the "Complications of childbirth" benefit (if included in your policy).
In case of home deliveries, we will pay up to the amount specified in the Table of Benefits if your plan includes the ‘Home delivery’ benefit.
b. Pre-natal care
Pre-natal care includes common screening and follow-up tests as required during a pregnancy. For women aged 35 and over, this includes Triple/Bart’s, Quadruple or Spina Bifida tests, amniocentesis and, if directly linked to an eligible amniocentesis, DNA-analysis.
Post-natal care refers to the routine post-partum medical care received by the mother for up to six weeks after delivery.
d. Newborn care
Newborn care includes customary examinations required to assess the integrity and basic function of the child's organs and skeletal structures. These essential examinations are carried out immediately following birth.
Cover doesn’t include further preventive diagnostic procedures, such as routine swabs, blood typing and hearing tests. However, if for medical reasons the child needs any follow-up investigations and treatment, these are covered under the newborn's own policy (if they have been added as a dependant).
For multiple birth babies born as a result of medically assisted reproduction, all babies born by surrogacy, adopted and fostered children, in-patient treatment is limited to a specified amount per child for the first three months following birth (please consult your Benefit Guide for full details). Out-patient treatment is paid within the terms of the Out-patient Plan (if included in your policy).
e. Complications of pregnancy
Complications of pregnancy relates to the health of the mother. We will cover only the following complications that arise during the pre-natal stages of pregnancy: ectopic pregnancy, gestational diabetes, pre-eclampsia, miscarriage, threatened miscarriage, stillbirth and hydatid form mole.
f. Complications of childbirth
Complications of childbirth refers only to post-partum haemorrhage and retained placental membrane. Where your plan also includes a routine maternity benefit, complications of childbirth includes medically necessary caesarean sections.
g. Maternity-related benefit limits
When a pregnancy spans two Insurance Years and the benefit limit changes at policy renewal, the following rules apply:
- In year one – the benefit limits apply to all eligible expenses.
- In year two – the updated benefit limits apply to all eligible expenses incurred in the second year, less the total benefit amount already reimbursed in year one.
- If the benefit limit decreases in year two and we have already paid up to or over this new amount for eligible costs incurred in year one, we will pay no additional benefit in year two.
Limit for multiple-birth babies, all babies born by surrogacy, adopted and fostered children
There is a limit for in-patient treatment that takes place in the first three months following birth if the baby:
- was born by surrogacy
- is adopted
- is fostered
- is a multiple-birth baby born as a result of medically assisted reproduction
Check your Benefit Guide to confirm the limit that applies per child. Out-patient treatment is paid under the terms of the Out-patient Plan.
h. Maternity-related exclusions
- Termination of pregnancy, except if the life of the pregnant woman is in danger.
- Treatment directly related to surrogacy, whether you are acting as a surrogate, or are the intended parent.
- Genetic testing, except:
a) Where specific genetic tests are included within your plan.
b) Where DNA tests are directly linked to an eligible amniocentesis i.e. in the case of women aged 35 or over.
c) Where testing for genetic receptor of tumours is covered.
- Pre- and post-natal classes.
- Triple/Bart’s, Quadruple or Spina Bifida tests, except for women aged 35 or over.
- Infertility Treatment