Is pregnancy covered by health insurance?
In a word, no. Health insurance does not cover pregnancy as it is deemed as a lifestyle choice. In the same way private health insurance does not cover cosmetic surgery to improve your appearance, transgender operations or injuries sustained from dangerous sports.
Which health insurance policies do not cover pregnancy?
All health insurance policies for cover in the UK will not cover routine pregnancy. However, some insurers will cover you for any complications arising from pregnancy or childbirth if you have been with the insurer for a specific period of time.
If you are looking to move or work abroad, an international health insurance policy can cover you for routine pregnancy at a private hospital in the country you are working or living. However, there is usually qualifying period before you are eligible for treatment.
What is meant by a 'complication'?
A complication arising from pregnancy could be covered by your private health insurance. Most insurers will cover some of or all of the following list of conditions as a complication from pregnancy;
- Ectopic pregnancy
- Still birth
- Hydatidiform mole
- Retained placenta
- Gestational diabetes
- Caesarean sections in specific clinical circumstances
Each insurer has a different set of conditions that may or may not cover pregnancy complications so it is important to check the terms of a policy before proceeding with your chosen health insurer. Compare policies in-depth online via Activequote.com.
What limitations are there on pregnancy complications?
Whilst health insurance can cover serious complications arising from pregnancy, minor conditions such as morning sickness are not covered by most insurers.
In addition, there are likely to be limitations on in-patient or out-patient treatments within your policy that would come into play even when treating a pregnancy complication. For example, you might find your doctor's fees are only covered up to a certain amount specified by your insurer. If the doctor charges more, you may need to pay the rest. Or you might have a limit on your out-patient cover that would mean any outpatient treatment for a complication would be subject to this limit too.
It is important to read through your policy thoroughly so you know exactly what is and what isn’t covered. You can find more detail to help your thinking on a private medical insurance policy in our article Best Health Insurance.
Why don't insurers cover routine pregnancy?
Health insurers will not cover pregnancy as it is usually a deliberate lifestyle choice. It is important to remember that if you are due to give birth you will be immediately seen to by the NHS in a private room, negating any benefit of avoiding NHS queues or giving birth in your own room.
Are there any time limits on pregnancy cover?
Most insurers will require you to have a minimum cover period before you are eligible to claim for any pregnancy-related complications. For example, Aviva require you to be covered for 10 months before you can make a claim for a pregnancy-related condition.
Why do insurers put these time limits in place?
Insurers place these time limits on policies to prevent the cover being available if you are part-way through a pregnancy. Whilst this may seem somewhat unfair, the reasoning is that if insurers make the pregnancy complications cover available as soon as the policy is purchased, it would tend to be bought by people who have already got a reason or in fact medical evidence to believe they may have complications during birth.
Insurers see this as against the spirit of insurance which is supposed to protect you against events that are unexpected rather than paying out for something that you know will happen. As there is no easy way to confirm whether or not a currently-pregnant individual is expecting or already has a complication, insurers choose to put the time limit in place to prevent the issue coming up.
Whilst potentially controversial, this is more-or-less an industry standard, making it hard for the public to have any choice. The main implication is that if you are planning a family and are concerned about having private health insurance for pregnancy complications, investigate and buy a policy well in advance.
What other pregnancy-related benefits are there?
Insurers can offer additional benefits related to pregnancy. Insurers may pay a cash benefit to policyholders following the birth of a child. For example, Vitality will pay £100 cash benefit per child if your policy has been in place for at least 10 months.
Does health insurance cover IVF or other fertility treatments?
Typically insurers will not cover any fertility treatment such as IVF. This also extends to any investigations into infertility or reversal of sterilisation.
Freedom Health are a less well-known provider of health insurance who specifically mention some (minimal) cover relating to infertility in their products. In particular, those buying their Elite level of cover with the Executive option will be covered for "Investigations resulting in the diagnosis for infertility only" and a 2-year qualifying period is required for that cover to be in place.
How can I get private healthcare for pregnancy?
As pregnancy is not covered by health insurance the only option to receive private healthcare for your pregnancy is to pay for it in full yourself.
Adding up the costs of private care for maternity can be significant - estimates in 2012 ranged from around £15,000 to around £25,000 for a birth at a private hospital or wing in London, according to Private Pregnancy. This fee should include all associated costs with the birth.
Find out the four reasons why new parents should health insurance.