Is Abortion Covered by Health Insurance Policy?

Neerja, aged 25 years was expecting her first child after marriage, but due to her weak immunity post-COVID-19, and multiple vitamin deficiencies, her doctor advised her to go for an abortion. The thought of abortion was not just an emotional turmoil for her but also made her worry about does health insurance cover abortion expenses? The cost for abortion in India may vary between Rs. 1,000-35,000, depending on the doctor, city, and other factors.

Abortion is the procedure of termination/ending a pregnancy. Abortion is legal in our country but may only be done on the recommendation of a qualified medical practitioner or doctor.

There are many queries regarding the availability of health insurance for abortion and naturally so, considering the sheer number of unplanned pregnancies and the diversity of reasons which sometimes necessitate abortion. What health insurance covers abortions? 

Learning More About Abortion 

Before getting into the specifics of health insurance for abortion, you should learn more about the actual procedure itself. Here are some salient points: 

• Abortion is the procedure of termination of a pregnancy. 
• The process helps in the removal of the fetus/embryo along with the placenta from the female uterus. 
• It is carried out to prevent birth and is executed with medicines or surgery. 
• Reports estimate 15.6 million abortions annually in the country. Abortion should be done in the early stages to ensure lower bleeding and pain. 
• Early pregnancy termination without complications does not usually lead to an impact on female fertility. 

Reasons Behind Abortion

• If the woman goes through an unplanned pregnancy and does not desire the same. 
• If the pregnancy threatens the life of a woman owing to medical complications. 
• If there are chromosomal abnormalities observed in the fetus including issues like Potter’s or Down’s Syndromes, for instance. 
• If there are birth defects of the fetus which need immediate attention or in the case of hydrocephalus. 
• If there is any premature membrane rupture. 

What Does The Law Say? 

Before checking out health insurance that covers abortion, it is crucial to know what the law says. Abortion can be legally done in the country although it is only possible on the directives/recommendations of qualified and specialist medical personnel. Here are some points worth noting in this regard: 

• Pregnancies up to a period of twenty weeks will need a qualified doctor’s approval. 
• Both unmarried/married women may end unplanned or undesired pregnancies owing to contraceptive failures. 
• 24 weeks is the limit of gestation for those in categories like victims of incest, survivors of rape, differently-abled, and minors. 
• If there are any disabilities of the fetus, then no such limit is present. However, the procedure will require the approval of a board of medical specialists set up by the Government and other authorities. 
• The details and name of the woman terminating her pregnancy will be strictly confidential until any individual with legal authorization needs the same. 

How Much Does Abortion Cost In India? 

The abortion price in India is usually between Rs. 1,000 and Rs. 35,000. It varies on the basis of the city, location and doctor in question. The costs are also influenced by the period of gestation. Abortions in second trimesters will be costlier than those in first trimesters. Gynecologists often charge fees for consultation along with doing an ultrasound. 

Is Abortion Covered By Health Insurance?

No, health insurance plans do not cover abortion in India. It is only covered by some maternity health insurance schemes. They cover expenditure on childbirth and pregnancy along with follow-up consultations, post-surgery care, surgery, fees of doctors and medicines required for abortions.

However, most of these plans will only provide coverage for abortion expenditure in case there are any dangerous or medically serious complications/conditions that necessitate the procedure. Some plans only offer coverage for medical costs of abortion when the pregnancy duration exceeds twelve weeks. Most of these plans are also available for women between 18-45 only. 

These plans also offer coverage after the 9-24 month waiting period. Customers cannot raise claims for coverage until this period gets over. This may vary across health insurance providers. Those needing abortion for tackling urgent medical complications due to pre-existing diseases can only get coverage if the policy has been renewed for four years in succession. The reason is that most maternity insurance plans offer coverage for pre-existing ailments after a four-year waiting period. Pregnancy termination needed after this period will get coverage from the insurance provider. 

Conclusion

Abortion happens regularly in India and that too, for varied reasons. It may be costly for many people as well. Hence, you should check the maternity insurance policy that you are getting. Check whether it covers abortion costs if certain conditions are met. Choose a policy with the lowest possible waiting period.