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I’m Pregnant, Maternity Insurance?

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I’m pregnant, Maternity Insurance?

I’m Pregnant, Maternity Insurance?

In February 2015, Wendy 24 realized that she was expectant. Her first child.

According to her, she had recently gotten engaged a month ago, and the pregnancy was just unplanned. Wendy also realized that at her workplace medical cover did not include maternity insurance. “I approached another insurance company but they told me they couldn’t just take me up on the cover. I should have been paying premiums ten months prior,” she says.

This was a standard waiting period for most insurance companies. Pregnant women couldn’t just get immediate cover. Something Wendy had no idea about.

According to Wendy, she wanted a private doctor. One she would maintain even after delivery. Consultation fees for each prenatal visit cost Shs2, 000. There was an extra charge for scans, physical exams, and prenatal supplements like iron and folic acid. Non-negotiable costs in Wendy’s budget. She had to do something.

“I explained the tight finances to my doctor, and she told me we could work around the insurance company. She changed the description of these extra costs and fixed them as regular hospital expenses under my medical cover. That way, insurance would take care of some of the prenatal care charges. If she hadn’t, my fiancé and I would have paid over Shs30, 000 in doctor’s visits only.” explains Wendy.

I’m pregnant, Maternity Insurance?

According to her, she experienced complications that resorted to an emergency Caesarean Section (CS).

“The bill came to just over Shs160, 000,” says Wendy. “We paid my doctor Shs75, 000 and the pediatrician Shs50, 000.” Other costs like bed charge, use of a delivery room and nursery cost took up the balance. NHIF covered Shs4, 800 for the three days she was in the hospital.

A scheduled CS would have cost us between Sh80, 000 and Sh100, 000, explains Wendy.

Wendy presented her baby’s birth certificate to her workplace’s insurance company, two weeks later and added him as her dependent.

Julius Komen an insurance agent with CIC insurance company explains the importance of maternity cover.

“This is one of the benefits under the medical cover.  It comes alongside dental and optical cover,” he says.
According to him, most insurance companies have a minimum benefit limit of Shs100, 000.

“Operate as you wish within this limit, he says. You can even have a private doctor. However, any costs above the limit are yours to settle. Emergency and scheduled CSs fall within this limit”, explains Julius.

“Maternity cover is not a walk-in-and-buy sort of cover, there is a waiting period of between 10 and 12 months from when you first apply for it”, he adds.

Regarding the newborn’s cover, Justus says, “If the baby is born with no congenital conditions, he is immediately put in as your dependent. If he has conditions, he is included as your dependent and enjoys cover for free for one full year. After one year, he is an independent person although with much higher premiums.”

It is very important to keep in mind that your coverage varies depending on what plan you have since the insurer can choose how they cover these benefits.

Mercy Tyra Murengu
A multi-award-winning journalist accredited by the Media Council of Kenya.

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