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A typical health insurance plan does not offer coverage for expenses in connection with an abortion. However, a health insurance add-on known as maternity cover is designed to cover abortions. You can opt for this add-on at the time of purchase or renewal of a health insurance plan by paying a nominal additional premium over and above your base premium. 

 

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.

 

The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

Is Abortion Covered by Health Insurance in India?

No, most general health insurance plans do not offer coverage for abortions across India. However, a highly specific insurance plan aimed at women called ‘maternity insurance’ provides coverage for abortions and abortion-related treatments along with coverage for all pregnancy-related medical costs. Although, even these maternity insurance plans offer very limited coverage when it comes to abortions, as they only cover the costs if the continuation of the pregnancy poses a serious or life-threatening medical risk to the pregnant woman. Some maternity plans only provide coverage for abortions after certain weeks since the conception of pregnancy has passed.

Waiting Period to Cover Abortions Under Health Insurance

Just as general health insurance plans have waiting periods for certain diseases, maternity insurance also has a waiting period when the insurer is not liable to provide coverage to the insured for the abortion. Once the full duration of the waiting period has passed, the insured will be eligible for abortion-related coverage. Generally, maternity plans in India have a waiting period of 9 months to 24 months when it comes to abortion-related coverage, depending on which type (or insurance company) of maternity plan you choose to buy. In case of abortions caused due to complications arising out of pre-existing conditions, the waiting period may extend up to 4 years. Remember to read the policy details of the maternity plan to understand waiting periods before settling on a plan.

Common Reasons for Abortion

A woman may choose to undergo an abortion for reasons, such as:

  • Unwanted or unplanned pregnancy

  • Medical risks to the woman due to pregnancy

  • If the foetus develops serious medical conditions such as anencephaly, spina bifida, hydrocephalus, etc.

Abortion Law in India

Abortion is completely legal in India, but can only be performed on recommendation from a qualified doctor. The rules regarding abortion have been laid out in the Medical Termination of Pregnancy Act, 2021 (MTP):

  • Under this act, abortions can be carried out till the 20th week of pregnancy under recommendation from a qualified doctor.

  • Both unmarried and married women have the choice to undergo an abortion for unwanted pregnancies.

  • The time limit for abortion can be extended up to 24 weeks in special cases such as rape survivors, victims of incest, and differently-abled women.

  • The personal details of the woman undergoing an abortion must be kept completely confidential unless the information is requested by law enforcement under special circumstances.

Cost of Abortion in India

The cost of an abortion in India varies from place to place and hospital to hospital. As per estimates, the cost of abortions in India can be anywhere between ₹1,000 to ₹50,000 or even more in private hospitals. Many women NGOs and support groups also offer low-cost abortions or financial assistance to women in need. Moreover, abortions that are carried out earlier in the pregnancy are less expensive than those carried out during the later stages. Gynaecologists may also charge consultation fees of around ₹10,000 for prescribing abortion pills.

Conclusion

Abortion is an eventuality that women must be prepared for, whether it’s a voluntary decision or a medical necessity. Being prepared with a maternity insurance plan is a prudent choice so you can get the best medical treatment possible from a good hospital. You can also look for a general health insurance plan that comes with maternity cover included. Most importantly, compare all available insurance policies and read all the documents before you buy any plan. 

Health Insurance Plans Available at Bajaj Markets

FAQs on Abortion Cover in Health Insurance

Do health insurance plans offer coverage for abortions?

No, most health insurance plans do not provide coverage for abortions. However, maternity plans may provide coverage for abortions in certain circumstances.  

Is there a waiting period for coverage of abortions?

Yes, there is generally a waiting period of 9 to 24 months for abortions in maternity insurance plans. It may even extend upto 4 years in special cases.

Is abortion legal in India?

Yes, abortions up to week 20 of pregnancy are legal in India but they must be done under recommendations from a professional doctor. The limit can be extended to 24 weeks for special circumstances.

Are there any side effects of abortion?

Some abortion side effects that women may experience include:

  • Heavy bleeding

  • Fever

  • Abdominal Pain 

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