Routine Maternity care and Childbirth

• Blood Tests (for the screening of Sickle diseases and thalassaemias, gestational diabetes, anaemia, blood grouping/rhesus D, haemogloblobinopathies, Red-cell allo-antibodies, Hepatitis B, HIV, Rubella, Syphilis)
• Urine Tests (including urinalysis for protein and Screening for asymptomatic bactieruria)
• Downs Syndrome Screening
• Combined Test, Triple Test, Quadruple test
• Testing for gestational diabetes for women with the following risk factors: previous macrosomic baby weighing 4.5 kg or above, previous gestational diabetes, a first-degree relative with diabetes, or a family origin with a high prevalence of diabetes
• Foetal echocardiography recommended as part of routine anomaly scan
• Monitoring of Blood pressure
• Foetal Scans – up to a maximum of 3. There is no cover for 3-D or 4-D scans or for scan photographs
  

Pre-authorisation is not required in respect of routine out-patient pre-natal appointments. If you have a claim for routine out-patient maternity care, please pay the medical bills and submit your claim to us in the following way:

We will need a fully completed Maternity Claim Form. Sections A and B should be completed by you, and section C must be completed and signed by your doctor.

The fully completed claim form must be sent to us by post together with the original itemised invoices and receipts.

If you receive your treatment within the Asia-Pacific region, please send your claim to our Malaysia office. If you receive your treatment elsewhere, please send to our UK office.

Upon receipt of your original claim documents and any other information we may need, we will confirm whether or not your claim is covered by your plan and, if it is, we will arrange reimbursement of all eligible expenses in accordance with the instructions you give us in Section B of your claim form.

If you purchase a maternity package, we will be unable to reimburse you until the delivery has taken place.

If your policy has an excess and the benefit you are claiming for has co-insurance and/or limits, we will apply the co-insurance first, then the excess, then the limit.

For example, if you have Elite Gold cover (which has 80% co-insurance and a limit of $6,400 for routine maternity) and you have a $100 excess, we will calculate payment on the following basis:

• If your covered routine maternity care costs total $8,500
  -   $8,500 (medical costs) x 80% (co-insurance) = $6,800
  -   Less $100 (excess) = $6,700
  -   Amount left exceeds $6,400 (limit)
  -   Payment = $6,400
  
  
• If your covered routine maternity costs are $7,500
  -   $7,500 (medical costs) x 80% (co-insurance) = $6,000
  -   Less $100 (excess) = $5,900
  -   Amount left is less than $6,400 (limit)
  -   Payment = $5,900

Once you are within 2 months of your estimated due date, you will need to contact us with the name and contact details of your treating doctor and the hospital at which you are due to give birth. Upon receipt of this information, we will then contact the hospital to obtain details of their maternity package costs and to ask them to complete our Maternity Notification of Admission form. This form provides us with the relevant information relating to the birth, as well as details of your previous medical history and an estimate of the cost of the birth.

Once we have received the requested information we will be in a position to assess the claim and confirm whether the costs are reasonable and customary. Once we have done so, we will liaise with the providers to arrange for the eligible costs to be settled directly by us, provided that the care is delivered during your current period of cover. If the birth is due to take place after your current period of cover expires, we will be unable to authorise the cost of the birth until after you have paid your renewal premium.

If the hospital require a deposit to secure a room, you will be responsible for obtaining a refund once the delivery has taken place.

• There is no cover for routine maternity care if you act as a surrogate or have anyone else acting as a surrogate for you.
• There is no cover for ante-natal classes or doulas.
• We do not pay for surgery undertaken on a child whilst it is in its mother’s womb.
• We do not pay for genetic testing and/or genetic engineering, or for cord blood collection.