Does Health Insurance Cover Abortion in India?

What is Abortion?

Abortion refers to the process of ending or terminating a pregnancy. The procedure removes the embryo/fetus and placenta from the uterus of a woman to prevent the birth of a child. Abortion is carried out either with the help of surgery or through medicines.

In India, about 15.6 million abortions take place every year. As per medical professionals, abortion should be carried out as early in the pregnancy as possible to observe less pain and bleeding. Also, early termination of pregnancy without any complications has no impact on the fertility of the woman.

Common Reasons for Abortion

A woman may get an abortion due to several reasons. Take a look at them below:

• If the woman does not want to get pregnant
• If the pregnancy is life-threatening due to a medical condition
• If the fetus has developed chromosomal abnormalities, such as Down Syndrome, Potter’s Syndrome, etc.
• If the fetus has developed birth defects, such as anencephaly, spina bifida, etc.
• If the fetus has developed hydrocephalus
• If the membranes have ruptured prematurely

Although abortion is a safe procedure, it may result in short-term complications, such as heavy bleeding, infection, etc.

Abortion Law in India

In India, abortion is legal but it can only be carried out on the recommendation of a qualified doctor. Take a look at the various guidelines for abortion in India as per the Medical Termination of Pregnancy (MTP) Act 2021:

• All pregnancies of up to 20 weeks require the approval of a qualified doctor.
• Both married and unmarried women can terminate unwanted pregnancies due to the failure of contraceptives.
• The gestation limit for abortions is 24 weeks for women falling under special categories, such as rape survivors, differently-abled women, victims of incest, minors, etc.
• Termination of pregnancy of 20 to 24 weeks or abortion by women in special categories requires approval from two qualified doctors.
• In the case of foetal disability, no maximum gestation limit has been set for abortion. However, abortion needs approval from a medical board of specialist doctors set up by the state government/ union territory administration.
• The name and details of the woman whose pregnancy is terminated are kept confidential unless a person authorized by the law requires it.

Cost of Abortion in India

The cost of abortion in India may range from Rs 1000 to Rs 35,000 depending on the city and the gynaecologist. For instance, abortion may cost you as high as Rs 10,000 in Mumbai and as low as Rs 3000 in Lucknow.

Similarly, the gestation period also affects the cost of abortion in the country. For example, an abortion carried out in the second trimester will be more expensive than the one carried out in the first trimester.

Moreover, gynaecologists may charge up to Rs 10,000 as consultation fees to provide abortion pills. Besides, an ultrasound of the pregnant woman is also required before her pregnancy can be terminated. The cost of ultrasound may or not be included in the cost of abortion charged by the doctors.

Is Abortion Covered by Health Insurance Plans in India?

No. Most health insurance plans in India does not cover the cost of an abortion. However, most maternity health insurance plans cover the cost of abortion in India. Maternity insurance plans cover the medical expenses incurred on pregnancy and childbirth. It covers the cost of surgery, ultrasound, post-surgery follow-up consultations, medicines, doctor’s fees, etc. incurred due to termination of pregnancy.

But not all kinds of abortions are covered by maternity insurance plans. Most maternity plans cover the cost of terminating a pregnancy only if there are serious or life-threatening complications. Alternatively, some plans only cover the medical expenses incurred on terminating a pregnancy of more than 12 weeks.

Moreover, most maternity insurance plans are only available for women between the age of 18 to 45 years.

Waiting Period to Cover Abortion Under Health Insurance

Most maternity insurance plans provide coverage for abortion after an initial waiting period of 9 months to 24 months. This means that you cannot raise a claim for abortion under your maternity insurance plan until the waiting period is over. Since the waiting period may vary from one maternity plan to another, you must check your policy documents to know the applicable waiting period.

In case you require an abortion due to a complication arising out of a pre-existing disease, then the coverage will be provided only if you have already renewed your policy for 4 consecutive years. This is because most maternity plans cover pre-existing diseases after a waiting period of 4 years.

Any termination of pregnancy required after your pre-existing disease waiting period is over will be covered by your insurance company.

Summing It Up

Abortion is extremely common in India, whether it is voluntary or medically necessary. Besides, it may be an expensive procedure for a lot of people. In case you are in your reproductive years or are planning to start a family soon, you must buy a maternity insurance policy. Make sure to compare maternity plans online and opt for the one with the minimum waiting period.