The claim process for maternity and pregnancy benefits under the WEA policy is slightly different than for normal claims, so we recommend being familiar with the following information:
- A pregnancy may only be covered if you have joined the policy before the conception. It's not possible to cover any pregnancy expense if you joined the policy after the pregnancy started. However, you will still be covered for medical conditions not related to the pregnancy.
A pregnancy will be covered under the WEA plan if the childbirth occurs more than 10 months after your policy Effective date. Therefore, the insurance company will cover any expenses related to the pregnancy only after 10 months have passed. Any expenses incurred within the first 10 months since you have joined the insurance, will not be covered.
If your pregnancy starts while you are still within the waiting period, the insurance company will place your ongoing expenses in a pending state, to decide whether to cover them after the childbirth or not.
In order to file a claim for maternity, you need to complete (and ask your doctor to complete as well) the maternity form attached and attach it your first maternity claim. Claims without the maternity form will not be approved until it is sent to the company.
Pregnancy is covered under the Elite plan. For the Care and Select plans, pregnancy coverage is available if the maternity rider was purchased before the beginning of the policy.
- The waiting period counting begins only once you have acquired pregnancy coverage, either through the Elite plan or through the rider. Therefore, it's not possible to sign up to the Select plan and then change to the Elite to cover the pregnancy.
- The way of adding your newborn to the policy and the coverage for congenital conditions depends on whether your pregnancy was covered or not. If your pregnancy ends more than 10 months after birth, you may add your newborn to the policy within the first 90 days since birth without any medical questions. However, if your pregnancy is not covered, or ends before 10 months have passed, you will need to complete a full application, including health questionnaire, in order for your newborn to be added to your policy.
- Any addition of a newborn may be subject to additional costs, and the cover for him/her will only be active once you have paid the required premiums.