The rise in expectant parents taking overseas holidays, or a “babymoon”, has been a story tropical islands and beachy resorts have been happy to promote. Less discussed is how difficult it is to find travel insurance that will cover your pregnancy.
Mums-to-be and couples dreaming of a last holiday before kids have had to think again.
Midwives and airlines are perfectly happy allowing air travel up until the 28th week or the third trimester of pregnancy without prior approval. Most insurers tend to draw the line for travel cover at 24 weeks.
So what explains this four-week coverage gap and the differing advice?
Air New Zealand and Jetstar advise passengers to carry a midwife or doctor’s letter “if you are beyond your 28th week”. Air New Zealand will allow mothers with an “uncomplicated pregnancy” to board long-haul flights of over four hours until the end of the 36th week. They can board a short haul or domestic flight with medical clearance, practically up until full term but their travel may not be insured.
Southern Cross, Cover-More and AMI are among the large travel insurers which follow this industry standard of covering medical expenses related to pregnancy for the first “23 weeks and six days.”
After this point, complications or expenses from childbirth overseas are not covered.
With most expectant mothers experiencing the worst symptoms and greatest risks of complications in the first and last trimester, it is usually the 12 weeks of the second trimester’s relative normalcy when couples might plan a trip.
A limit on travel insurance makes the window during which travellers might consider a “babymoon” even smaller.
The policy wording “will not cover” reads to most as “do not travel”. Underwriters and insurance brokers are in the business of probability. One assumes there is good reason and relatively high probability of something adverse happening.
But why are the priorities of carriers and insurers so different and what is this risk that airlines are happy to overlook?
Why is pregnancy not covered on travel insurance after 24 weeks?
The truth is it has nothing to do with some “inherent danger” of expectant mums relaxing on the beach. In fact, some time off, sun and fresh air after the long first trimester could be just what the midwife ordered.
It has less to do with the risk to mother and child, more to do with the costs of care overseas.
An airline’s biggest concern is the risk of passengers giving birth on their planes, particularly long-haul ones.
From an insurer’s point of view, the biggest risk is landing a bill for neonatal care overseas, which can be enormous.
The priorities of carriers and insurers are different. According to one source, it’s about the increased probability of a having to cover the mother’s medical costs as well as pay for care of pre-term babies, past 24 weeks.
In the US, the full cost of admitting a mother and child to a neonatal intensive care unit between 28 and 32 weeks is $40,000–100,000, a cost insurers are keen to avoid underwriting.
Chief medical officer for Southern Cross insurance Dr Stephen Child says even a couple of weeks increases the chance of a child being born prematurely surviving.
“Babies born at 20 weeks are unlikely to survive, but the survival rate for those born at 23 to 24 weeks increases to nearly 60 per cent,” Child says.
Southern Cross recently included neonatal care for the newborn in their travel coverage as well as medical care for the mother.
However, like many of the other New Zealand insurers, cover does not extend beyond 23 weeks and six days.
Cover-More, another insurer which follows the same 167-day cutoff, says they were separately advised by their own chief medical officer Dr Steve Rashford. It’s not that travel itself may bring about premature labour or increase the risk to the child. As explained, the later on the pregnancy, the greater the chance of survival for a premature child, and every day closer to the due date increases the chance of the baby being born while travelling.
“It is always up to our customers to decide if they are comfortable with the limits that we have on cover,” a spokesperson for the insurer said.
When is the best time to go on babymoon?
The worst symptoms and fatigue for expectant mothers are during the first and last trimester. However, the second trimester is “just right”.
The American College of Obstetricians and Gynecologists recommends 14 and 28 weeks as the optimum time for travel when pregnant.
Short overseas trips are perfectly safe, if you are expecting a normal uncomplicated pregnancy.
What are complicating factors in travel insurance when pregnant?
Under “off-the-peg” travel insurance policies, normal pregnancy is covered as standard.
There are all sorts of ethical and legal reasons why pregnancy, unlike other pre-existing medical conditions, is not grounds for insurers to deny cover to expectant mothers medical cover. The Human Rights Act 1993 and New Zealand Constitution are two.
Pregnancy is a normal condition. However, there are a range of “complicating factors” which may change your ability to get travel insurance or get on a plane.
Depending on your insurer, IVF babies might not be covered.
Twins, triplets or other “multiple pregnancies” attract additional premiums from insurers because of the higher risk of complications. Air New Zealand requires a doctor’s note and clearance from their medical team to fly passengers carrying more than one child. They will also only carry passengers expecting multiple births up to 36 weeks or 32 weeks on routes over four hours.
“Medically assisted” pregnancies – such as couples who have undergone IVF treatment or hormone therapy – can lead to a higher premium. In some cases associated medical costs for claims will not be covered under standard travel insurance policies.
You can also be denied insurance for previous complications or face a higher premium.
“Previous complications are unfortunate but do mean that an expectant mother is at more risk of developing complications in the future,” says a spokesperson for Cover-More.
Source: Nz Herald
