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Health Insurance With Maternity Cover To Dismiss Your Anxiety About Pregnancy

For young couples, starting a family is a big decision – one that needs all factors to be taken care of – including the financial needs. Unplanned pregnancies can bring financial stress and burden on the couple and the families. Add to it, the fact that maternity expenses are on the rise in India.

However, couples should know that high costs shouldn’t be considered a barrier to utilizing quality maternity care. Maternity health insurance cover can help couples fight anxiety and stress related to the financial expenditures related to pregnancy. While many insurers offer maternity coverage as an add-on or ride to the regular health insurance plan, a number of insurance companies in India have introduced dedicated maternity coverage. There’s much to know if you’re planning on buying maternity coverage. Here’s all that you’ll learn about in this blog:

  • What is maternity health insurance?
  • Expenses covered by maternity health insurance
  • Factors to consider when buying maternity cover
  • Health insurance plans with maternity cover available in the market
  • Pro tips for buying maternity insurance


What is maternity health insurance?

Usually provided as an add-on or rider to the general health insurance plans, maternity insurance provides coverage for childbirth related expenses. It provides coverage for both caesarean and normal deliveries. Health insurance coverage is offered up to a certain period before and after the birth (usually 30 days and 90 days respectively).

The insurance covers expenses towards different delivery methods – cesarean or normal. Maternity coverage can be a part of individual, family or group health insurance plans. It can be a standalone policy or included as an add-on to the health plan.


Expenses covered by maternity health insurance

Typically, the expenses covered under health insurance with maternity coverage are:

  • In-patient care
  • Pre hospitalization (30 days)
  • Post hospitalization (60 days)
  • Day care treatment
  • Delivery expenses
  • Pre and post-natal expenses
  • Newborn baby cover
  • Room rent
  • Surgeon fees
  • Doctor’s consultation fees

    Factors to consider when buying maternity cover

    Inclusions and exclusions: It is essential to have a thorough understanding of the inclusions and exclusions of maternity cover from the insurer, as each insurer may have different criteria. 

    Waiting period: Most maternity insurance plans have a waiting period of 3 to 4 years; some more and some lesser. It is advisable to choose a plan with a waiting period that matches the policyholder’s family planning horizon. Group insurance plans that offer maternity cover may have a shorter waiting period of 9 to 10 months.

    Sub limits for coverage: Sub limits are usually limits on the amount of coverage. These could be either on a fixed amount basis or a percentage of the sum insured of the policy. 

    For e.g. if the sum insured of a general health insurance plan is Rs 3 lakh and the sub limit for maternity coverage is 10%, then the policyholder can avail benefit of Rs 30,000 towards maternity expenses. This amount may not be sufficient in all cases. Think A-rated maternity hospitals in urban cities or complications post delivery. Hence, it is important to ensure an adequate sub limit.

    Hospitalization and daycare norms: Maternity treatment is usually not considered as daycare treatment. A normal delivery would require at least 2 days of hospitalization and a caesarean would require more. It is essential to check all these details with the insurer. 

    Premium: Maternity cover is usually expensive as it entails high risk and has an almost 100% claim ratio compared to other plans. It is essential to compare premiums of different insurance plans with maternity coverage.

    Claim process: The claim process for maternity health insurance may vary for different insurers. Depending on the plan, the claims can be of two types: cashless or reimbursement. Most typically, the process involves filling up a claim form and submitting it along with documents such as hospital and doctor’s bills, medical bills and more.


    Health insurance plans with maternity coverage available in the market

    Bharti AXA Smart Super Health Insurance

    Waiting period: 9 months

    Up to 2 deliveries or terminations

    Available with 3-year policy  

    Max Bupa Heartbeat Family Floater

    No additional premium for coverage of newborn baby from day 1

    Policy period: 2 years

    Coverage for up to 2 deliveries 

    Royal Sundaram Total Health Plus

    Coverage: 10% of sum insured, maximum of Rs 20,000 or Rs 50,000 depending on the plan chosen

    Up to two deliveries

    Covers hospitalization and complications arising 

    Star Health Wedding Gift Pregnancy Cover

    Policy period: 1 or 2 years

    Delivery expenses – normal and cesarean – up to Rs 35, 000

    Post delivery complication cover for mother 

    Apollo Munich Easy Health Family Floater

    Coverage for newborn baby within 90 days of birth

    Delivery expenses – normal and cesarean

    Coverage between Rs 15,000 to Rs 50,000 depending on the plan chosen 


    Pro tips for buying maternity insurance 

    1.    It is better to plan pregnancy much in advance, at times, years in advance because certain insurance plans have a waiting period before the maternity cover can be claimed. If one buys a maternity insurance after conceiving, insurance companies consider it a pre-existing condition and hence apply waiting period to it. 

    2.    If a person has maternity coverage in the employer’s group health insurance, it is better to utilize that instead of claiming from a personal health insurance plan. In this way, one can avail no-claim benefits on the personal plan.

    3.    Do not depend on maternity coverage only. As most insurance plans have a sub limit on maternity cover, it is essential to build adequate savings for pregnancy. E.g. maternity insurance could have a sub limit of Rs 50,000, which might not be enough to cover all maternity expenses considering private hospitals charge a high amount for room rent, ambulance, and other procedures. 

    4.    All health insurance plans do not offer maternity coverage, hence it is important to check whether or not a policy provides maternity cover at the time of purchasing the policy. 


    To sum it up

    Insurance companies in India have made family planning much easier for young couples with maternity coverage. It is one of the best ways to meet the steep costs of maternity expenses. With a wide range of options in the insurance market, find out which one would best suit your needs. Get started by simply contacting us.


    FAQs: Health Insurance With Maternity Coverage

    Should one buy a separate maternity insurance if they already have maternity coverage under the employer’s group health insurance?

    It depends on the features of the maternity coverage provided in the group health insurance. If the features and coverage amount seems insufficient, then one must buy a personal health plan with maternity coverage.

    Can men avail maternity coverage through their health insurance?

    Yes, men can buy maternity coverage as an add-on to their personal health insurance plan. However, in order to avail the coverage, they would have to add their wife to the insurance policy.

    Can single women avail maternity coverage?

    Yes, single women, irrespective of their marital status can avail maternity coverage as part of their health insurance.

    What are the factors to consider when opting for maternity coverage with health insurance plans?

    A few factors to consider would be: claim settlement ratio, premium, sub limit, inclusions and exclusions, and waiting period, among others.

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