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Maternity Insurance Plans: The Coverage and Waiting Period

Maternity or pregnancy is one of the most exciting and also worrisome moments in a parent’s life! It is the time when you are carrying a little human inside you, a human who is a part of you. It is the one who would define you and take your legacy forward. And during this crucial period of your life, you shouldn’t worry about anything but your and your baby’s health. 

It is said that you should think good, speak good, and listen to good content while in pregnancy. And with medical inflation shooting through the roof, you need a Maternity Insurance which would help you sail through the pocket burning tests and procedures.

What do we understand by maternity insurance?

Maternity Insurance is like additional coverage to your Health Insurance. Most Insurance companies provide maternity Insurance as add-on or other services with your original health insurance policy. This insurance option covers expenses related to both type of delivery; cesarean and normal. Maternity Insurance covers all the costs which are pre and post-hospitalization, prenatal and postnatal along with vaccination of the newborn and coverage for the baby up to a specific period of pre-decided time. Apart from these, various expenses like nursing and room charges, surgeon fees, doctor consultation, and anesthetist consultation are also covered.

How Is the Premium Calculated for Maternity Insurance?

The premium which is payable on a maternity insurance policy is usually higher than the premium paid on a regular health plan. The certainty of a claim being filed under this policy is absolute; or at least it is very high. That is why insurers charge a higher premium on these policies. Therefore, before you decide to buy such coverage, it is recommended you do a detailed cost-benefit analysis of different plans offered by various insurance providers.

Most of the maternity insurance policies are add-ons to the existing health insurance policies; this can have a massive impact on the premium you are being charged. Apart from this, your premium for a maternity Insurance policy also varies according to factors such as age, health, waiting period etc.

The age of the mother is a crucial factor as the premium amount is directly proportional to your age. Your current health status is also factored in. Insurance companies base their premium on your current health status too. You might have to apply for loading wherein one has to pay slightly more for enrolment. The waiting period on the insurance policy you choose is yet another significant factor; less the waiting period, more the premium. 

Waiting period for most of the maternity insurance policies in India ranges from 3 to 4 years. Some of the maternity Insurance policies have a waiting period as long as six years too. So, these policies are bound to have a lower premium. This is because many couples might end up having a child before the waiting term is over. However, most of the expensive maternity insurance policies have a waiting period of fewer than two years. These policies tend to charge a higher premium from you as you are offered increased flexibility.

How to get the most out of your Maternity Insurance?

As buying maternity Insurance is essential, why not get the most out of it? Here are some of the facts through which you can get the most out of your insurance policy.

  • Avail Tax Benefit

You can avail a tax benefit by showing payment of insurance premiums while filing income tax returns. This is one of the most significant advantages you get when you buy insurance. Rather than giving your hard-earned income to the government, which would not benefit you in any which ways, why should not you safeguard yourself and your loved ones with a maternity insurance policy? You get tax benefits up to Rs.60,000.

  • Avail the cashless facility

This is a method of claiming the insurance policy. In this method of cashless claims, the insurer directly pays the hospital, the bills without you being an intermediary party, thus causing no additional stress to you. The usage of this facility is possible only if the hospital is under the network hospitals of the Insurer.

  • No Claim bonus or NCB

You can also avail no claim bonus or NCB from the date of purchase of such a plan till the date of pregnancy/ delivery. The gap between these periods can help you claim a no-claim bonus, which means no claim was made in the past year or for a longer time frame. You could be rewarded for not making any claim by the Insurer.

  • Vaccination to a newborn

The vaccinations given to the newest family member is also covered in the policy. Be sure to get your baby vaccinated regularly.

  • Natal care

Natal means taking up preventive healthcare options via check-ups, scans, and more. Remember, Maternity insurance plans cover 30 days of prenatal pregnancy tests and 60 days after the delivery.

What does a maternity insurance cover?

Before diving in and buying a maternity Insurance, it is imperative to understand the inclusions and exclusions thoroughly. This would not only help you make sound financial decisions but also ensure optimum utilization of your insurance plan.

  • Maternity health insurance covers every type of expense which a pregnant couple goes through. Such costs can be pre- and post-hospitalization, ambulance services, consultation fees, and room rent. It covers both the deliveries, be it regular or cesarean section.
  • Your newborn baby generally receives coverage for a minimum of 90 days or more. This is pre-decided time among the parties’ vis-à-vis insurer and insured in which the Insurer covers all the vaccines your baby gets.
  • Insurance companies also cover 30-days of prenatal and 60-days of post-natal health check-ups. This means that all your check-ups and scans would be covered in your insurance plan. 
  • All the vaccination costs which are given to your newborn baby is under the coverage of the policy for one whole year. 

What is the waiting period in Maternity Insurance?

A waiting period in any health insurance is defined as the time that must pass before you can avail the full benefits of the coverage. Therefore it is essential to understand the waiting period concept in Maternity plans.

While looking for a maternity Insurance, a woman who is already pregnant might find it challenging to get coverage with no waiting period as insurers then consider pregnancy as a pre-existing condition and beyond the scope. The standard waiting period for a maternity Insurance ranges from 9 months up to 6 years.

Can the waiting period in Maternity Insurance be reduced?

The waiting period can only be reduced by paying a higher premium. Hence it is highly advisable to buy a maternity Insurance by planning well ahead of time. By planning early, you would be able to eliminate the waiting period risk.

When is the best time to buy Maternity Insurance?

Ideally, the right time to buy maternity health insurance can be 25 years as the waiting period can go up to 6 years after the purchase of the insurance policy. Apart from this, the best time can be as soon as you get married or when you are planning for a child in the next 2-3 years. Considering the waiting period that needs to be fulfilled, the decision should be made sooner. 

Pregnancy is a crucial phase in a couple’s life, and prior planning is the only best way to safe and hassle-free parenthood. Hence, investing in a maternity Insurance plan would help future parents stay financially stable and enjoy the feeling of becoming parents without worrying about the enormous hospital bills.

FAQs: Maternity Insurance Plans

Is maternity insurance beneficial?

Yes, buying maternity Insurance is beneficial as motherhood is an instinct and a phenomenon that you would witness at some point in your life, but hospitalization expenses are a reality and also extremely steep. Hence it would help if you safeguarded yourselves from the financial trouble you might get into while bearing a child in you. It is one of the most cost-effective ways in which you can welcome the newest member of your family to your home.

How do I claim maternity health insurance in India?

The claim procedure for maternity health insurance is precisely the same as the claim procedure of any other health insurance product. However, it would help if you kept in mind that the maternity coverage in health insurance policies usually comes with a waiting period, and you can only claim the benefit after the waiting period is over. Also, it is better to choose cashless claims for your policy as it would directly pay all the medical bills to the hospital without you being asked to shell out money upfront.

Which health insurance plans cover maternity?

Generally, health insurance plans do not cover maternity and consider it as a pre-existing illness. Maternity Insurance comes as an add-on service or rider with an existing health insurance policy. Also, it would help if you considered the fact that pregnancy is regarded as a pre-existing illness, and there is a waiting clause associated with maternity Insurance.

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