guide to maternity coverage

Why is a Maternity Insurance Plan a Good Idea Before Pregnancy?

Becoming a mother is a privilege reserved for women. Becoming a mother is the greatest and also the toughest thing in one’s life. The tremendous pain a woman undergoes to give birth and raise a child is seriously unimaginable. 

The new-born baby brings joy to their lives and gives a reason that life goes on. However, your bundle of joy deserves a lot more including proper care; before and after birth.

Pregnancy in itself is a huge deal and so while being due for delivery, various expenses are to be incurred. Apart from this, there are a plethora of features that we’ll discuss here:

  • Coverage
  • In-patient hospitalization
  • Claim Process
  • Tax benefit
  • Premium
  • Pre- and post-natal care
  • Waiting period
  • No-claim bonus

What is a maternity insurance plan? 

The insurance segment has introduced maternity plans for women who will begin the beautiful process of becoming a mother. Being a mother is not easy, and for reducing some of the financial stress on her back, maternity insurance plans have been introduced. Maternity insurance plans provide coverage for various expenses related to pregnancy. The coverage offered is vast thereby, providing financial support for a complete range of expenses related to pregnancy and childbirth.

Health insurance with maternity benefits is the motive of the policy. The plan is valid until a certain period after the baby is born. All the costs related to maternity will be covered under this plan. 

Why maternity insurance and not normal policies?

You might be wondering why to purchase an entire policy for the expenses that are already covered under health insurance. Even though the Affordable Act 2014, states that maternity needs to be mandatorily covered under health insurance policies, maternity costs and the incidental costs are much bigger than what a normal policy can provide. Due to the Affordable act amendment almost all insurance companies in India today provide maternity cover. You must note that normal plans do not provide entire coverage and additional benefits offered under maternity insurance.

Although, if the woman is already pregnant, coverage can be denied. Health insurance companies consider pregnancy as a pre-existing condition, and thus for the same, no coverage will be provided. Health insurance companies usually have a minimum waiting period of 9 months from the purchase date of the policy.

 Health insurance plans provide coverage for expenses such as pregnancy, labour, delivery, and new-born baby care. Other expenses need to be borne by the parents, and this does not stimulate your interest. In some cases, a woman might face some complications for which C-section or any additional care is required. Or the baby needs additional care. In such situations, maternity health insurance plans provide vast coverage.  To receive proper coverage and no additional stress or liability in this process one shall opt for maternity insurance plans.

Features of dedicated maternity insurance plans

Some of the benefits offered by maternity insurance plans are: 

  • Coverage –

As earlier mentioned, maternity insurance plans provide vast coverage. The various expenses covered under the plan are pre-and post-hospitalization expenses, ambulance fees, consultation fees, normal or caesarean delivery are all covered.

  • In-patient hospitalization –

Once the woman’s water breaks or is in labour, it is important to get her hospitalized as soon as possible. The various expenses related to the same are covered. Hospitalization expenses such as room rent, consultation fees, tests and other diagnostics are all covered under a maternity insurance plan.

  • Claim process –

The claim process can either be through a cashless facility or through a reimbursement facility. If the insured gets hospitalized in a hospital that is in the insurance company’s network, then the cashless facility can be availed. If the situation is not good enough to reach a network hospital, then admission into any hospital can be done. The insurance company will reimburse the various expenses on receipt of original receipts and bills.

  • Tax benefit –

The purchase of a maternity insurance plan can also allow you to opt for tax benefits. The exemption can be benefitted from section 80D of the Income Tax Act, 1961.

  • Premium –

The premium payable for maternity health insurance plans is slightly higher. It is because the policy offers 100% claim settlement thereby guaranteeing the coverage. Other factors such as age, complications, diseases being suffered form an effect on the premium chargeable by the insurance company.

  • Pre- and post-natal care –

Pre-natal care covers various expenses incurred for check-ups, scans, and more for up to 30 days before delivery. Post-natal care includes expenses incurred for up to 60 days after the delivery.

  • Waiting period –

Maternity insurance plans have different waiting periods. The term varies from one insurance company to another. To give a rough idea, the waiting period may vary from 9 months to 6 years. Any policy taken without disclosing pregnancy is normally void ab initio.

  • No-claim bonus –

For the number of years, you have not made a claim it leads to benefitting from the no-claim bonus component. The amount is normally added up to the total sum insured and escalation is normally 5% of sum assured for the same premium.

Why should you purchase a maternity insurance plan early?

Not only maternity but any health insurance plan purchased at an early stage of your life provides you with additional benefits. Every insurance plan comes with a waiting period. The clause of the waiting period was introduced so that policyholders do not take undue advantage of the coverage offered by the company.

Maternity insurance plans have a waiting period of 9 months to 6 years. To avail of the coverage offered, you need to serve the necessary waiting period. The term may not be the same for everyone as one may have certain health issues while some may not. If the waiting period is not entirely served and you get pregnant then the expenses relating to the new-born will not be covered under the insurance plan.

Maternity insurance companies consider the woman’s age, her health condition, and her medical history. The later one opts for such a policy, the higher will be the insurance premium payable and so buying a maternity health insurance plan at an early stage of your life helps you to save on premiums and enjoy additional benefits.

Insurance companies do not provide coverage to a woman who is already pregnant but that does not mean she cannot purchase such a plan. But the policy can be officially reinstated if she has served the waiting period and gets pregnant again during the validity of the insurance plan.

Who shall purchase a maternity insurance plan?

Ideally, people that shall apply for a maternity insurance plan are: 

  • Couples who have been married recently.
  • Couples planning to have a child in the next 2-3 years.
  • Parents planning a second child.

The planning of a child is not only physical and psychological, but also financial. That is very important. It gives the couple a head-start to parenthood and can thereby plan their future parallel to their plans. 

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