The act of bearing a child and commencing the voyage of motherhood is a momentous occasion replete with elation and delight. One of your responsibilities as a mother is to provide care for the infant. Even though this is an exhilarating time in your life, it is prudent to be prepared for any potential uncertainties that may arise.
The escalating expenses associated with hospitalisation and medical care may impose financial burdens. In this situation, maternity health insurance can effectively alleviate financial constraints.
This article will provide a comprehensive analysis of maternity health insurance, including its characteristics, advantages, application and claim processes, and much more.
What is maternity insurance?
Maternity or pregnancy insurance, which is a supplemental or distinct policy that covers all maternity-related expenses, is one type of health insurance. Maternity cover provides financial assistance for a variety of medical expenses, including but not limited to prenatal and postnatal costs, infant baby expenses, C-sections, and more. Currently, a significant number of businesses provide maternity insurance to their female staff.
The majority of insurance policies in India carry a maximum waiting period of six years or nine months. During this time, the insured is precluded from filing a claim; therefore, it is advisable to verify the policy’s waiting period and purchase health insurance at least a few years before starting a family.
Why Do You Need Maternity Insurance?
These policies provide coverage for medical procedures performed during pregnancy, childbirth, and additional expenditures. Numerous characteristics and advantages of maternity health insurance are outlined below:
- Maternity insurance safeguards a newly formed family financially against the escalating expenses associated with healthcare.
- It covers all hospitalisation expenses associated with maternity. Typically, coverage commences thirty days before delivery and may continue for sixty days following hospitalisation.
- Maternity insurance provides coverage for the expenses associated with a newborn for a period of up to 90 days, thereby financially protecting the family if critical or congenital conditions are diagnosed.
- Using maternity insurance, these policies and riders provide comprehensive coverage for prenatal and postnatal expenses. This includes postpartum complications, medical expenses associated with caesarean sections, and standard deliveries for the insured.
What Is Included Under Maternity Insurance Plans?
Listed below are the following benefits that are included in maternity insurance plans:
- Expenses associated with pregnancy complications
- Coverage for C-section delivery
- New-born’s vaccination expenses
- New-born child expenses
- Coverage for delivery cost
- Reimbursement for in-patient hospitalisation expenses
- Coverage for pre- or post-natal care expenses
- Stem cell preservation expenses
- Coverage for medically demanded pregnancy termination costs
What Is Not Included Under Maternity Insurance Plans?
Listed below are the following benefits, which are typically not included in maternity insurance plans:
- Expenses incurred on pre-delivery consultation and medical tests
- Expenses related to ectopic pregnancy
- Coverage for post-hospitalisation expenses
- Cash benefits from hospital
- Coverage for regular medical check-ups
- Coverage for pre-hospitalisation expenses
- Coverage in case of surrogacy
When should I purchase maternity health insurance?
In the event of an intended pregnancy, obtaining maternity coverage well in advance of the anticipated due date is consistently advised. This is because the majority of maternity coverages require a delay period. The waiting period is subject to variation among insurers but typically spans from a minimum of nine months to a maximum of six years.
Additionally, it is advantageous to obtain maternity coverage early so that you can be eligible for coverage for any pre-existing medical conditions. These may include diabetes, hypertension, and other conditions that require treatment during delivery.
Therefore, obtaining maternity health insurance a minimum of two years before starting a family is always recommended.
How is the maternity insurance premium calculated?
Maternity health insurance carries a comparatively higher premium in comparison to standard health plans. This is the case due to the utter surety associated with filing the insurance claim. As a result, insurers assess a substantial premium. It is imperative to safeguard all health insurance documents.
Before deciding on coverage, a thorough cost-benefit analysis is recommended. After comparing the numerous health insurance policies available in India, conclude. Bear in mind that the cost of maternity insurance will increase in tandem with your age. Expenses associated with pregnancy continue to rise daily. To maximise benefits at a reasonable premium, it is strongly advised to purchase one in advance and avoid procrastination in the long run.
Which are the best maternity insurance plans available in India?
Here is a list of some of the best maternity health insurance plans available in India:
- Aditya Birla Activ Fit Plan
- Bajaj Allianz Health Guard Plan
- Cholamandalam Flexi Health Supreme Plan
- HDFC ERGO MyHealth Suraksha Plan
- Digit Health Care Plus Policy
- Care Joy Maternity Insurance Plan
- Kotak Mahindra Health Premier Plan
- Reliance Health Infinity Insurance Plan
Features of Maternity Health Insurance
Here are a few of the key characteristics of maternity health insurance that various insurers offer:
| Particulars | Coverage |
| Day care treatment | Available |
| Ambulance Cover | Available |
| Cashless treatment | Available in network hospitals |
| Hospitalisation Cover | Room rent, anaesthetist fees, operation theatre charges, doctor fees, normal delivery, C-section delivery |
| Waiting Period | 9 to 36 months |
| Pre- and post-hospitalisation | Pre-hospitalisation expenses of up to 30 days
Post-hospitalisation expenses of up to 60 days |
| New Born Cover | Medical treatments and vaccination expenses |
Benefits of Maternity Health Insurance
Financial Assistance
Maternity health insurance provides financial assistance for the expenses associated with both caesarean sections and vaginal deliveries. Additionally, numerous medical procedures that may be required for prenatal and postnatal care are all protected by the policy.
Newborn Cover
It provides coverage for newborns for 90 days, beginning on the day of birth. This includes costs associated with medical emergencies in addition to vaccinations.
Delivery Charges
Additionally covered by a Mediclaim plan with maternity benefits are ambulance charges, prenatal and postnatal care, and delivery costs. Everything is included, including both standard and Caesarean deliveries.
What Factors Should You Consider While Buying a Maternity Health Insurance Policy?
The following are some considerations that should be made before purchasing maternity health insurance:
- Look for a plan that provides financial coverage for a variety of other medical expenses in addition to hospitalisation coverage to select the best option.
- Before acquiring a policy, you should investigate the premium discounts it provides.
- For cashless remedies, review the list of network institutions to ensure that you have access to one in the event of an emergency.
- It is critical to thoroughly review the maternity health insurance policy’s terms and conditions to comprehend its waiting period, sub-limit, inclusions, and exclusions.
- Select the maternity coverage policy that offers the greatest benefits at a reasonable price by comparing it to other available options.
- Consider checking some of the must-have benefits, such as new-age treatments, new-born baby coverage, daycare procedures, etc., before finalising a maternity health insurance policy.
- Additionally, contemplate reviewing the claim submission process of the policy and deciding to purchase it only if it is uncomplicated and expeditious.
Who Can Benefit from Maternity Health Insurance Coverage?
Those who meet the subsequent requirements may be eligible to obtain maternity health insurance coverage and benefit from its benefits:
Married women under the age of forty are eligible to receive the benefits of the scheme.
The plan is available to all women who purchase maternity coverage in addition to health insurance.
The benefit of the cover is available to any woman for a maximum of two deliveries.
It is advisable to obtain maternity insurance at least two years prior to starting a family, given the potential for lengthy waiting periods ranging from nine months to six years.
Eligibility Criteria for Maternity Health Insurance
While the eligibility requirements for maternity health insurance may differ among insurers, the majority of policies impose age restrictions on policyholders. The age range of the applicant is 18 to 45 years. Take note that the majority of insurance companies typically offer maternity coverage for a maximum of two pregnancies.
Documents Required to Claim Maternity Insurance
Listed below are the documents required to raise a claim for maternity insurance:
- Pre-authorisation form/insurance claim form (duly filled)
- Policy documents
- Hospital discharge details
- Original medical treatment bills, reports bills, and receipts
- Doctor’s prescriptions and other consultation bills
- Recent passport-size photo
- KYC documents
Claim Process to Avail Maternity Health Insurance Policy
Cashless Claim
Step 1: The first step begins with an initial intimation; in the case of cashless hospitalization, reach out to your insurer within the first 24 hours.
Step 2: Then, you will have to fill out a pre-authorization form to seek the insurer’s approval.
Step 3: The insurer will verify your request and approve or reject it as per the stated norms.
Step 4: The approved claim will then be settled with the hospital directly.
Reimbursement Claim
Step 1: Pay the hospital bill and preserve all prescriptions and payment receipts.
Step 2: Register a maternity health insurance claim under the reimbursement category.
Step 3: In this step, you need to submit all required documents, such as payment receipts and medical bills, diagnostic reports, prescriptions, and other relevant documents backing your claim.
Step 4: The insurance company will then receive your request and, following successful verification, will either approve or reject it.
A Buying Guide for Maternity Health Insurance Plans
Here is a step-by-step guide to helping you purchase maternity health insurance coverage:
Step 1: To start with, first log in to your insurance company. If this is your first time, consider signing up.
Step 2: Then click on options similar to ‘Apply Now’ or ‘Get Quote’ to get into the application process.
Step 3: Now, fill out the application form. Here, you are required to enter some of the basic details, such as name, contact number, date of birth, gender, etc., and proceed.
Step 4: Select the policy type and the amount of premium you are opting for.
Step 5: Then, you have to enter some additional details, such as your height, weight, residential address, nominee details, etc.
Step 6: You will be directed toward an interface where you will have to answer some basic questions regarding your previous and current health conditions.
Step 7: Next, you will have to confirm the above-entered details and proceed to the payment gateway.
Step 8: Pay the amount using your desired mode of payment.
Step 9: Upon successful payment, your transaction becomes complete, and you will receive your policy documents in your email.
Things You Must Know Before Buying a Maternity Health Insurance Policy
Some of the most important considerations before purchasing maternity health insurance are as follows:
Newborn Cover: For ninety days, it provides coverage for all medical expenses incurred by a neonate. It also comprises all necessary vaccinations during the first few months.
Abortion or Termination: Certain insurance providers provide coverage for up to two instances of abortion or termination.
Waiting Period: Pregnancy health coverage generally entails a waiting period of between nine months and six years. Consider verifying the policy’s waiting period before making a final decision.
Number of Children Covered: It is advisable to confirm the scope of the plan’s coverage for infants as well. The majority of insurers provide coverage for the expenses of up to two children.
A person’s parenthood is among the most anticipated events of their lifetime. However, astronomical medical expenses can deplete your savings for the child’s future and cause you concern. Pregnancy health insurance plans are therefore advised to provide the mother and neonate with optimal medical care and peace of mind.