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Maternity Insurance Coverage

Jagrity Sharma Jagrity Sharma 11 October 2019

As a responsible parent, you should prepare for the expenses related to pregnancy and delivery of the new-born. In this day and age, with the medical expenses on a rise, it is crucial to be well-prepared for all expected and unexpected expenses with a medical insurance policy.

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While the anxiety of becoming a parent may take days to settle, one thing you should not worry about are the hospitalisation expenses. But this is possible only if you have adequate maternity insurance coverage. The benefits of maternity coverage include financial protection during pregnancy, pre and post-hospitalisation expenses, pre and post-natal care for the new-born, ambulance charges and delivery cost, irrespective of whether it is a normal or a caesarean delivery. The maternity health insurance policy also covers the new-born baby until a certain period.

Now, the question is- Should you opt for a health insurance that also covers maternity coverage? Or should you buy a separate maternity cover? Let’s quickly understand maternity insurance as this will help you make a better decision.

Waiting period: All maternity insurance come with a waiting period, generally ranging from 36 months to 72 months of continuous renewals. Hence, if you are planning to have a child in the immediate future, this benefit may not help. However, some maternity focused health insurance policies come with a very low waiting period of just nine months.

Limits on maternity spend: Both, individual and group policies that offer maternity coverage as an add-on coverage, have a limit on the coverage amount. They offer a flat figure or linked with the overall sum assured. Hence, if you do not wish to have limited maternity coverage, you should opt for a separate maternity cover.

Coverage: The policy document of the maternity insurance gives complete clarity on what the policy covers. It is essential to check if the policy also offers other benefits such as cover for the new-born baby, cover for termination of pregnancy, associated pregnancy complications, and pre and post-natal expenses for the new-born baby. Similarly, it is important to keep a note of the sub-limits, other exclusions, special conditions, etc.

How to make a claim of maternity insurance?

Upon being hospitalised for delivery, it is advisable to inform the insurance company immediately to take the claim process forward. The claim can be both cashless and reimbursement. Let’s look at the claim process.

Cashless claim at network hospitals of your insurance company:

  • Submit the duly filled cashless hospitalization claim form that the hospital provides you at the time of hospitalisation.
  • The hospital authorities will send the claim form to the insurance company, along with your doctor’s reports.
  • The claim experts of the insurance company may raise queries, which either the hospital or you have to reply to. Once your claim is approved, the insurance company will pay the hospital directly according to the sum insured that you have opted for. Reimbursement of the claim for treatment at any hospital other than network hospitals of the insurance company:
  • Submit the duly filled claim form post hospitalisation to the insurance company along with the other required documents such as reports, treatment summary, discharge report, bills of reports, and medical treatments, etc.
  • The claim experts of your insurance company may raise concerns, if any, which you have to reply to and submit the additional documents, if required.
  • If your claim is approved, the insurance company will reimburse you according to your eligible sum insured. List of top maternity plans & its features The following are some of the top maternity insurance plans offered by insurance companies in India.
Name of Insurance CompanyName of Maternity Insurance Policy
Max BupaHeartbeat Family Floater
Apollo MunichEasy Health Young Family
Royal SundaramLifeline Elite
Star HealthWedding Gift Insurance Plan
HDFC ERGOHealth Suraksha Gold

Features of maternity insurance plans offered by the insurance companies mentioned in the above table.

Comprehensive coverage: A comprehensive maternity health insurance policy covers the expenses incurred at the time of delivery, pre and post-hospitalisation expenses, as well as ambulance charges, medicines, hospital room rent, and doctor's consultation fees.

Hospitalisation coverage: Maternity insurance plans cover pre and post-hospitalisation expenses related to pregnancy for a specific span of time before and after hospitalisation, as mentioned in the insurance company’s policy document.

Pre and post-natal care for the new born baby: A comprehensive maternity health insurance plan covers not only the mother, but also the new-born, in case he/she is diagnosed with critical illnesses as specified in the policy document.

Cashless hospitalisation: Maternity health insurance policies from leading companies offer a cashless facility at their network hospitals across the country. You can avail the facilities at the network hospitals of an insurer without having to pay the medical bills.

Claim-free bonus: Many insurance companies offer a discount on the premium for the next year if the policy does not raise a claim in a certain policy year. Moreover, insurance companies offer an easy and streamlined online application facility as per the convenience of the individuals. The policy can be bought online at the click of a few buttons.

Flexibility to choose the sum insured: You have an option to choose the sum insured that you want to cover as a maternity expenditure when the need arises. You can choose the desired sum insured at the time of purchasing the maternity health insurance policy.

Tax savings: You can avail tax benefits for the premiums paid towards maternity insurance under Section 80D of the Income Tax Act, 1961.

Eligibility: Different insurance companies have their eligibility criteria for maternity insurance plans. An individual who meets the eligibility criteria of the insurance company can buy a maternity health insurance policy from that company.

Maternity insurance coverage serves as a great supplement for your health insurance policy when you are planning to embrace parenthood.

Hence, it is highly recommended that you buy maternity insurance beforehand for a financially secure pregnancy. Risking hospitalisation charges and rising medical inflation usually pose as a challenge in meeting the hospitalisation expenses and may get in the way of receiving quality medical services, for both you and the new-born. So, it’s best to get a maternity insurance plan in advance.

Jagrity Sharma
Written by Jagrity Sharma
A bibliophile who hates alliterations, but loves cream, comics and content immensely! On another note, a content marketer who leverages the power of words to explain...almost anything!