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Planning to Start a Family? Prepare Better with right Health Insurance

Neha Gadoo Neha Gadoo 30 January 2017

If you are thinking of starting a family, insurance planning is a must. Though welcoming a new life is a period full of anticipation and joy, it also comes with its challenges and responsibilities.

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In every conceivable manner, the family is link to our past, bridge to our future. – Alex Haley

When a couple brings a new life on the planet and becomes a parent, it is a very special and unique feeling. In yesteryears, things were no complex as in today. Neither were there so many complicated and intrusive medical procedures, nor the high medical costs. Also, in the earlier days, there was a very strong support system in the form of joint family, where the whole maternity and baby rearing process was a household affair.

But things have changed today. Medical costs have risen considerably. Whatever be the income group, families want the best medical care in the best of hospitals. As a result, medical bill for a delivery in metro cities easily crosses a lac in a decent hospital. Hence, it is all the more important that a young married couple planning to start a family in some year’s time should pay enough attention towards ensuring the right health insurance.

First, know the financial impact of starting a family:

A reality one has to accept in today’s times is that starting a family is a costly affair. Following are some of the expenses one can expect in this journey:

  • Pregnancy period: This will involve routine check-ups with the doctor, expenses on medicines and tests, and around 3-4 sonography tests. Estimated total cost can be taken as Rs. 25,000.

  • Expenses on hospitalisation for delivery: This will depend on the type of delivery, hospital and facilities chosen.

  • Normal delivery: Rs. 50,000-75,000

  • Caesarean procedure: Rs. 1-2 lacs

  • Post hospitalisation recovery period: This involves medicines and routine checkups for a period of at least 6 months post delivery Estimated total cost can be taken as Rs. 25,000.

  • Household help: during first 6 months, since the mother is very weak, a full/part time household help (bai) is required to do the cleaning work, massaging the baby etc. Estimated total cost can be taken as Rs. 25,000.

  • Newborn’s medical expenses: Since in the first year, the baby’s immunity system is not developed, there one or the other cold or infection for which you have to run to the doctor. A single consultation with a child specialist can cost you between Rs. 300-1000 per visit. Estimated total cost can be taken as Rs. 50,000.

  • Baby’s vaccination expenses: For a period of one year, you have to be prepared to visit the doctor at least once a month to get your child all the vaccinations as per the prescribed schedule. A single vaccine can range from Rs. 2,000-5,000 a month. Estimated total cost can be taken as Rs. 50,000.

  • First year newborn care expenses: you have to make additional provisioning for baby’s medicines, and baby specific purchasing like baby oil, powder, diapers, lactogen and what not. You can assume min. monthly expenses of Rs. 2500 on this front. Estimated annual cost can be taken as Rs. 30,000.

So, now you get the magnitude. The “baby making process” is not cheap. The entire process can set you back by in the range of Rs. 1.5-2.5 lacs over a one and a half year period.

Assess your insurance cover for maternity expenses:

So, given this high cost, it is important for you to assess your insurance preparedness well in advance of even thinking about planning to start a family.

Also, note that a health insurance policy will not cover all these costs, but will cover you only for the hospitalisation expenses in case of delivery, that too, if it is specifically mentioned to be covered in the policy. However, why having a proper health insurance is important at this stage is that given the high expenses in this period, the family can ill afford the cost of hospitalisation of anyone else in the family or either of the couples. So, first of all, both couples should have their own health insurance plan, either as an individual plan or under a common family floater, in addition to being covered under the group health cover offered by respective employers.

When we speak about maternity expenses, you need to check the respective clauses in the maternity health insurance policy wordings to ascertain whether maternity expenses are covered or not. For e.g. in case of Apollo Munich Optima Restore policy, pregnancy and maternity expenses are expressly excluded, which means that company will not pay for pregnancy related complication or maternity expenses . However, Religare has launched a new product “Joy” which covers maternity as well as pre and post natal expenses. Here, maternity expenses coverage is limited upto Rs. 50,000. There is a reduced 9 month waiting period, as against 3-4 years in policies of other companies.

In case of employer provided cover also, not all employers provide maternity covers so you need to check with your HR team on the exact cover in case of maternity claim. Group policies that cover maternity generally come with a restriction on maternity expenses upto Rs. 50,000.

Create a dedicated fund for other expenses

Now that you know the costs of starting a family, you can at best partly fund the same by proper planning and taking the right insurance policy. However, since there is a host of other expenses that insurance policy will not cover & pay, it is advisable to also maintain a decent medical fund so that this expense does not cause a strain on your finances. What you need to take care after the child is born

Congratulations! You have finally become a proud parent.

As and when you get a discharge from the hospital, make it a point to complete all the documentation formalities. If you had applied for cashless claim, then there is not much of an issue. However, if you are planning to claim re-imbursement from the insurer, then make sure to collect all the originals (discharge card, medical prescriptions, bills, test reports, admit card duly attested by attending doctor, lab reports etc.) and submit the claim within the mentioned time limit to insurer. Also you should make it a point to Include baby as beneficiary in employer’s group policy: This will ensure that your baby is also covered in the policy.


Proper and thoughtful planning done well in advance not only helps a young couple protect themselves from any medical emergencies during this period & but can also save them from unnecessary anxieties and allow them to enjoy this journey to parenthood to the maximum.

Neha Gadoo
Written by Neha Gadoo
Daring and Bold, Neha loves philosophy, trekking and walking bare feet in the rain. Loves talking and can stare out of a car window for hours continuously.