Health Coverage for Expecting Mothers

Insure well if you are planning a baby!

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What Is Maternity Insurance?

While the anxiety about parenthood will take days to settle, one thing you don't need to worry as much are the hospitalization expenses if you have adequate maternity cover. While there are numerous other factors that the couple should consider before and after conceiving to ensure a safe and healthy pregnancy, one cannot overlook the cost involved. With high-end hospitals spreading their web across the country, the cost of a normal delivery clubbed with the hospitalization in a decent hospital in any metro city could range anywhere between Rs.60,000 to Rs.2 Lakhs. These shocking figures only suggest a need for proper planning of finances towards the expenses that will incur. Hence, a Maternity cover offered by several Health Insurance companies is one modern approach to tackle these costs.

Why Do You Need Maternity Insurance?

As a responsible parent, you must prepare suitably for the cost related to pregnancy and the delivery of the baby. With the medical costs soaring high, one has to be well prepared for all expected and unexpected expenses. And this is why you should consider a Maternity cover in your health insurance plan

  • Covers Your Maternity Expenses: Most regular-joe medical health insurance policies does not cover maternity costs and thus are of no use when the time comes for the baby’s delivery.

  • Safeguard Against the Rising Healthcare Costs: With healthcare inflation about 15-18% each year, the cost of hospitalization will be more than twice within the next five years.

Also Read: Why You Should Opt for Higher Health Insurance Coverage?

Does Regular Health Insurance Policies Provide Maternity Cover?

Yes, they do. But this goes against the principle of insurance. You don't insure an event that is most likely to occur. You insure an event that only has a rare possibility of occurrence. See the difference? However, most insurers still promote this cover for a couple of reasons:

Reason 1 - It is a great marketing ploy, as the brochure reads 'MATERNITY COVER INCLUDED.'

Reason 2 - It helps cushion the maternity expenses for 'loyal' customers

What Does Maternity Cover Include?

  • Includes expenses for hospitalization and the costs for the delivery of the baby (normal or caesarean)
  • Covers costs that are related to pre and post hospitalization, as well as pre & post-natal care
  • Covers the new-born baby as well, up to a particular time limit
  • Includes the ambulance charges for ferrying the to-be mom to the nearest network hospital of your choice

So Let's Quickly Decode Maternity Insurance

So should you opt for the health insurance plan that features to cover maternity expenses? Well, it's not as black & white as it seems. There is a CATCH.

maternity waiting period
Waiting Period

All maternity covers come with very stringent waiting period ranging from 36 to 72 months of continuous renewals. So, if you are planning a baby in the immediate future, this benefit is as useful as a discount coupon for a hardware store in Honolulu. However, some innovative maternity focussed health insurance plans such as "Joy" from Religare Health Insurance comes with an extremely low waiting period of just nine months.

Limits on Maternity Spend
Limits on Maternity Spend

Both group and individual policies that offer maternity as an add-on cover have a restraint on the coverage amount, either by way of a flat figure or linked to the overall sum assured. Very few policies cover it for more than Rs.50,000. As the actual cost for the delivery goes upwards of Rs.1 Lakh, especially in metro cities, one might require shelling out a good chunk from his pocket.

maternity coverage

The policy wordings of the plan gives a real clarity on what and how of the coverage. Check if the plan also offers other benefits such as cover for the newborn from day one, coverage for termination of pregnancy, associated pregnancy complications & pre and post-natal expense. Similarly, keep an eye on the sub-limits, whether the plan covers both types of deliveries and other exclusions/special conditions, etc.

Some Holistic Insights On Funding Maternity Expense

If you believe in planning finances and want the best the medical attention for you/your spouse and your baby, it makes absolute sense to plan your medical expense related to maternity.

OK, now that we've briefly reviewed what maternity health insurance plans are all about, following are some pointers on how one should plan for this expense in a holistic manner:

  • Do not be in a hurry to purchase a health policy only because it offers a maternity cover. Maternity cover can be just one of the “pluses” but cannot be the sole criterion for buying a health cover. Evaluate the policy for all other valuable benefits and choose the best.

  • Since there is a sub-limit for maternity related expenses that does not match the actual costs, it is likely that the insurance policy will fund only up to 20%-30% of the cover. Hence, you should target a dedicated fund for the whole of the expense, without considering the insurance claim. This arrangement will provide a complete peace of mind. If you get a maximum maternity claim payout, that will be an icing on the cake.

  • Employer's group health insurance plans have better conditions on the maternity cover. As these plans have fewer limitations compared to individual plans, claiming them is much easier and favorable. Hence, in case you happen to incur an expense, first, try to claim from the group policy without recourse to your individual one. This measure will also help you preserve the no claim bonus of your own policy.

So Mommy and Daddy-To-Be, Here’s What You Need To Do…

If you are keen on a high-end private room in a decent hospital, you can expect to get a claim payout up to 20%-30% of your maternity costs. Hence, it’s wise not to rely entirely only on health insurance maternity benefit to tackle the delivery and hospital related expenses. Check the waiting period in your policy or the one you plan to buy, to know if and when you can claim. When it comes to the spending limit, it is not very different across insurance products available today.

Likewise, don't decide your basic health insurance plan purely basis the Maternity Cover. It's a valuable feature only after a particular period and for a limited amount; not something you should primarily seek.

Bringing a whole new life into this world is certainly no cake-walk. Plan well and ins ure adequately to make this experience a real cherishable one. Call if you have any questions or need help in choosing the best plan to safeguard your financial future.

FAQs on maternity health insurance

If I am already pregnant, can I be covered for maternity?

As most insurers count pregnancy as a pre-existing condition, they will not accept your application if you are already pregnant unless you are entering a group policy.

What if my baby is born with a birth deformity?

If your baby is born with an abnormality, deformity, disease, illness or injury, it is termed as a congenital condition. The coverage for such deformity purely depends on the insurance company and varies from all to none to partial.

Is my baby covered right from the birth?

Some insurers do cover the newborn baby from day one until they are 90 days old. From day 91, they can be added to the parent's policy by paying the additional premium. And some don't at all. However, this decision entirely rests with the underwriting team of the insurance company.

My daughter is getting married soon, and I wish to gift her a health insurance plan. What other benefits should I consider along with Maternity cover?

Congratulation on such a thoughtful gesture! Apart from Maternity cover, you can consider a plan that offers other valuable benefits as a cover for critical illness, hospital cash, room-rent waiver, etc. Also, find a plan that has fewer restrictions on sub-limits. Call to assist you with the best deal!

How do I claim the Maternity cover?

As in all health policies, you must intimate the insurance company about the pregnancy if your plan includes the Maternity. And when you get hospitalized for the delivery of the baby, you must raise a claim with the insurance company. The sooner, the better.