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Maternity Health Insurance Plan in India

By Finserv MARKETS - Mar 12,2019
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Maternity Insurance Plan

In rural India, more than 86% of the population is not under any health insurance. As for urban India, 82% of the population’s health is uninsured. That means only less than 20% of Indians have health insurance.

Now, imagine how many women out of these would be covered for maternity? Very few. In fact, given the situation of such poor health insurance coverage, childbirth becomes expensive for many couples and families.

There are many reasons why so few people opt for health insurance that provides maternity cover. Affordability may be a factor for some, but also awareness about such things is very poor. There is excitement and anxiety in homes that are set to welcome a newborn.

There is advice flowing in from all quarters, from grandmothers to aunts and every other member of the family on what you should or shouldn’t do. As to-be-parents, you often receive opinions on everything from, “The baby should be swaddled only with muslin cloth”, “You should try cloth diapers instead” to “You should go to that hospital”. But unfortunately, there is no advice on getting a maternity insurance plan or a newborn baby cover added to your insurance.

People often forget that the expenses related to motherhood begin from the day a woman gets pregnant. Not only the hospitalization and delivery-related expenses, but post-delivery care is equally essential and expensive. These expenses can push you over the edge if you are not financially prepared.

A sensible approach to tackle these expenses is seeking maternity insurance. Here’s a little guide on what is maternity insurance, why you need it, and how you can get one.

What is Maternity Insurance?

Maternity insurance is a plan designed to cover the maternity and health care cost for expecting mothers and their new-borns. Usually, a maternity benefit is provided as an add-on or additional rider with your existing health insurance policy.

A maternity benefit is also often provided by corporations for their female employees, along with their group health insurance policies. However, as with all riders, the coverage provided under maternity benefit has a sub-limit that may not be enough to pay for the entire cost of the pregnancy. In this case, a complete pregnancy health insurance package is an ideal option.

Why do you need Maternity Health Insurance?

In today’s age, not having a maternity health cover is not an option. As much as the new addition to the family is a blessing, the medical costs are a financial burden. Whether you choose a respectable hospital or a maternity nursing home – you will definitely return home with a wad of bills.

Given the increasing complications of childbirth, extended hospital stay post-delivery, medicines and hospital charges – giving birth to your baby in a mid-range hospital will cost you anywhere between Rs. 50,000 to Rs. 1.5 lakh. The cost may increase if the baby is born via a c-section instead of normal delivery or if there are further complications.

The family health insurance plan available at Finserv MARKETS provides coverage of up to Rs. 25,000 for normal delivery and up to Rs. 35,000 for cesarean section, depending on the sum insured.

This estimated lump-sum is not inclusive of prenatal care like fertility treatment, frequent doctor’s appointment fee, diagnostic expenses, medicines and pregnancy-related costs. All these expenses can end up being heavy on your pocket.

Wouldn’t it be nice to bring home a baby without having to exhaust your savings? If you are expecting or planning to have a baby, then a family health plan with a pregnancy insurance cover is a must for you!

At Finserv MARKETS, the maternity health cover is offered as a part of the family insurance plan which comes with many benefits like a huge network of hospitals that allow cashless treatment, swift settlement process with a settlement rate of 94% and customisable plans.

As you can see the maternity insurance cover not only protects you but also provides you with financial security. So, if you are planning to have a baby or are already pregnant, then pregnancy insurance should be the first thing you should pack in your baby bag.

Eligibility Criteria

To avail the benefits of maternity health insurance, the age range is between 18 years and 45 years. For the children covered under the plan, the age range is between 1 day and 24 years old. However, this range tends to vary depending on the insurer.

What to Look For in a Maternity Insurance Cover?

When looking for adequate maternity health insurance, here are a few things that you need to take into consideration –

  1. Coverage of the policy: The policy that you choose needs to provide adequate coverage that caters to all your motherhood-related expenses. This includes hospitalization costs, medications, tests, monthly checkups, and any unforeseen expenses.
  2. The waiting period of the plan: Many maternity health plans cover with a waiting period of 2-5 years. In simple words, the waiting period is nothing but the amount of time you have to wait after taking the policy to avail the maternity benefits. It is highly advisable to choose a health insurance plan early in life so that you can avail the maternity benefits in the future (as required).
  3. Clauses: You must go through all the documentation of the policy carefully. Compare the features and benefits offered to you with other plans available in the market. Then choose a plan that best suits your maternity needs.

Key Benefits Of Maternity Health Insurance

The comprehensive maternity insurance plan available on Finserv MARKETS offers the following benefits –

  • Comprehensive Coverage: A maternity health insurance plan offers coverage for delivery expenses, hospital stays, and medicines that may require in due course.
  • Newborn Care: The coverage can be extended to the infant child if in case they are diagnosed with a critical illness.
  • Quick Online Application: You can apply for pregnancy insurance on our online platform from the comforts of your home or on the go.
  • Ambulance Charges: In case of emergencies, the plan also covers ambulance charges.
  • Hospitalization Expenses Covered: All the motherhood-related expenses, which includes post and pre hospitalization charges, are covered under the plan.
  • Cashless Facility: You can avail cashless payment facility in all the network hospitals.
  • Hassle-Free Claim Settlement: The claim settlement process is hassle-free and quick due to a single point of contact throughout the process.
  • Claim-Free Bonus: You can gain a 10% additional bonus for every claim-free year.
  • Tax Benefits: You can save tax under Section 80D of the Income Tax Act, 1961.

Maternity Health Insurance – Exclusions

Every insurance plan comes with certain limitations. Following things are excluded from maternity insurance –

  • Follow-up diagnostics during the nine months of pregnancy
  • Tonics and vitamins for the mother and the newborn (unless it is a part of the treatment)
  • Consultation fees for the routine checkups

It is advisable that the to-be-parents check these clauses before choosing a pregnancy insurance plan that’s most suitable for them.

When Should You Buy Maternity Insurance?

Since, one cannot reap maximum benefits of the insurance plan if bought while being pregnant and as it takes a waiting period of 2 to 6 years – ideally, it should be bought when the couple is planning for a baby. One can avail the health insurance benefits when they’re in between the age of 18 to 45 and if they have a steady paying job.

Maternity Health Insurance Claim Process

Inform your insurer immediately when you are hospitalized for delivery. This way, they can initiate the claim process. The claim settlement can either be cashless or reimbursement, depending on your situation at the given time.

The claim process is as follows –

  • After informing your insurer regarding the hospitalization, submit the claim form application
  • The hospital will verify the documentation provided by you and then send across the necessary documentation to the insurer
  • In case you are seeking treatment at a network hospital, after verification, the insurer will settle the claim with the hospital directly
  • Otherwise, you first have to pay the hospital for the expenses incurred and submit the bills and necessary documents to your insurer. Upon verification, the insurer will reimburse the cost.

FAQs related to Maternity Insurance

Q: I am already pregnant. Can I still get maternity health insurance coverage?

A: Most insurers consider pregnancy as a pre-existing condition, and thus the maternity benefit will not be offered if you are already pregnant. Therefore, ensure that you go through the terms and conditions of the policy before the purchase.

Q: What is covered under maternity insurance plan?

A: Maternity insurance provides coverage for up to a specific limit. The coverage is for both normal and c-section deliveries. A few insurers also offer pre and post-natal expenses and coverage for the newborn.

Q: How are premiums in pregnancy insurance calculated?

A: Premium amounts are slightly more compared to basic health insurance plans. Since the certainty of a claim being filed under the plan is absolute, the premiums offered are comparatively high. Thus, it is advisable to compare maternity insurance online and choose the coverage that best suits your needs.

Q: What is the minimum sum assured under maternity insurance?

A: The sum assured amount varies for different insurers. Hence, as we mentioned earlier, you should go through the policy documentation carefully before seeking pregnancy insurance.

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Bajaj Finserv Direct Limited ("BFDL"), erstwhile Bajaj Financial Holdings Limited is a registered corporate agent of Bajaj Allianz Life Insurance Company Limited and Bajaj Allianz General Insurance Company Limited under the IRDAI composite registration number CA0551 valid till 10-Apr-2021. BFDL also renders services to Bajaj Finance Limited (‘BFL’) and Bajaj Housing Finance Limited (‘BHFL’) (referred hereinafter as ‘Lending Partner’) in sourcing of customers, providing preliminary credit support activities, fulfilment services and post-acquisition customer services related to lending business. Registered Office: Bajaj Auto Limited Complex, Mumbai – Pune Road, Akurdi, Pune – 411 035 CIN: U65923PN2014PLC150522