Maternity Insurance

Maternity insurance is an add-on cover for a health insurance policy that you can opt for at the time of purchase or renewal by paying a nominal additional premium. This add-on cover is designed to provide comprehensive coverage for medical costs related to pregnancies and childbirth. 

Maternity insurance typically covers normal and C-section deliveries, pre and post-natal care, hospitalisation, diagnosis, medications, doctor consultations, and more.

The Maternity Health Insurance Cover offers the following benefits:

• Comprehensive Coverage

With pregnancy/ Maternity Insurance, you can gain coverage for C-section and normal delivery expenses, hospital stays, medications, any complications resulting from the pregnancy and more!

• Covers Hospitalisation Expenses

The pre and post-hospitalisation expenses resulting from check-ups, medications, follow-ups, etc. before and after delivery are covered.

• Secures the Newborn

In case the newborn is diagnosed with a critical illness, the insurance cover shall be extended to the child for up to 90 days after birth. Moreover, it also covers the cost of vaccinations.

• Cashless Hospitalisation

You can do away with the worry of hefty medical bills due to your pregnancy as the cashless hospitalisation facility ensures financial security!

• Ambulance Cover

You can rest assured about the ambulance charges incurred during an emergency with the Maternity Insurance policy!

What’s Covered and Not Covered Under Maternity Cover

Here are some key inclusions and exclusions in case of a Maternity Insurance plan that you must consider:

With soaring medical care costs due to medical inflation, the expenses related to pregnancy and childbirth have subsequently increased over the years. The costs incurred for a C-section or normal delivery is not inclusive of prenatal care like fertility treatment, frequent doctor’s appointment fees, diagnostic expenses, medications, and other pregnancy-related costs.

Without sufficient insurance coverage, bearing such hefty healthcare costs can take a toll on your finances. The National Family Health Surveys (NFHS - 5) reported a high number of C-sections in India which could be due to complicated pregnancy cases. However, the caesarean section is a more expensive procedure. This is why Maternity Insurance Cover becomes crucial for families planning for a child as it not only covers childbirth but also provides insurance coverage to the newborn baby!

While deciding to purchase Maternity Insurance coverage, it is vital to pick extensive coverage that secures most pregnancy-related costs. Hence, go through the features of the maternity add-on cover offered by your insurer to understand if it suits your requirements. You should make sure the following features are available under your pregnancy insurance:

• Pre and post-natal expenses

• Normal and c-section delivery costs

• Newborn baby cover

• Coverage for vaccination

• Hospitalisation expenses

• Ambulance cover 

• Newly Married Couples

Couples who have recently gotten married and would start planning for a child after some years can consider a Maternity Insurance to complete the waiting period in health insurance sooner.

• Couples Planning for Children

Individuals who have finally reached a stage in their marriage where they want to start considering a child.

• Families Planning a Second Child

Couples who already have one kid and want insurance coverage before planning for another child.

• Couples Who Want Children in the Future

Individuals who aren’t planning to conceive anytime soon but want to have maternity coverage for the future!

It is imperative to do thorough research before buying any insurance policy. Here are a few important aspects that you should consider before choosing a Maternity Insurance:

• Premium Quote

As the maternity cover is an add-on, you have to purchase it separately from your health insurance policy. Although the features of the cover offer extensive coverage, ensure you take the additional premium into account.

• Waiting Period

Many Maternity Insurance plans have a fixed waiting period that you must complete to avail the benefits. Thus, the insurance provider will not accept any claims before the waiting period. So, make sure you check the waiting period applicable to your add-on cover. Furthermore, it is highly advisable to choose a health insurance plan with maternity cover early in life to enjoy the coverage.

• Sub-Limit Clauses

Many medical facilities or covers in health insurance come with a sub-limit clause. Similarly, maternity health insurance coverage could also have sub-limits. So, make sure to go through the policy documents after compare health insurance plans and choose the one that best suits your needs.

• Policy Coverage

The policy that you choose needs to provide adequate coverage that caters to all your pregnancy-related expenses. This includes hospitalisation costs, medications, checkups, consultations, and any costs arising from complications.

Although the eligibility criteria for Maternity Insurance shall vary from one insurer to another, here are some common norms to meet:

• Minimum Entry Age: Child - 1 day to 24 years old, Adult - 18 years or above

• Maximum Entry Age: 45 years old

Here are a few steps which you can follow to purchase a health insurance plan with Maternity Insurance Cover:

• Step 1: Go to the ‘Health Insurance Premium Calculator’ page.

• Step 2: Enter the personal details required on the page such as your name, age, contact number, residential pin code, etc. and proceed.

• Step 3: Select the maternity add-on cover from the add-on options.

• Step 4: Compare the available policies based on the sum insured and other benefits.

• Step 5: Proceed with a suitable health plan and review the policy details.

• Step 6: Pay the premium online.

Your health insurance policy with Maternity Insurance will be issued soon!

Inform your insurer immediately when you are hospitalised for childbirth. This way, they can initiate the claim process for your Maternity Insurance. The claim settlement can either be cashless or reimbursement, depending on the hospital you are admitted to. Here’s how you can file a cashless and reimbursement claim:

• Cashless Claim

1. You can avail the cashless insurance settlement facility when seeking medical assistance at a network hospital.

2. Fill out the claim application form available at the insurance desk at the network hospital.

3. The hospital shall seek approval and initiate the claim process. Submit the necessary documents to the insurer.

4. Once the claim application is approved, the insurer will settle the amount directly with the hospital.

• Reimbursement Claim

When availing medical assistance at a non-network hospital, you can proceed to claim compensation with reimbursement claims against your Maternity Insurance.

1. Notify the insurer regarding the hospitalisation due to pregnancy.

2. Fill out the Maternity Insurance claim application form after discharge and submit the necessary documents and hospital bills.

3. The insurer will assess your claim application and raise a request for additional documents (if needed).

4. Once the claim application is approved, the insurer will compensate for the expenses incurred as per the terms of your Maternity Insurance.

Make sure you have the following documents while raising a Maternity Insurance claim:

• Health insurance policy document

• KYC documents

• Claim application form

• Discharge summary

• Original invoices and bills, in case of reimbursement claims

• Pre-authorisation form, in case of cashless claims

• Other documents that may be required by the insurer

Health Insurance Plans Available at Bajaj Markets