What is 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. Even the costs associated with managing and treating complications during pregnancy and medical termination of pregnancy are generally included in this add-on cover.

 

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Why do you Need Health Insurance With Maternity Cover?

With soaring medical care costs, the expenses related to pregnancy and childbirth have subsequently increased over the years. The cost 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 pregnancy-related costs.

Without sufficient insurance coverage, bearing such hefty healthcare costs can take a toll on any family. The National Family Health Surveys (NFHS - 5) reported a high number of C-sections in India which could be due to complicated pregnancy cases. But the caesarean section is a more expensive procedure. This is why m

aternity 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!

How to Buy Maternity Insurance Online

Follow the below-mentioned steps to purchase a health insurance plan with a maternity cover:

 

  • Step 1: Click on the Buy Now button mentioned on the top of the 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: You shall find various health plans visible on the screen.

  • Step 4: Select the maternity add-on cover from the add-on options.

  • Step 5: Compare the available policies based on the sum insured and other benefits.

  • Step 6: Proceed with a suitable health plan and review the policy details.

  • Step 7: Pay the premium online.

  • Step 8: Your health insurance policy with maternity insurance will be issued soon!

Features and Benefits of Maternity Cover

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!

Eligibility Criteria for Maternity Insurance

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

What’s Covered and Not Covered in Maternity Insurance

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

Inclusions 

Exclusions 

  • Cost of Delivery & Labour

The maternity insurance add-on cover shall cover all the expenses arising from the delivery of a baby. The coverage might limit the number of pregnancies covered under the plan.

  • Room Rent & Hospitalisation

The health insurance policy shall cover the hospitalisation expenses and the room rent incurred while you are admitted.

  • C-Section

In case the doctor recommends a caesarean section or also known as a C-section for the well-being of the mother and child, maternity health insurance covers the expenses.

  • Pregnancy Complications

To ensure you are covered against any pregnancy-related complications, maternity health insurance includes all medical costs incurred for the same.

  • Medically Required Pregnancy Termination

In case of medically required termination of your pregnancy, the maternity health insurance add-on cover has got your back.

  • Newborn Baby Cover

The insurance plan protects your infant with a newborn baby cover by offering coverage for the first 90 days from birth.

  • Any pre or post-natal expenses incurred, unless it leads to hospitalisation.

  • Vitamins, tonics or other supplements for the mother and the child.

  • An ectopic pregnancy will not be under maternity insurance unless included in the base health plan.

  • In case of pregnancy claims after you have exhausted the number of pregnancies covered under maternity insurance.

  • Any insurance claims raised during the waiting period.

  • Healthcare costs of harvesting and storing stem cells are not covered.

  • Some maternity health insurance might not cover infertility treatments.

What to Look for in a Maternity Insurance?

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 

Who Should Opt for Maternity Insurance?

  • 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!

Factors to Keep in Mind While Buying Maternity Insurance

It is imperative to do thorough research before buying any insurance policy. Here is a look at some 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 comparing various 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.

How to Claim Maternity Health Insurance

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 claim 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.

Documents Required for Claiming Under 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

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FAQs on Maternity Health Insurance

  • ✔️Can I get maternity insurance while pregnant?

    Yes, you can opt for maternity insurance coverage while you are pregnant. But you cannot raise any insurance claims before the waiting period is completed. Thus, it is recommended to get maternity coverage a couple of years before planning for a child.

  • ✔️What is covered under the maternity insurance plan?

    Maternity health insurance offers coverage for both normal and c-section deliveries along with a newborn baby cover.

  • ✔️How are premiums in pregnancy insurance calculated?

    As maternity insurance/ pregnancy insurance is an add-on cover, the premium quote will vary from insurer to insurer. So, contact your insurance company to find out the maternity cover price and opt for it during insurance renewal.

  • ✔️Can I opt for health insurance while I am pregnant?

    Yes. You can opt for a comprehensive health insurance plan while you are pregnant.

  • ✔️Are there any maternity covers without any waiting period?

    No. Currently, all maternity health insurance covers have a waiting period.

  • ✔️How many pregnancies are covered under the maternity cover?

    Most insurance companies cover the medical care expenses of up to two pregnancies under the maternity health insurance cover. 

  • ✔️Who can avail of the maternity cover benefit?

    You can avail the maternity cover benefits if you meet the following criteria:

    • If you have purchased a maternity add-on cover with your health insurance policy.

    • If you haven’t exhausted the coverage available under the add-on (or had more than two children).

    • In case you have completed the waiting period applicable under the cover.

  • ✔️Is the newborn child covered by maternity insurance?

    Most maternity health plans extend coverage for newborn babies for up to 3 months/ 90 days. However, it is best that you confirm the same with your insurance provider.  

  • ✔️Are maternity benefits taxable?

    Yes, the maternity benefits fall under the category of income and hence are taxable. However, you can get tax exemptions under Section 80D.

  • ✔️Is second childbirth also covered in maternity insurance?

    Most maternity insurance plans offer coverage for up to 2 pregnancies. However, it is best that you confirm the same with your insurance provider.