Health Insurance With Maternity Cover

Parenthood is one of the most special experiences of one’s life, particularly for women. During pregnancy, the female body undergoes both physical as well as hormonal changes which can have an everlasting impact on their overall well-being. Despite the precautions that you may take, medical complications may occur in some cases. These situations are sudden and can leave you startled. At such times, timely medical treatment is of utmost priority. Worrying about finances can be another burden when you already have health complications to worry about. So why not opt for maternity insurance coverage? There is apprehension when it comes to pregnancy, and maternity health insurance is the safest bet at such times. Let us understand all that you need to know about maternity insurance plans.

What is a maternity health insurance policy?

Maternity health insurance covers all expenses associated with childbirth for expecting mothers as well as newborns. One can avail of maternity insurance coverage as a standalone policy or add it to your existing family health insurance plan. This additional coverage to your existing plan can be in the form of additional riders or add-ons. Some employers also extend the facility to avail maternity coverage under group insurance policies.

Why should you opt for maternity insurance cover?

No one would want to compromise on the health facilities at any time. So, why hold back when it comes to welcoming a new life into this world? With a maternity insurance cover, you can ensure you get the best medical facilities, both for the mother as well as the new-born. Moreover, standardised medical treatments are no longer easily affordable and can break your bank. Having a pregnancy insurance policy ensures you get access to state-of-the-art medical procedures and can also take care of unforeseen complications. Medical professionals, too, charge hefty fees for consultation and surgery, if required. This can be an unexpected blow to your saving that otherwise can be used for your child’s future. A maternity insurance policy covers the fees paid to professionals like a gynaecologist, an anaesthetist, a paediatrician, and more. A maternity insurance cover also includes the cost of childbirth, and pre-natal as well as post-natal expenses. Some family health plans with maternity benefits offer coverage for the newborn as early as 90 days after birth.

Does regular health insurance plans cover pregnancy?

You may be wondering whether your regular health insurance plan already covers pregnancy and related medical issues. * Now, whether your regular health plan covers pregnancy or not is mostly dependent on the insurer and the product you choose. In most cases, maternity coverage is provided as a part of top-up health insurance plans. It may not be available as a part of the standard health insurance package. * You could also opt for maternity insurance coverage by opting for a relevant add-on. There may be limits to the maternity expense coverage under the health insurance plan. For instance, if the sum assured of your regular health insurance policy 3 lakhs to Rs 7.5 lakhs, then the maternity coverage may be limited to Rs 15,000 for normal delivery and Rs 25,000 for caesarean delivery ^[1]. *  Furthermore, the waiting period for maternity cover may be different from that of the regular health plan. Thus, one should have a thorough understanding of the same before opting for this cover. *

What to look out for when buying maternity insurance?

These are some important factors to consider when buying maternity insurance -

1. Coverage

When shortlisting pregnancy insurance, check for the coverage it offers. Many maternity plans extend their cover to provide health check-up facilities, any pregnancy-related medical tests, hospitalisation at the time of birth, along with unforeseen emergencies that need to be addressed. *

2. Waiting Period

There is usually a clause pertaining to the waiting period in health insurance and maternity insurance policies. This means any treatment or check-up shall be included under the insurance cover only after completing a pre-specified duration. Thus, it is advisable to buy maternity health insurance in advance. *

3. Clauses

One must carefully read through all the policy terms to understand the fine print. This helps in avoiding cases of rejected claims and to compare the various features of each policy before zeroing down. *

4. Claims process

You do not want to be rushing here and there to gather dozens of documents or explain the situation to your insurance agent for hours during the peak pregnancy period. Hence, an easy claim-raising and settlement process is essential.  *

Is pregnancy termed as a pre-existing condition when buying maternity insurance?

Most insurers consider pregnancy as a pre-existing condition and are excluded from the coverage of your policy. You may rarely find a maternity cover without a waiting period, and thus you must plan and accordingly opt for one. To conclude, putting off buying a maternity cover is not advisable as it attracts a waiting period to it. It would be best if you buy health insurance as early as possible so that the stipulated terms are fulfilled, and your child and the mother enjoy complete medical attention at the time of delivery without worrying about the finances.

What is not covered in maternity insurance coverage?

It is also crucial to know what elements may not be covered under your maternity health insurance coverage. Here are a few:

1. Pre-existing conditions that could affect pregnancy

If you suffer from a health condition that could have a negative impact on your pregnancy, then it may not be covered under maternity coverage. However, this depends upon the insurer’s terms and conditions. *

2. Infertility expenses

If you or your partner seek treatments related to infertility, then the charges for the same may not be covered. *

3. Congenital diseases

Medical conditions that a newborn may have inherited or may occur in them before their birth may not be covered. *

4. Unprescribed medicines

You may be taking vitamins and supplements to aid your health. However, if they are not mandated by the doctors, they are not covered under maternity insurance. *

FAQs

1. Does maternity insurance cover newborns too?

Yes, most maternity insurance plans include newborn coverage. The extent of coverage for a newborn in terms of tenure and compensation limits can be found in the terms and conditions of the maternity health insurance plan documents. *

2. What is the usual waiting period for maternity insurance coverage?

The waiting period for maternity coverage differs from product to product. In some cases, it may be 72 months while some plans may allow claims under this coverage after a period of 12 months only. * Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.