What is Maternity Health Insurance?
Having a baby can be one of the most beautiful experiences in life. However, unless you are adequately prepared, it can also be a very anxious time. Having one extra member in the family means added expenses. So it’s important to prepare not just emotionally but also financially. This is where maternity health insurance comes to the rescue. It is designed to cover medical expenses that occur during a pregnancy. A maternity insurance policy includes pre-natal check-ups, cost of hospitalization at the time of delivery, post-natal treatment, etc., taking the financial burden off your shoulders!
What is the importance of Maternity Health Insurance?
Pregnancy brings a lot of joy and cheer. But it also carries with it a lot of extra expenses. Pregnancy and related complications are not covered by normal Health Insurance Policies. So, a couple needs to plan properly to meet these additional costs.
Almost all major companies in India provide health insurance with maternity coverage for their employees. However, there is a limit to this cover. Hence, it’s always wiser to take a personal Maternity Insurance Policy.
You can buy a stand-alone Maternity Insurance Policy or as an add-on to an existing Health Insurance Policy.
- Technology has enabled us to monitor a baby’s movements and heartbeats inside the womb. Deformities in the baby can also be traced before its birth. Some tests can monitor the mother’s health. However, all these cost a lot. A Maternity Insurance Policy can take care of all such expenses.
- Some policies of health insurance with maternity cover the expenses of the newborn baby for a few days. They also cover most of the prescribed vaccinations.
- Most policies of health insurance with maternity cover both normal and complicated deliveries. Some also offer newborn baby care in hospitals. These may also protect against congenital diseases.
- Post-delivery complications are also covered by most Maternity Health Insurance Policies.
What is the right time to take Maternity Health Insurance?
Most Maternity Health Insurance Policies have a waiting period of about 2-4 years. Also, most companies do not give maternity coverage to an already pregnant woman. Additionally, there is an age cap for the maternity cover. Considering all this, it’s better to buy a plan of health insurance with maternity coverage well before you plan to conceive.
Common Exclusions & Inclusions in Maternity Health Insurance
- Delivery Procedure Expense – Normal / Caesarean Section.
- Hospitalization, including the room rent, doctor’s fee, nurse’s charges, medicines, etc.
- Pre and post-natal charges.
- Child Cover for certain complications.
- Hospitalization arising out of any maternity-related issue. This can be either in the pre-natal period or post-pregnancy. Usually, this is for about 30 days in the pre-natal period and 60 days after the delivery.
- Emergency ambulance charges, if incurred.
- Vaccination costs of the baby for up to a period of 1 year.
Maternity Health Insurance Policies/Add-ons Offered by Various Companies
|Maximum Maternity Benefit
|Care Maternity Insurance – Joy Today
|Up to 2 deliveriesNew born cover
|Rs. 35,000 – 50,000Rs. 30,000 – 50,000
|1/ 2/ 3 years
|Bajaj Allainz Health-Guard
|Up to 2 deliveries/ terminations
|Rs 15,000- 30,000Rs 25,000- 35,000
|1/ 2/ 3 years
|SBI Arogya Premier
|Up to 2 deliveriesNewborn cover
|Rs. 15,000 for normal delivery and Rs. 25,000 for Caesarean Section, all inclusive, except vaccinationsDepending on plan
|1/ 2/ 3 years
|HDFC ERGO My Health Medisure Classic
|Up to 2 deliveriesTermination
|Rs. 20,000 for normal delivery and Rs. 40,000 for Caesarean Section, all inclusive
|1 year/ 2 years
|Niva Bupa Heartbeat Gold
|Up to 2 deliveries or terminationsNew born coverVaccinations for 1st year
|Rs 40000-1 Lakh, all inclusive
|1 year/ 2 years
Top maternity health insurance plans
Here is a detailed list of features and benefits of health insurance with maternity coverage plans mentioned in the table above –
- Care Joy Maternity Plan – Today
Care’s Joy plan is a specific maternity oriented health insurance plan which is suitable for families planning a kid soon. The plan comes in two variants of Today and Tomorrow. The salient features of the Today variant are mentioned below –
- Coverage for maternity is allowed after a very short waiting period of 9 months only
- The policy is available on an individual sum insured basis only
- Pre-entrance health check-ups are not needed if you are up to 45 years of age
- Coverage for maternity expenses also includes expenses incurred on pre-natal and post-natal care
- Newborn baby coverage is inbuilt under the policy wherein the newborn baby is covered for up to 90 days from the date of birth free of cost
- There is no sub-limit on room rent. You can avail of a single private AC room and the costs of the room would be covered under the plan
- The policy comes with a term of 1/ 2/ 3 years wherein you can pay the aggregate premium at once when buying the policy
- HDFC Ergo Health Easy Health Premium
HDFC Ergo Health’s Easy Health plan is a very popular health insurance plan which comes in three variants of Standard, Exclusive and Premium. Premium is the most advanced variant of the plan which has the following benefits –
- The plan can be taken on an individual or family floater sum insured basis
- There is a Stay Active benefit under the plan which allows premium discounts at the time of renewals if you take a specified number of steps during a policy year
- A daily cash benefit is paid if you choose shared accommodation or if you accompany a minor child
- Emergency air ambulance is allowed for higher levels of the sum insured
- OPD treatments are also covered by the plan for up to 1% of the sum insured subject to specified limits
- Free health check-ups are allowed every year
- You can enhance the scope of the policy by adding the critical illness rider available with the plan
- SBI Arogya Premier
This policy also extends coverage for maternity-related expenses after a short waiting period of 9 months. Other salient features of the policy are as follows –
- The sum insured is automatically restored if it is exhausted in a policy year. This restoration benefit is inbuilt under the plan and requires no additional premium
- No pre-entrance health check-ups are needed till 55 years of age
- You can enjoy an increase in the sum insured by 10% every year free of cost if no claims are made in the previous policy year. This increase is allowed on a cumulative basis up to a maximum of 50%
- Free health check-ups are allowed under the plan after every 4 policy years
- Air ambulance costs are also covered under the policy for up to INR 1 lakh
- HDFC Ergo my: Health Medisure Classic
This is a comprehensive health insurance plan which allows coverage for maternity related expenses after a waiting period. The features and benefits of this health insurance with maternity plan are as follows –
- Pre and post hospitalisation expenses are covered for 30 days and 60 days respectively
- Domiciliary hospitalisation expenses are also covered provided such hospitalisation exceeds 3 days
- The newborn baby gets automatically covered under the policy from birth till the first 90 days. Thereafter, the baby can be covered by paying an additional premium
- Coverage for non-allopathic AYUSH treatments is available under the plan for up to INR 25,000
- The plan allows optional coverage against critical illnesses. Moreover, you can avail an optional benefit of waiver of room rent limit by paying an additional premium
- Free health check-ups are allowed after 4 claim-free policy years
- The policy pays a hospital daily cash benefit if your hospitalisation exceeds 3 days
- No claim bonus of 5% increase in the sum insured is allowed for every claim-free year on a cumulative basis. The maximum increase allowed under the plan is 50%
- A premium discount of 10% can be availed if two or more family members are covered under the plan
- Niva Bupa Heartbeat Gold
Niva Bupa’s Heartbeat Gold is a popular health plan which offers coverage for maternity-related costs. The salient features of the policy are as follows –
- Coverage of up to INR 50 lakhs is available under the plan
- AYUSH treatments are covered up to the sum insured without any sub-limits
- Maternity coverage of up to INR 50,000 is allowed under the plan
- The plan covers the cost of pharmacy and diagnostic tests if such costs are incurred at a networked hospital
- Coverage for mental disorders and their treatment is provided
- 10% of the sum insured is increased up to a maximum of 100% every year if no claim is made and the plan is renewed
- Free health check-ups are allowed every year
- A range of optional coverage benefits are available under the policy
- Bajaj Allainz Health Guard-Gold
Bajaj Allainz Health Guard is comprehensive that would suit all your health-related requirements. The salient features of the policy are as follows –
- Under the Gold Variant of the Bajaj Allainz Health Guard, the cost of childbirth and pre and post-natal expenses are covered
- In the case of Sum Insured from Rs. 3 lakhs to 7.5 lakhs, the maximum liability is Rs 15,000 and Rs. 25,000 for normal delivery and cesarean delivery respectively
- In the case of Sum Insured from Rs. 10 lakhs to 50 lakhs, the maximum liability is Rs 25,000 and Rs. 35,000 for normal delivery and caesarean delivery respectively
- Ectopic pregnancy is not covered under this benefit, however, it would be covered under In-Patient treatment
- The complications that may arise due to the childbirth or maternity would be covered up to the sum insured
Claim Process for Maternity Health Insurance
To make a claim in your plan of health insurance with maternity, you should follow the below-mentioned steps –
- Inform the insurance company immediately of your claim and get it registered
- If you are seeking cashless claims, get admitted to a networked hospital
- Obtain a pre-authorization form and fill it up for getting the approval for cashless claim settlements. The form should be submitted to the insurance company within 24 hours of an emergency hospitalisation or 3-4 days before a planned hospitalisation
- Depending on the form submitted, the insurance company would approve cashless claims and you can avail treatments without paying the medical bills yourself
- After being discharged from the hospital, file your insurance claim with the company and get it settled
- In case of admission into a non-networked hospital, pay the medical bills yourself. After discharge, fill up a claim form and submit the relevant documents to get reimbursement of the medical expenses which you have incurred.
Documents required for claim settlement with Maternity health insurance
For the claim to be completely settled in your plan of health insurance for maternity, you need to submit the following documethe –
- Claim form, duly filled and signed
- Policy bond
- Identity proof of the insured
- Pre-authorization form for cashless claim approval
- Doctor’s referral letter which advises on hospitalisation
- All medical bills in original
- All hospital reports in original
- All medical records and prescriptions
- Test reports of diagnostic tests undertaken
- Discharge summary issued by the hospital
- Any other document needed by the insurance company for claim settlement
- In case of reimbursement claims, you should provide your bank account details wherein the money would be reimbursed. A cancelled cheque or passbook copy of your bank account might be submitted for bank details.
Pregnancy is a very important part of life, so it is wiser to understand the financial implications of pregnancy and choose a maternity insurance policy that will take care of the major expenses. Understand all the inclusions and exclusions before making a final decision. Maternity Insurance Plans are generally quite expensive. So choose either stand-alone health insurance with a maternity cover plan or an add-on based on your financial situation and requirement. Or, just choose Turtlemint. We are always there to guide you every step of the way.
Why Choose Turtlemint?
Turtlemint provides a one-stop destination for all your maternity insurance needs that is quick, simple, and convenient.
- Compare all maternity health insurance policies in India with one click and find the best one.
- Calculate the premium using our free premium calculator to understand the cost.
- Contact our experts to resolve any queries through online chat or telephonic discussions.
- Download all brochures and policy documents from one place.
- Buy the best maternity insurance policy online at Turtlemint.
- Do maternity insurance online renewal quickly.
Know how to renew your health insurance policy online
Most of the regular health insurance companies provide maternity health insurance as well. Either as a stand-alone plan or as an add-on.
There is a limit on the coverage. Refer above for details on some leading maternity health insurance plans and their coverage.
Different companies have different waiting periods. Though the average is between 3-4 years, some insurance companies have a low waiting period of 9 months.
Some regular health insurance policies include maternity cover as well.
Unless it is a group policy, no health insurance company will allow an already pregnant person to buy maternity insurance.
Some insurance companies cover the baby from birth till 90 days. After this period, the baby can be included in the family floater policy.
There are many health insurance plans which cover maternity related expenses. Under many plans maternity coverage is unbuilt under the scope of the policy while under some plans the cover is available as an optional benefit. So, if you are planning a family soon, you can invest in health insurance with maternity so that you can get coverage for the maternity expenses incurred at the time of childbirth.
There are many plans which cover maternity. Some plans include Care Joy, Star Health Family Health Optima, SBI Arogya Premier, Max Bupa Heartbeat Gold, etc.
The premium for a plan of health insurance with maternity depends on a lot of factors. These factors include the sum insured you have chosen, your age, number of insured members, your medical history and existing medical condition, the policy tenure and the pricing practice of the insurance company.
Individuals planning on having a child can purchase health insurance with maternity. The minimum entry age is 18 years and the maximum age up to which maternity coverage is allowed is usually limited to 45 years.