Maternity Health Insurance: Buy Pregnancy Insurance Plan
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Maternity Health Insurance

Health Insurance Plans

What is a Maternity Insurance Plan?

A maternity insurance plan is a type of health insurance plan that helps cover expenses related to pregnancy and childbirth. This plan allows you to manage costs associated with childbirth and maternity care, including pre- and post-natal expenses and delivery charges, among others. Delivery charges based on normal or caesarean procedures can range from a few thousand rupees to lakhs.

A maternity health insurance plan helps you meet these expenses with ease. Depending on the plan’s terms and conditions, it can also provide expenses for the hospitalisation of the newborn along with vaccination.

Why Do You Need Maternity Insurance?

Maternity insurance is needed to:

Cover medical expenses related to childbirth

With the rising medical inflation, the cost of childbirth procedures have shot up rapidly. In private hospitals and nursing homes, it can easily cost up to a lakh of rupees. Maternity health insurance helps you meet this cost without requiring you to dip into your savings.

Access to quality healthcare

Parents want the best possible healthcare for their newborn child. A maternity health insurance plan provides you with the financial muscle to access better healthcare facilities at top hospitals and nursing homes for both, the mother and the child.

Cashless hospitalisation

Childbirths are time-sensitive affairs. A maternity health insurance plan allows cashless hospitalisation, thereby ensuring you receive medical attention as soon as possible without worrying about making upfront payments.

Coverage for newborn

A maternity health insurance plan also covers medical expenses for the newborn for a specific period after childbirth, including vaccinations.

Having maternity insurance gives you peace of mind and financial security in one of the most important phases of your life.

Coverage for pre-and post-natal expenses

There are multiple expenses that you need to bear before and after childbirth. A maternity health insurance plan helps you cover pre-and-post natal expenses. Prenatal expenses include doctor’s visits, medications, various tests, etc. On the other hand, postnatal expenses are costs incurred after delivery, including hospitalisation stay, tests for the newborn, etc.

Maternity Health Insurance - Eligibility Criteria

While the specifics may differ across policies, to buy the policy:

  • You must be within a certain age bracket, which can range from 18 to 50 years
  • You need to complete a certain waiting period before the coverage kicks in (generally 24 months)
  • You will covered only for a fixed number of deliveries in your lifetime (max 3 in most cases)

Talk to your insurer before buying the policy to know the specific eligibility criteria.

Maternity & Newborn Cover With Health Insurance

Maternity and newborn coverage is generally offered as an add-on to health insurance. It means you get this coverage by paying an additional premium over and above the base policy premium. It is essential to note that maternity health insurance generally has a waiting period of 24 months or 2 years. That said, several policies offer you the option to reduce the waiting period through add-ons or optional covers from 24 months to 12 months.

Also, if you have taken a policy without maternity cover and want to opt for it, you can ask your insurer to add it at the time of renewal.

Health Insurance Plans

Features of Maternity Insurance Plan

Some key features of a maternity health insurance plan are as follows:

Comprehensive coverage

Maternity insurance offers comprehensive coverage, including pre-and-postnatal expenses, costs for vaccination, etc.

Easy application

You can buy maternity health insurance online in a few clicks, hassle-free.

Reduces your tax outgo

The premiums paid towards a maternity health insurance plan qualify for tax exemption under section 80D of the Income Tax Act under the old tax regime.

Advantages of Maternity Insurance Plan

The advantages of maternity health insurance are multi-fold. These include:

  • Financial preparedness before childbirth
  • A cashless facility ensures no waiting for reimbursement
  • Ensures funds are not a paucity during delivery

Inclusions in Maternity Insurance

  • Inclusions
  • Exclusions

Though specifics may differ across policies, here are some inclusions of a maternity insurance plan:

  • Pays for maternity expenses

    This insurance policy covers maternity expenses incurred during childbirth. This could be a flat sum insured or a certain percentage of the annual sum insured by a health policy offering maternity cover. The policy also covers expenses related to the medically recommended lawful termination of pregnancy only for life-threatening situations, subject to a maximum of 3 terminations.

  • Pays for prenatal and postnatal expenses

    The policy covers prenatal (from conception until baby delivery) and postnatal (after childbirth) expenses. Generally, postnatal expenses incurred on an inpatient basis up to 30 days from the date of baby delivery are covered.

  • Newborn baby cover

    A maternity health insurance plan covers medical expenses incurred on hospitalisation (for a minimum consecutive 24 hours) of a newborn baby. Note that costs are covered for a specific period - a maximum of 90 days from the baby’s birth.

  • Vaccination for the new born baby in the first year

    A maternity insurance plan covers vaccination expenses for newborn babies until they are one year old during the policy period, subject to a maximum limit as per the policy’s terms and conditions (₹10,000 max).

Maternity insurance has certain exclusions. Exclusions are events under which you will not be covered under a maternity health insurance plan. These include:

  • Unlawful termination of pregnancy
  • Any medical expenses incurred for the management of Ectopic pregnancy
  • Medical treatment expenses traceable to childbirth, including complicated deliveries and caesarean sections incurred during hospitalisation
  • Expenses incurred during the waiting period
  • Maternity benefits availed outside the geographical boundaries of India
  • Expenses towards miscarriage, unless due to an accident

When to Purchase Maternity Health Insurance?

As maternity health insurance has a waiting period, it’s best to purchase it a couple of years before family planning. This ensures you meet the waiting period clause and get coverage during pregnancy and childbirth. Compare different plans and choose the best that fits your needs.

Documents Required to Apply for Maternity Health Insurance

You need to provide basic documents related to identity and address to buy maternity health insurance. These could be:

  • Aadhaar card
  • PAN card
  • Voter card
  • Passport
  • Driving licence

Your insurer will inform you if you need to produce any additional documents to buy this plan, which could be medical reports in certain cases.

Frequently Asked Questions on Maternity Health Insurances

Can I purchase maternity insurance if I’m already pregnant?

While you can purchase maternity insurance if you are pregnant, note that coverage kicks-in only after the waiting period.

Can I claim maternity benefits from two insurance policies?

While you can purchase maternity insurance if you are pregnant, coverage kicks in only after the waiting period.

Can both husband and wife claim maternity insurance?

If both husband and wife have separate policies, they can claim maternity insurance from their respective policies.

Why should I consider buying maternity insurance?

Maternity health insurance provides holistic coverage during pregnancy and childbirth. It eases financial burden and also covers pre- and post-natal expenses.

Is coverage available for a third childbirth under maternity insurance plans?

Most maternity insurance plans cover up to three deliveries. However, check the policy documents to see if the policy provides coverage for more than three childbirths.

What factors should I consider before purchasing maternity insurance?

Waiting period, sum insured on offer, inclusions and exclusions, insurer’s claim settlement ratio, quality of service, etc. are some factors to consider before buying maternity insurance.

How does the maternity insurance claims process work?

Inform your insurer about hospitalisation and fill out the claims forms along with the required documents, including original bills, receipts, discharge certificates, original investigation reports, etc.

Is there a maximum claim limit for maternity insurance?

Maternity coverage under a regular health policy is usually capped up to a certain percentage of the annual sum insured. For standalone maternity insurance plans, this could be a flat sum insured per your chosen policy.

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