Maternity Health Insurance: Things You Must Know About


4 min read

Motherhood is a joyous feeling. The delight of bringing a new life into the world, the maturity of taking on a responsibility of a child, watching the child grow, all these joys can only be experienced by parents. But what about the associated costs? Aren’t the costs a nightmare?

Right from the time you get pregnant till the time your child becomes financially independent, there are huge expenses involved. What if some of these expenses are handled?

Yes, you heard me right. There are health insurance policies which provide coverage for maternity. Maternity insurance cover is either inbuilt in the plan itself or you can take it by paying an additional premium. In most cases you find maternity cover inbuilt in the plan benefits.

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Salient features of maternity insurance in health insurance plans

Coverage extended

Under maternity cover you would find that health insurance plans specify a limit on the amount of coverage extended. These limits vary for normal delivery and Cesarean delivery. There is a higher limit for Cesarean delivery compared to normal one. Moreover, the limits depend on the Sum Insured. The higher the Sum Insured the higher would be the limit on maternity coverage. Under maternity insurance, only hospitalization expenses incurred at the time of maternity and delivery are covered. For instance, say the limit on Cesarean delivery under the plan is Rs.50, 000. During your pregnancy you get hospitalized for maternity related complications twice and incur a bill of Rs.10, 000. At the time of delivery, the allowed limit of health insurance would be Rs.40, 000 since you already claimed Rs.10, 000 earlier.


Maternity coverage also has some common exclusions although the coverage varies between different plans. These common exclusions include the following:

  • Fertility related treatments
  • Abortion or termination of pregnancy
  • Premature birth defects in the baby
  • Expenses incurred on the child. You might find some of these exclusions covered in some plans but in most plans these exclusions are common. So, when you are considering maternity insurance keep an eye out for these exclusions.

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Group insurance vis-à-vis individual insurance

There is a difference between group insurance plans and individual insurance plans when it comes to maternity coverage. Many group insurance plans do not provide coverage for maternity. If you are enrolled in a group plan, check for maternity coverage. If there is no coverage, you would have to opt for an individual plan. Other group plans which provide maternity coverage cover new born babies either from Day 1 or after the baby has completed 3 months. So, you would have to check for the coverage of the new born baby in your group insurance plan.

Waiting Period

A very common and important feature of maternity cover is the inherent waiting period. Any health insurance plan which covers maternity provides coverage only after a specified waiting period. This waiting period usually ranges from 2 years to 6 years and it varies between different health insurance plans. Considering this waiting period is very important if you are thinking of starting a family soon. That is why it is always advised to buy maternity insurance at the earliest so that when you would start a family the applicable waiting period would be over.

Claiming maternity cover

As stated earlier, there is a limit on maternity coverage provided by a health insurance plan. When you incur maternity related expenses and are making a claim, remember that claims would be admissible only up to the specified limit. Moreover, your hospital bill should present clubbed charges for the mother and the new-born baby. If the baby’s charges are billed separately your health insurance policy would not pay for such separate charges. Maternity insurance comes in handy in shouldering the huge expenses involved with pregnancy and child birth. However, before you buy a health insurance plan covering maternity you should be aware of the above-mentioned features. Compare between the different maternity coverage plans and choose a plan which has the highest limit on coverage, has a low waiting period and has minimum exclusions. Motherhood is a joyful feeling. Don’t let the expenses weigh you down. Buy a maternity insurance plan.

Choose wisely!

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FAQs: Things You Must Know about Maternity Health Insurance Plans

What all things are covered in maternity insurance?

A maternity insurance policy is a type of health insurance policy that covers the medical expenses for delivery, hospitalisation, and medicines. Parenthood is one of the most significant life experiences for a couple.

What is not covered under maternity insurance?

What is Not Covered under Maternity Insurance Plan? Pre-existing diseases affecting pregnancy. Congenital Diseases. Treatment expenses related to infertility.

Can I take maternity insurance if already pregnant?

Most insurance companies do not provide maternity insurance if you are already pregnant. This is because they consider your pregnancy as a pre-existing condition and is beyond the policy cover.

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Feb 26, 2021
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PayBima Team
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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