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Maternity health insurance

Health Insurance Guidelines

Getting pregnant and embracing motherhood is the greatest joy that a woman can experience. The phase of a nine-month pregnancy of a woman is like a roller-coaster ride when she undergoes a wave of emotions along with several changes in her physical and hormonal self. On one hand, there is this immense joy of being a parent and on the other there is also the fear of the impending associated expenses.

All this makes it inevitable for would-be parents to be well prepared financially. A maternity health insurance is a plan that helps in handling the soaring costs of medical treatment during pregnancy and after the birth of the new-born. Let’s delve more into this topic in this post.

What is Maternity Health Insurance?

Maternity health insurance is a health plan crafted to cover the maternity expenses of pregnant and expecting mothers along with their newly born child. A maternity insurance plan can be bought as a full-fledged insurance policy or as a rider with your existing health plan. It covers the expenses of both normal and cesarean delivery. Such a plan covers everything starting from pre-and post-hospitalization, room rent, consultation, surgeon fee, delivery cost, medications, tests, anaesthetist etc.

Features of Maternity health Insurance

Here are some key features of maternity health insurance plans:

Features  Specifications
Cashless reimbursement in network hospital   Available 
Sum insured  Up to INR 50 lakh
Newborn Care   Covered 
Tax benefits  Available 
Ambulance charges   Covered 
OPD Cover  Covered 
Daycare Procedures Covered 
Pre-and Postnatal Care  Covered 
health insurance plan

Get ₹5 lac health insurance

starting @ ₹245/month*
*Terms & conditions apply

Who is Eligible to Avail Maternity Health Insurance?

Parenthood does bring great joys. However, it also brings associated expenses and large medical bills throughout the term of pregnancy. Hence, it is important to stay prepared with appropriate health insurance.

The criteria of eligibility to avail a maternity health plan differs as per the insurance companies. 18 years is the minimum age at which a woman can buy maternity insurance, while the maximum limit of age is 45 years. You must also note that maternity insurance comes with a waiting period of 9 months to 6 years before the insured could avail the benefits.

Documents needed to buy Maternity health Insurance

Below are the documents needed while buying a maternity health insurance plan:

  • Duly filled application form
  • Address proof like telephone bill, PAN card, Passport, Ration Card, electricity bill, Aadhaar card, etc.
  • Passport size photographs
  • Identity proof like passport, Aadhaar card, Pan card, voting ID card etc.

How to raise a claim for Maternity health Insurance

Here are the steps to follow:

  • Notify the insurer and submit the duly filled claim form offered by the hospital
  • Once the hospital does the paperwork, they will send notification to the insurance provider
  • The insurer will verify the papers and will pay the hospital as part of the cashless claim payment
  • If you go for the reimbursement system of payment, you can pay the hospital bill at the time of discharge. Later, you can raise a claim with your insurer within the prescribed time frame with all the paperwork and seek for a reimbursement claim

Inclusions of Maternity health Insurance

The inclusions of maternity health insurance might vary as per the insurance company. Here are some common inclusions:

  • Normal/Cesarean delivery
  • Room rent charges
  • Prenatal expenses
  • Post-natal expenses
  • Hospitalization costs for patients
  • New born baby cover
  • Complications in pregnancy
  • Expenses of medically necessary termination of pregnancy
  • Preservation of stem cell
  • Ambulance expenses
  • Daycare treatments etc.
health insurance

Get ₹10 lac health insurance

starting @ ₹334/month*
*!Terms & conditions apply

Exclusions of Maternity health Insurance

Like inclusions, the exclusions might also vary from insurer to insurer. Here are some common exclusions of pregnancy health insurance:

  • IVF or In-vitro fertilization treatment
  • Ectopic pregnancy expenses
  • Expenses of pre- and post-hospitalization
  • Regular check up
  • Late pregnancies above 45 years of age
  • Expenses of surrogacy etc.

Best Maternity Health Insurance Plans in India 2023

There are several insurance companies offering health insurance with maternity cover as an in-built feature of their plan or as an add-on benefit. Here are some popular maternity insurance plans mentioned in the table below:

Name of the Insurance Company Name of the Health Insurance Plan Waiting period Entry age Sum insured  Benefits of the Plan 
Aditya Birla Health Insurance Activ Health Platinum Enhanced Plan 48 months 18 - 45 years INR 2 lakh - 2 Crore Organ Donor Expenses Pre-Hospitalisation Post-Hospitalisation Expenses In-Patient Hospitalisation 
ManipalCigna Health Insurance ProHealth Insurance Plan 48 months 18 - 45 years INR 4.5 lakh – 1 crore In-Patient Hospitalisation  Daycare Expenses Domiciliary Hospitalisation 
Royal Sundaram General Insurance Total Health Plus Plan 36 months 18 - 65 years INR 3 lakh - 10 lakh In-Patient Hospitalisation  Maternity Expenses Pre-Hospitalisation Post-Hospitalisation 
Care Health Insurance Joy Plan 48 months 18 - 65 years INR 3 lakh -5 lakh Pre-Hospitalisation  Post-Hospitalisation  In-Patient Hospitalisation  Daycare Procedures
Bajaj Allianz General Insurance Health Guard Family Floater Plan 72 months 18 - 65 years INR 3 lakh – 1 crore Pre-Hospitalisation  Post-Hospitalisation  Ambulance Expenses Daycare Treatments

To Conclude

A maternity or pregnancy insurance is an important coverage for a family to embrace parenthood. However, it is important to consider the maternity plan well before purchasing a health insurance that covers pregnancy so that you can get maximum benefit from it. Along with waiting periods, new-born care and number of child births, one should also check if the policy covers abortion or termination of pregnancy.

Frequently Asked Questions

No. Maternity insurance coverage is not available without a waiting period in India. There is a waiting period of 9 months to 6 years on all maternity plans offered in the country.

No. Maternity insurance policies cannot be bought if the female is already pregnant as these plans are available with a compulsory waiting period.

Yes. They are beneficial and women who are planning to start a family soon must opt for a maternity insurance plan. These plans cover the medical expenses incurred during the pregnancy period as well as the expenses of the new-born baby.

Here are the things to consider:

  • Waiting period of the maternity insurance
  • Number of child births covered under the plan
  • Amount of coverage offered to the new born baby
  • The eligibility criteria of the plan
  • Added benefits

Though most policies allow coverage for two children only. But there might be some plan allowing coverage to the third child.

* Rs. 245/month is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*! Rs. 334/month is the starting price for a 10 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*@ Rs. 12/day is the starting price for a 5 lac family health insurance for an 25-year-old male and 22-year-old female, with no pre-existing diseases.
*# Rs. 12/day is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*$ Rs. 600/month is the starting price for a 20 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*^ Rs. 12/day is the starting price for a health insurance that covers coronavirus for an 25-year-old male, with no pre-existing diseases.