Maternity health insurance is an add on cover that one can opt for in an Individual Health Insurance plan or Family Health Insurance Plan. This health insurance with maternity cover can cover your maternity related expenses like the delivery costs, both C-section and normal during the policy tenure up to the sum insured. Read on to know how your employees can claim the cover, why this cover is important, pros and cons.
Pregnancy is a significant phase of life for many people. In order to experience a pressure free parenthood it is important to plan both mentally and financially. Maternity related expenses like hospitalization charges, newborn baby expenses have become a costly affair these days.
Hence, proper financial planning by opting for proper health insurance with maternity cover can take the financial burden off your head.
Read: Maternity benefits act
Maternity health insurance is an add on cover that one can opt for in an Individual Health Insurance plan or Family Health Insurance Plan. This health insurance with maternity cover can cover your maternity related expenses like the delivery costs, both C-section and normal during the policy tenure up to the sum insured.
Anyone with an existing health insurance or is planning to take it in the future can opt for health insurance with maternity cover in India. This plan will not only benefit the policyholder but also the spouse in the time of need. For instance, if the husband is the policyholder, opting for maternity health insurance can cover his wife.
The medical expenses are continuously increasing these days. According to Business Today, the healthcare inflation rate in India is 15% a year.
Now this is too technical, isn’t it? Now let's cut down to the basic facts
Now these costs highly depend on the area of residence and the city you live in.
Also, opting for the best health insurance with maternity cover can provide you with great financial security during pregnancy and childbirth. It can cover your hospitalization expenses, delivery expenses and sometimes your newborn baby expenses up to 90 days are also covered.
Not only that, opting for a health insurance policy means you can also save on your taxes. Under the section 80D of the Income Tax act of 1961, one can avail tax benefits in health insurance for paying the premiums.
Here are the essential benefits of choosing maternity insurance or a health insurance plan with maternity cover:
Reduces financial burden by covering normal and C-section delivery expenses.
Most plans cover medical expenses 30 days before and 60 days after delivery.
Covers newborn hospitalization and medical care for up to 90 days from birth.
Access cashless delivery at network hospitals, reducing out-of-pocket expenses.
Includes coverage for emergency C-sections and complications arising during pregnancy.
One can choose the best maternity cover health insurance by considering the following factors in mind. You can compare health insurance plans by various factors, but these remain the basic points of comparison for maternity health insurance.
A maternity health insurance covers hospitalization expenses 30 days before the delivery and 60 days after delivery. However, the number of days covered during this period can vary from one insurer to another.
The maternity cover in health insurance covers the delivery expenses, normal or c-section delivery both are covered in the plan. However, if the cost exceeds the sum insured then, the rest may be paid by the policyholder. In some cases one can opt for a co-pay health insurance scheme.
The health insurance with maternity cover also extends the coverage for the newborn baby from day one, for up to 90 days without any additional premium. This may also include premature labor, vaccination expenses depending on your insurer.
A most important factor in any health insurance maternity cover is the ease of settling claims. Make sure the insurer has a good network of Third Party Administrators (TPA) and network hospitals for cashless claim settlement. If it is not a network hospital, then make sure your insurer has an easy reimbursement claim settlement option.
There are a few expenses that may not fall under the health insurance with maternity cover. However, this may be subjective to the insurer.
Most health insurance companies do not cover the expenses due to infertility treatments or IVF procedures under the maternity health insurance. Make sure you read the policy related documents carefully as there are a few insurers who may cover these expenses also.
Under the maternity insurance, the consultation fees for the regular gynaecologist visit are not covered.
In most cases your maternity health insurance may cover the cost of medicines prescribed by your doctor. However, other medicines like supplements which are taken additionally may not be covered. This maternity insurance plan may not cover non-allopathic medicines or treatment unless specified.
The charges against collection and storage of stem cells are not covered by the maternity cover health insurance.
A good understanding of maternity insurance plans offered by various health insurers is required before making any financial decisions. Here is a list of a few health insurance companies providing maternity insurance plans.
SBI maternity insurance comes under the SBI Arogya Premier Plan. Anyone aged between 18 years to 65 years are eligible to purchase this plan. The SBI maternity insurance waiting period is around 9 months. After this waiting period this policy covers maternity related expenses. The sum insured starts from 10 lakhs and goes upto 30 lakhs. Another advantage of this policy is that people up to 55 years of age with no medical history do not require a medical checkup.
The Star health insurance for maternity comes under a policy called Star wedding gift insurance policy. Any couple aged between 18 to 40 years are eligible to purchase this policy. There are two options available in this policy. This plan covers up to two deliveries including normal and c-section deliveries. It also covers hospitalization expenses, pre and post natal expenses, post delivery complications for the mother and newborn baby expenses. However, it comes with a waiting period of 3 years and the maximum sum insured is 10 lakhs.
It was previously known as Religare joy maternity insurance plan. Under this option called Care health joy today plan, one will be able to claim the maternity expenses after a waiting period of 9 months. However, under Care health joy tomorrow plan one has to wait for a span of 2 years to cover the maternity expenses.
Many employers offer group health insurance with maternity cover for employees and spouses.
Key benefits include:
Because employers customize plans, the maternity limit usually ranges from ₹25,000 to ₹1,00,000, depending on the company’s policy. Group plans are often more generous than retail maternity insurance. However, this can vary among different health insurance companies in India.
A maternity cover in health insurance is an add-on cover that one can opt for in an existing health insurance policy to cover the policyholder or the spouse.
The second childbirth will be covered by maternity health insurance if you have an add on maternity cover in your health insurance. This covers up to the prescribed sum insured in the policy.
In Star Health Insurance, the maternity insurance comes under the Star Comprehensive Insurance Policy. The maximum sum insured in this policy is Rs. 5 Lakhs.
Yes, the newborn baby is covered from day 1 to 90 days in health insurance with maternity cover.
The health insurers consider pregnancy as a pre-existing condition and hence there is a waiting period for it. Hence, it is advisable to purchase a maternity cover in advance.
In maternity health insurance, maternity related hospitalization, delivery expenses and newborn baby expenses are generally covered.
There are two ways to claim maternity insurance. They are cashless claims and reimbursement claims. In a cashless claim, the insurer directly settles the claim to the network hospital. Under a reimbursement claim, the policyholder pays the bills during hospitalization and later reimburses it from the insurer. The health insurance claim process depends upon the type of hospital you choose, a network or a non-network hospital.
Read: What is Domiciliary Hospitalization?
Offer your employees the benefit of health insurance with maternity cover. Pazcare offers group medical insurance plans that comes with an add-on maternity coverage. The plan offers coverage to most maternity related expenses like hospitalization charges, delivery expenses, newborn baby cover up to 90 days. Not only this, you can step up the employee benefits experience by including corporate wellness programs in your benefits plan. The wellness programs include unlimited doctor consultations, personalized therapy sessions, healthcare packages specially curated for women, regular health check-ups at discounted prices. To know more about group health insurance and its benefits, read the group health insurance guide curated by Pazcare.
Talk to our team to get more insights and competitive quotes for your team.
The waiting period varies from insurer to insurer. In some companies, the maternity and newborn waiting period are from 2 to 4 years.
Maternity insurance is insurance that covers expenses related to maternity like hospitalization, C-section, delivery expenses, newborn expenses etc.
Legally, a woman should have worked with the company for at 80 days minimum in the 12 months preceding the date of her expected delivery.
A maternity cover in health insurance is an add-on cover that one can opt for in an existing health insurance policy to cover the policyholder or the spouse.
In maternity health insurance, maternity related hospitalization, delivery expenses and newborn baby expenses are generally covered.
Maternity is not covered in group health insurance by default. It is an add-on cover that you can buy and add to your base group health policy.
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