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Is Pregnancy Covered Under Health Insurance?

Motherhood is the beginning of a whole new journey for two adults becoming parents. It is an exciting and thrilling phase for new to be parents. Every new experience brings along its share of responsibilities and expenses. During pregnancy and childbirth, the mother and child have to undergo various medication and health care treatments. These generate medicinal bills, hospitalisation bills during childbirth, medical expenses, nursing bills, etc. One must plan before even planning a baby. A health insurance policy in this regard can be a boon. Most health Insurance policies cover both health and medical expenses before and after having a baby.

Reasons to Purchase a Pregnancy Insurance

Maternity insurance covers all maternity and health care cost for both expecting mothers and their new born babies. The maternity benefit can be availed as an add-on or additional rider with your existing critical illness policy, health policy, best medical insurance policy, etc. Maternity insurance benefit is also provided by corporates for their female employees under a Group Health insurance policy. However, the coverage provided under either policy has a sub-limit that is not enough to pay for all costs of pregnancy. It is best if you can purchase a complete pregnancy health insurance package.

List of Insurance Plans with Maternity Insurance Cover

To answer the question- is maternity covered under a health insurance plan: YES, it is covered. However, earlier it is covered as an add-on or rider cover on additional premium. However, with the advancements of the health insurance sector, may insurance providers have introduced health insurance plans in India with a maternity cover as an in-built benefit.

Here’s the list of some of the best maternity insurance cover available with the various Indian insurers. One can consider them as per the need and budget:

Insurance Policy

Sum Insured

Features

Aditya Birla Active Health Platinum- Enhanced plan

2 lakh to 2 crore

· Covers expenses for the new born baby's necessary medical treatments, vaccinations,

· and lawful medical termination of the pregnancy.

· The sum assured ranges from Rs 2 lakh to Rs 2 Crores,

Bajaj Allianz Health Guard Gold Family Floater Policy

3-50 Lakh

· Family float plan covers maternity and new born baby expenses

· Coverage from Rs 3 lakh to Rs 50 lakh

Bharti AXA Smart Super Health Insurance Policy

5-100 Lakh

· Is of three types: Value, Classic and Uber plan

· The cover value, the sum assured differs from plan to plan

· It may provide coverage from Rs 50,000/- to 3 lakh

Care (Formerly known as Religare) Joy Health Insurance Plan

3/5 Lakh

· After 9 months of policy purchase, you can claim maternity expenses

Cholamandalam Privilege Healthline Insurance Plan

5-25 Lakh

· Family floater plan covers maternity expenses after a waiting period of 5 years

· offers no claim bonus upto 50% of the sum assured

Digit Health Insurance with Maternity Cover

2-25 Lakh

· New born baby cover, costs of infertility, medically emergency termination of pregnancy

· increase of sum insured up to 200% for the second child

Edelweiss Health Insurance Gold and Platinum Plan

20 Lakh – 1 Crore

· Coverage is provided after

the completion of a waiting period of 4 years

Future Generali Health Total Mediclaim Insurance

Up to 1 Crore

 

· Offers maternity cover after the completion of the waiting period of 2-years

· both the parents are insured under the same plan

HDFC Easy Health Family Floater Plan (formerly known as Apollo Munich)

2- 5 Lakh

· exclusive and premium options cover maternity expenses incurred both before and after childbirth

· new born baby expenses from age 1-90 days

HDFC Ergo General Insurance my: Health Suraksha Gold Plan

7.5- 15 Lakh

· maternity benefits are provided after completion of 4 years of the waiting period

· sum assured from Rs 3 lacs to Rs 10 lakh

Kotak Mahindra Premier Plan

-

· Covers medical expenses incurred on the child delivery or legal termination of the baby

· Coverage provided for 2 deliveries during the policy term

Oriental Happy Family Floater Diamond Plan

12- 20 Lakh

· In addition to spouse and children, covers parents and parents in law

Royal Sundaram Lifeline Elite Plan

25 Lakh- 1.5 Crore

· Covers maternity hospitalisation and any complication arriving before or after delivery

· A waiting period of 3 years

Star Health Wedding Gift Pregnancy Cover

3/5 Lakh

· The plan provides coverage for normal as well as cesarean delivery including pre and postnatal expenses, and any post-delivery complication

· A waiting period of 3 years

SBI Arogya Premier Plan

10-30 Lakh

· Plan covers maternity expenses after 9 months of the waiting period

· Covers treatment expenses incurred on Ayurveda, Homeopathy, Siddha, and Unani treatment.

Tata AIG Medicare Premier Plan

5-50 Lakh

· Maternity expense cover

· cashless hospitalisation

· 7 family members can be covered

Universal Sompo Complete Healthcare Insurance

1-10 Lakh

· Complete healthcare plan

· Maternity cover and children benefits

· Can add dependents up to the age of 25


Features and Benefits of Health insurance with Pregnancy Cover

The policy comes with the following features and benefits:

  • Added coverage for all medical expenses and treatment during childbirth, including expenses during pregnancy complication or at birth, or c-section during your lifetime
  • Certain policies may also cover expenses for lawful termination of pregnancy during the policy term
  • Most maternity health insurance policies have a waiting period of 3 to 6 years in which no claim benefits are allowed. While Group health insurance policies offer maternity coverage with 9 months' waiting period and a sub-limit not more than Rs 50,000
  • Most critical illness policies and family health insurance policies may exclude pregnancy just like any other pre-existing illness.  
  • If the insured does not make any claims for a continuous period after the waiting period under any health insurance policy, then he or she is granted a no claim bonus which is a significant reduction in the premium amount for successive years’ premiums.
  • Mostly, insurance companies also offer cashless treatment at their network hospitals which you can choose from at the time of purchasing the policy

Important Factors to Consider While Buying a Maternity Cover

In order to ensure the right insurance coverage, one has to consider certain things. Here you go:

  • Policy must provide adequate cover for all or most of the pregnancy-related costs including hospitalisation, medications, tests, check-ups and on any unforeseen events.
  • Most policies do not allow claims to be made within the waiting period, which is 2-5 years in between before making this maternity benefit available. Therefore, it is advisable to purchase a maternity benefits policy in advance to claim the benefits in a time of need.
  • Compare and analyse all the features, benefits, clauses, terms and conditions before purchasing any health insurance plan.
  • Most policies may cover 20% to 30% of costs or more up to 50%. Learn the amount of coverage that is offered for maternity under your health insurance plan. 

How to Purchase a Maternity Insurance Policy Online?

To buy a policy online, you can go to the company’s online portal to learn of all the policy benefits, clauses, eligibility criteria, premium rates, etc. to make an informed decision. You can fill up the online application form and submit the same with all supporting documents for proof of age, proof of address, proof of identity, proof of pregnancy and medical test reports if required.

Once the application has been accepted, you can pay the initial premium amount  

Additionally, you can also buy the policy through insurance aggregators such as paisawiki.com. This is the most convenient way of buying insurance, where you get to compare the policies as well.

  • Just visit the official website of Paisawiki.com
  • Go to the ‘health’ option and click on ‘Get Free Quote’
  • Provide relevant information as per asked and click on ‘Submit’
  • A list of health insurance policies will be suggested as per your insurance need
  • You can select a maternity insurance plan and choose to ‘compare’ as well
  • After comparing and calculating the premiums, you can buy the policy directly from there.
  • The policy premiums are to be paid online using debit/credit card or net banking
  • Upon successful payment of the premiums, a soft copy of the policy will be sent to the registered mail Id. The hard copy will be sent to the mailing address.

FAQs

  • Q. Is maternity health insurance cover better than a critical illness insurance or group health insurance or family floater health insurance policy?

    Ans: Although most health insurance policies provide pregnancy coverage, these have sub-limits and limited coverage sum. However, a complete maturity plan will cover all expenses and costs related to treatment during pregnancy, at childbirth, and pre and postnatal care expenses.

  • Q. If my company has a group maternity cover, do I need to purchase a separate policy also?

    Ans: Under group maternity plans, the premium to be paid in comparison to individual maternity insurance is very less. But benefits are also limited. However, certain insurance companies may offer more benefits than in comparison to an individual policy. Therefore, it is advisable to first claim under group insurance for maximum benefit and then make a claim for an individual plan. For that you must have a separate insurance plan in place, apart from a group insurance plan.

  • Q. How early in life should I buy maternity policy?

    Ans: It is best to start investing as early as possible for increased sum assurance at lowest of premium rates. If you eventually plan to have a baby, you must plan to purchase a policy in time to cope with ever-increasing medical expenses and treatment costs with time.

  • Q. Will Maternity insurance cover all costs from end to end?

    Ans: Maximum insurance policies cover most costs under maternity cover. It is best to read all policy documents to know the exact coverage rate and amount without solely focusing on the claiming aspect of the policy.

  • Q. Can basic health care insurance be enough for maternity expenses?

    Ans: A basic health insurance plan covers more than one illness and disease and not just Maternity Cover. It's a valuable feature only for a particular period and for a limited amount. However, medical costs are forever on the rise, so depending on your ability and coverage you seek, you must choose a health insurance policy accordingly.

  • Q. How do I claim maternity cover?

    Ans: First, inform the insurance company about your pregnancy if your health insurance policy provides maternity cover. The moment you get hospitalised for the delivery of your baby, you should raise the claim with your insurance company. The sooner, the better. Thus, you should make a claim as early as possible.

Written By: Paisawiki - Updated: 03 November 2020

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