Maternity insurance covers the delivery expenses of both normal and caesarean deliveries. You can get maternity health insurance as an addon rider by paying a little extra premium. Depending upon the options and top-ups you choose, it may also cover ambulance, pre and post-natal care of infants, medicines, tests, etc.
Also See: Health Insurance For Heart Patients
Modernization and westernization are tightening their grip over India. It is good as it has brought India on the world map. To a great extent it is bringing gender equality but as everything has a flip side, it has a big role in shifting the average age of women becoming mothers from 26-27 years to 32-33 years.
As women have started giving more importance to their careers, they tend to plan their families in their 30s as motherhood in their career formation years can jeopardize their growth. But this choice has its own consequences as having a first child in the 30s can have complications in the pregnancy.
This increases the ratio of caesarean deliveries to normal deliveries very significantly in metropolitan cities. That is why many women are opting for health plans that offer maternity cover. Maternity plans, in general, have a long waiting period. The Waiting Period can extend to 3-6 years. Thus, at times it becomes futile to go for a Maternity insurance plan.
Maternity Health Insurance Plan Details
It is important to note that most maternity health insurance policies have a waiting period of 3-4 years. Maternity health insurance is, therefore, a critical aspect of a planned pregnancy.
The Coverage varies from Insurer to insurer but some general expenses which may be covered are as follows:
Inclusions in Maternity Insurance
- Hospitalization expenses (with a cap)
- Pre-hospitalization expenses: 30days
- Post-hospitalization expenses: 60days
- Delivery expenses
- Ambulance charges
- Pre and postnatal expenses (depends upon the type of delivery- cesarean and normal)
- Baby cover (if new-born is diagnosed with congenital disorders)
- Emergencies (several insurances provides cover emergencies for up to Rs. 50000)
Exclusions in Maternity Insurance
- Non-allopathic treatment costs
- Consultation fees
- Regular check-ups
- Medicine costs
- Congenital diseases
- Termination of pregnancy (Under 12 weeks)
- Pre-existing ailments or injuries diagnosed within 48 months of the policy commencement
- Expenses related to self-inflicted injuries, drug use or alcohol
- AIDS treatment-related expenses
- Dental treatment expenses
- In-vitro-fertilization and infertility related expenses.
Maternity Health Insurance Premium
A Health Insurance Policy with Maternity Coverage is expensive as it is considered a high-Risk product owing to almost 100% Claim ratio as opposed to other insurance policies. Premium, which is typically higher than basic policies depends upon various factors as listed below:
- Type of industry
- Risk factors
- Age profile
- Number of employees (group policies)
- Company location (group policies)
When shall be the right time to seek such a plan? Maternity is a life-altering journey for a woman in more way than one with rising medical Inflation and overall expenditure; childbirth-related expenses have become expensive.
Lack of proper planning may result in you burning a hole in your pocket which may override the happiness of being blessed with a child. According to experts, you should plan well in advance given that maternity health insurance policies typically have a long waiting period, which may prove to be tricky for most consumers.
Given that most insurance companies do not offer maternity health insurance to the woman who is already pregnant, deeming it as a pre-existing condition, women who wish to take maternity insurance should apply for it before they conceive.
Top 5 Maternity Health Insurance Plans in India – 2020
Below is the list of top 5 health plans with maternity coverage that you should consider in 2020.
Note: This is Not IRDAI Ranking. Here, I just listed health insurance plans which come with maternity coverage.
This is a designated maternity insurance policy. There are many benefits to this plan. Some of them are:
- Cover for 2 deliveries.
- All hospital expenses covered, including childbirth through caesarean section.
- Cover for all medical expenses of the newborn baby. Additional lump sum payment if the baby is diagnosed with cerebral palsy or Down’s syndrome after birth.
- Pre and postnatal expenses.
This plan has a waiting period of 2 years. And this is suitable for couples who want to start a family after a couple of years of their marriage.
The Easy Health Exclusive plan is a comprehensive health insurance plan from Apollo Munich. This plan has provisions for maternity coverage. Under this plan, claims can be made for:
- Maternity expenses, including caesarean sections.
- Newborn medical expenses, for babies aged 0 – 90 days.
- Pre and postnatal care expenses.
A maximum amount of ₹ 50,000 can be claimed for maternity expenses under this plan. There is a waiting period of four years for the maternity benefits under this plan.
Maternity coverage is available under the Gold Family Floater option of the Health Assure Plan from HDFC Life. HDFC Life is one of the most reputed health insurance providers in India. Under this plan, claims can be possible for:
- Inpatient maternity expenses.
- Legal medical termination of pregnancy.
But the expenses of the newborn baby will not be covered under this policy. Here, there is a waiting period of three years for maternity benefits.
The Complete Health Insurance Plan from ICICI Lombard also has provisions for maternity coverage. If you opt for this option you can claim:
- Medical expenses incurred due to childbirth, including caesarean section operations.
- Medical expenses of the newborn for the first 3 months.
- Pre and postnatal expenses.
But this coverage also has a waiting period of three years. A maximum claim of ₹ 25,000 for caesarean sections and ₹ 15,000 for normal deliveries can be possible under this policy.
- The plan provides coverage for expenses related to pregnancy and childbirth including hospitalization.
- Expenses of newborn babies up to the age of 90 days.
- A waiting period of 9 months for Joy Today and 24 months for Joy Tomorrow.
This is a very good plan as the waiting period is relatively lower. Also, it is one of the few policies to provide maternity cover for up to 45 years of age.
A steep rise in maternity expenses over the years is forcing couples to look for options to fund this expense and hence insurers highlight the maternity benefit feature in their health insurance policies.
The couple purchasing these policies should fully understand the scope, Exclusions, and pricing of these policies and also create a separate medical fund to meet this requirement.