Maternity Insurance: All You Need To Know

by | Sep 11, 2024

Are you planning to buy a health insurance plan? Yes! Well in that case, you need to check whether it includes maternity insurance and associated cost. 

You must be asking – why maternity should be covered in a health insurance plan? You can bear the cost out of your pocket.

True. You can always bear the cost of your first baby birth on your own. 

But, the recent scenario is changing. 

Currently, the healthcare inflation has been rising at 18-20% annually. And the impact of price rise is affecting the maternity cost in urban cities. Even the rural healthcare inflation is also up.

According to a recent survey from Wise, the average cost of childbirth in India are as follows:

Regular Birth (Normal delivery) 15k – 75k
For a C-section birth 25k – 2 Lacs
In-Vitro Fertilisation Cost 2 Lacs – 3 Lacs

 

According to a study done by IIT Madras, the prevalence of C-section delivery in India increased from 17.2% to 21.5% in the last five years up to 2021. For the private sector hospitals, the number stands at 43.1% (2016) and 49.7% (2021).

From the above mentioned data and statistics, you must have understood the importance of maternity insurance policy in the current world. 

Now the big question is;

  1. What is Maternity Insurance?
  2. What is covered under a Maternity Insurance plan?
  3. What are the exclusions in Maternity Cover?
  4. Which insurance plans should you opt for Maternity cover?

In this article, we’ll try to uncover the basics of maternity cover in detail.

What is Maternity Insurance? 

It is pretty clear from the name that this insurance will cover the cost associated with your childbirth, including the pre- and post-natal expenses. 

Generally, many insurance companies are offering maternity insurance policy as a standalone product. While some insurance companies have clubbed this benefit as an add-on feature in regular health insurance plans.

What are covered (inclusions) under a Maternity Insurance plans?

We know that maternity insurance plans are designed in such a way that it protects your finances in the most crucial and happy times in your life. To understand the aspects of maternity insurance coverages, let’s dig deep into the policy features of reputed health insurers for understanding the coverage options and clauses.

Pre- and Post-Hospitalisation In general, it is covered from 30 days (pre-hospitalisation) and 60 days (post-hospitalisation). 

During this period, your plan will cover the cost of consultation, medicines and many things under the pre-hospitalisation period. 

And your plan will cover the expenses after the discharge like follow-up medications & consultation under the post-hospitalisation phase.

Delivery Expenses Maternity insurance covers the normal delivery cost of your baby like labor room charges, doctor’s fee and others.

On the other hand, if you want your maternity insurance to cover C-section delivery, that’ll also be covered under your insurance including the surgery and hospital stay cost.

Pre-natal & Post-natal Care Maternity plan covers the medical expenses incurred before and after your delivery. Medicines, diagnostic test, doctor’s fee etc. are covered.
Newborn Care Maternity cover also protects your newborn baby for up to 90 days after birth, which includes vaccinations, medical attention, etc.
Cashless Treatment Many insurers are offering cashless treatment at the network hospitals, where you don’t have to pay cash out of your own pocket. 


NOTE: It’s best to buy maternity policy as soon as possible, as most insurance companies don’t offer it while you’re already pregnant.

 

What is not covered (exclusions) under a Maternity Insurance plan?

When it comes to covering the maternity benefits in health insurance, maternity insurance plans have certain limitations which are not covered.

Waiting Period We know that pregnancy is usually a planned procedure, so insurers put a waiting period from 9 months to 6 years (depending on plans). 

Any pregnancy related claims filed with the insurer during the waiting period will be rejected.

Pre-existing Diseases Pregnancy costs are not covered if you purchase your policy after becoming pregnant. And hence the claim associated with such pregnancies will get rejected.
Regular Check-Up Visits to your doctor for periodic check-ups is not covered.

Do not confuse this with pre-hospitalisation. If you’re hospitalised on 31st July, then doctor consultation fees will be covered from 1st July till 30th July. 
Consultation & Diagnostic Test During the 9th month of pregnancy, it does not cover the cost of consultation fees and diagnostic tests. 
Complications from unrecognized procedures Expenses arise due to complications from any other treatment or procedures not recognized by medical authorities are not covered.
Infertility Treatment Maternity health insurance doesn’t cover the cost of infertility treatment like In-vitro fertilization. But some health insurance plans have now started covering these. Before buying maternity cover, check what is covered under the plan.
Non-medical expenses Diapers, blankets, baby’s clothes and any other personal items are not covered under maternity insurance.
Supplements Vitamins & tonics cost are excluded under maternity cover
Late pregnancy Maternity health insurance does not give cover after the age of 45 yr.
Stem Cells Storage and Harvesting It is not covered under maternity insurance.

Which insurance plans should you opt for Maternity cover?

In general, all health insurers comply to this condition for maternity insurance plans:

  • Medical treatment expenses related to childbirth (including complicated deliveries and caesarean sections incurred during hospitalisation). Except ectopic pregnancy (When a fertilised egg grows outside the uterus, often in the fallopian tube. It is a dangerous condition that cannot develop into a healthy baby and requires medical attention)
  • Expenses towards miscarriage (unless due to an accident). And unlawful medical termination (forceful abortion, sex determination) of pregnancy during the policy period

Top Health Insurance Plans Offering Maternity Insurance Cover

Aditya Birla ActivOne Maternity ₹ 50,000 maternity cover after a waiting period of 3 months
Care Supreme – Value ₹ 25,000 maternity cover from Day 1
Niva Bupa Aspire Gold+  Direct ₹ 5,000 maternity cover after a waiting period of 4 years.
Star Comprehensive ₹ 20,000 maternity cover after waiting period of 2 years
ICICI Lombard Elevate ₹ 1,00,000 available as an optional benefit
TATA AIG Medicare Premier ₹ 60,000 maternity cover after a waiting period of 4 years.
Manipal Cigna Prime Advantage ₹ 1,00,000 available as an optional benefit.

Conclusion

Very few health insurer offer maternity insurance policy exclusively in India. Usually, health insurance companies offer them as a feature or add-on to a regular policy. Do read your policy details carefully before opting for any maternity cover plan.

Author

  • Shashank Bhardwaj

    Shashank Bhardwaj is Marketing Manager at Algates Insurance. He has been part of company from past 2 years, where he managed to research and develop content in life and health insurance domain.

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