During motherhood, you go through various stages of memorable experiences. The last thing you want is the thought of medical expenses to prevent you from enjoying this beautiful phase. Maternity insurance eliminates this concern. It takes care of the medical costs associated with childbirth and post-natal care. You can invest in maternity health insurance before you plan to start your family as a proactive measure to secure your finances during pregnancy and childbirth.
With the solid support of maternity insurance benefits, you can manage the costs associated with delivery, whether normal or caesarean, smoothly. The best insurance plan for pregnancy combats inflating hospitalisation costs and lets you put your savings to better use for your new-born’s future. The key is to consider your individual health concerns, coverage needs, and budget, and make the right choice while buying your maternity insurance policy.
Features & Benefits of Medical Insurance for Pregnancy
Look out for these salient features and benefits while purchasing health insurance for pregnancy plans:
- Extensive Maternity Cover
The pregnancy phase involves a range of expenses like hospitalisation, medications, doctor consultations, delivery procedure, etc. You need not worry about the financial burden of managing them if you buy medical insurance for pregnancy. Such an insurance plan offers extensive coverage to handle most, if not all pregnancy-specific expenses. The insurance providers generally offer policies with sufficient sums insured to meet the hefty maternity costs. Some policies also let you deal with the cost of treating childbirth-related complications.
- Easy Buying Process
Insurance companies have a simple onboarding procedure to encourage investment in health policies for pregnancy. You can complete all the buying formalities, like filling out the declaration form and submitting the documents online. You may do this either through the insurer’s interactive portal or app. When you buy insurance digitally, you also get to learn about the coverage benefits and other discounts the insurer offers on their official portal. This facility helps you make an informed buying decision.
- Coverage for Modern Procedures
Each pregnancy is different. Hence, your delivery method depends on your health complications and other factors. The doctor may choose a different approach, using modern procedures with high-tech equipment to deliver your baby. Considering all these possibilities, insurers cover delivery expenses regardless of the procedure type. You can claim coverage for both normal and caesarean section deliveries. Additionally, you get covered for treating any complications you might face during childbirth.
- Seamless Claim Settlement
The claim filing procedure should not deprive you of being able to fully enjoy the childbirth experience. Keeping this in mind, insurance providers ensure that the claim settlement procedure is quick and easy. They let you clear the bills and then raise a claim for reimbursement online. Alternatively, you can get admitted to a hospital within the insurers’ network and forego the hassle of clearing bills with the cashless claim facility. In this method, the insurance company settles the bill directly with the hospital.
- Emergency Assistance
Time is of the essence when it comes to delivery. You want to ensure you reach the hospital conveniently. Thankfully, insurers offer an ambulance cover as an additional rider thus allowing you to reach the hospital at the earliest. This benefit is applicable with both maternity insurance plans and individual health insurance plans with maternity coverage riders. It thus helps to choose the best insurance plan for pregnancy to get comprehensive coverage. Some insurers also offer air ambulance riders that prove helpful when you need emergency assistance.
Coverage and Exceptions in Health Insurance for Pregnancy
Some of the standard medical expenses included and excluded from maternity insurance coverage are as follows.
Inclusions
- Delivery Cost
Medical expenses concerning your delivery, such as the surgical cost, medicines, doctor consultations, nursing charges, ambulance services, etc., are covered under medical insurance for pregnancy for a maximum of two children.
- Hospitalisation Expenses
The cost incurred during your hospital stay during the childbirth process are also addressed under maternity cover. You can claim the costs associated with hospital room rent, cost of drugs, specialist’s fees, etc. The kind of coverage you can get depends on the type of policy and sum insured you choose.
- New-born Coverage
Besides delivery, you can also get assistance with pre-natal expenses. Most insurance companies include new-born baby coverage with maternity insurance which you can use for up to 90 days or a year to pay for your baby’s treatment, vaccinations, and other medical costs.
Exclusions
- Cost of Supplements
During pregnancy, the doctor may advise you to take supplements to increase your body’s vitamin levels. You may also need to consume tonic and other beneficial nutrients. The cost of buying these supplements is not covered under maternity health insurance.
- Premature Pregnancy Termination
If you undergo a procedure to terminate your pregnancy voluntarily, you cannot claim the expenses under maternity coverage. The insurers only cover you for costs incurred if it is medically necessary to terminate the pregnancy.
- In-vitro Fertilisation
If you choose to conceive through in-vitro fertilisation, the treatment expenses for the same are not covered under medical insurance for pregnancy. That said, a few insurers in India have started offering coverage for artificially inseminated conceptions, but the terms and conditions of such policies are quite different from regular maternity cover plans.
Eligibility Criteria and Documentation for Buying Maternity Health Insurance
Age is the primary factor that influences your eligibility for buying a maternity insurance policy. The minimum entry age is 18 to 24 years, and the exit age is 45 years. The exact parameter differs from one insurer to another. You must prove your eligibility by submitting ID and address proof documents including your birth certificate, PAN card, Aadhaar Card, Voter’s ID, or Driver’s License. Additionally, you need to submit a health report if the insurer requests it.
Best Maternity Insurance Plans
Consider this list to find the best insurance plan for pregnancy if you are planning to start a family.
- Health Premia by Niva Bupa Health Insurance
Health Premia is a comprehensive coverage plan that keeps up with your lifestyle and addresses medical expenses incurred in different stages of your life. To that effect, maternity and new-born coverage form an important part of this policy. You can choose between silver, gold, and platinum plans to cover maternity costs ranging between ₹60,000 to ₹2 lakhs. Such coverage remains active worldwide with a free annual check-up. Besides the maternity expenses, Health premia also covers your new-born baby from day one till the policy period ends at no extra premium.
- Medicare Premier by TATA AIG
All-round safety is the central focus of Medicare Premiere. Hence, you get a wide range of expenses covered under this regular insurance plan where you can purchase a maternity add-on cover. The coverage comes with a special maternity benefit of up to ₹50,000. A unique selling point of this insurance plan is that the insurer covers costs up to ₹60,000 in the event of the birth of a girl child. Additionally, the Medicare Premiere covers the first-year vaccination expenses up to ₹10,000 for male births. Once again, for a girl child, coverage the amount goes up to ₹15,000.
- Pro Health Preferred by ManipalCigna
Specifically designed for married couples planning to start a family, ManipalCigna’s Pro-Health Preferred is the best health insurance for pregnancy. With a sum insured of ₹15 lakhs to ₹50 lakhs, it lets you manage all the major medical expenses with ease. In case of maternity, you get coverage of up to ₹50,000 for normal deliveries and up to ₹1 lakh for C-section deliveries. The policy also covers the cost of vaccinations for your new-born in the first year. In case your policy comes with a longer waiting period of 48 months, you can reduce the same to 24 months by purchasing the waiting period reducer/waiver add-on rider. For a higher sum insured, you can choose Pro Health Premier by Manipal Cigna, which covers up to ₹1 lakh for normal and ₹2 lakh for C-section deliveries.
- Health Elite by ICICI Lombard
With a coverage amount ranging from ₹3 lakhs to ₹50 lakhs, Health Elite covers a vast list of expenses to give you holistic medical protection. You can rely on it to pay for in-patient treatment, day-care procedures, pre-and-post hospitalisation, donor expenses, outpatient treatments, and more. Health Elite also provides discounted benefits like no limit on room rent, 0% copay, and a 50% renewal bonus. Additionally, the plan includes a maternity cover which covers up to ₹50,000 for Caesarean section and ₹25,000 for normal deliveries. You can file a maternity cover claim after three years of buying the policy.
- Comprehensive Policy by Star Health
Carefully crafted to offer complete protection, comprehensive Policy by Star Health is also considered among the best health insurance for pregnancy. The policy comes with a maternity cover with high sums insured to help you manage the general pregnancy related expenses. The coverage also extends to post-natal expenses for the infant. Besides, you can choose a private single A/C room for a comfortable childbirth experience and get full coverage for the expenses without worrying about caps on room rent. Air ambulance assistance, second medical opinion, and annual health check-ups for every claim-free year are other benefits offered by Star Health.
- Care Joy by Care
Care Joy is medical insurance plan specifically designed to cover pregnancy expenses. The vast range of features and benefits make it the best insurance plan for pregnancy. As maternity includes delivery and new-born care, the policy is segregated into Care Joy Today and Care Joy Tomorrow to address the expenses of both stages. These plans offer a blend of hospitalisation and maternity coverage, letting you deliver in a private AC room without rent capping. You also enjoy a low waiting period of nine months for filing maternity-related insurance claims. The initial care expenses of your new-born are covered for up to 90 days after the delivery to give you financial relief post-pregnancy.
- Digit Health Care Plus Policy by Go Digit
Digit Health Care Plus is a healthcare policy that eliminates the financial burden of sudden medical expenses. It provides holistic features to address high medical costs relating to varied treatments. You can extend the base cover of your Digit Health Care Plus plan with multiple add-on options. One of them is maternity and new-born baby cover. This cover enables you to bear the maternity expenses of up to two children. You can also claim the cost of treating complications arising from childbirth. Besides delivery, the cost incurred on your baby’s hospitalisation after birth is covered for up to 90 days.
- Arogya Plus by SBI General Insurance
You can get the best medical treatment with the financial protection of Arogya Plus. As a family-focused insurance plan, it covers maternity expenses up to a specified limit. In terms of overall coverage, you have the flexibility to choose between a sum insured amount of ₹1 lakhs, ₹2 lakhs, and ₹3 lakhs. Similarly, you can stretch the policy tenure from one to three years based on your preferences. Other highlights include coverage of 142 day-care expenses, no pre-policy medical check-ups up to 55 years and no exit age. For enhanced protection, you can upgrade to Arogya Top Up Health Plan.
Aspects to Consider While Shortlisting the Best Health Insurance for Pregnancy
You must take into account these critical factors while choosing the best health insurance policy for pregnancy.
- Premium and Sum Insured
The cost of maternity coverage in a health insurance policy varies based on different offers from different insurers. The best health insurance for pregnancy plan is one that comes with an affordable premium, while offering comprehensive coverage and a sufficient sum insured to help you manage the various expenses. You must research various insurers and conduct a cost-analysis to select the perfect fit for you.
- Waiting Period
You must ride out a waiting period ranging between 9-24 months before you can file a maternity claim. Some insurers may offer to reduce the waiting period by purchasing an add-on rider to waive or reduce the waiting period. It is worth checking this aspect to make an informed choice based on the convenience you want.
- Sub-limits
Most health insurance policies have a sub-limit on maternity coverage. Thus, while choosing the best plan for you must assess the sub-limits which typically apply to room rent, pre and post-natal expenses, new-born cover, etc. Assessing the sub limits helps you understand the actual coverage and the out-of-pocket expenses you may have to bear.
- Special Coverage Benefits
Almost all policies offer similar coverage for pre-and-post pregnancy expenses. However, some insurers offer maternity coverage riders with value-added benefits. You should look into the advanced features covered under maternity plans while shortlisting the best insurance plan for pregnancy.
- Network Hospitals
Being unable to reach the hospital on time during an emergency can have dire consequences on your pregnancy. You may also need hospitalisation to manage a delicate pregnancy at any given time. It thus befits you to select an insurer with a wide hospital network, ideally with your preferred hospital in your vicinity, within the insurer’s network.
FAQs:
Can I buy medical insurance for pregnancy when I am pregnant?
Yes, you can buy a policy after conceiving, but you cannot file a maternity claim against it. This is because you need to ride out a waiting period, ranging from 9 to 24 months, during which you cannot file claims.
Do all medical insurance policies come with a waiting period for maternity coverage?
Yes, all insurers require you to ride out waiting periods, not just for maternity but for general health insurance coverage too. The exact duration varies from policy to policy and insurer to insurer.
When is the ideal time to buy a health insurance policy for pregnancy?
It is best to buy a health policy with maternity coverage soon after your marriage. Doing so allows you ride out the waiting period smoothly, especially if you plan to start your family a few years after your marriage.
How is maternity insurance premium determined?
Insurers do not generally take any special factors into account while determining maternity coverage costs. The coverage is usually offered as an additional rider. Insurers merely assess the costs associated with maternity expenses while determining the premiums and sum insured.
How many children are covered under maternity health insurance plans?
Health insurance for pregnancy covers a maximum of two childbirths. However, the exact coverage differs based on insurers' terms and conditions.
How to choose the best insurance plan for pregnancy coverage?
The best plan depends on your specific pregnancy needs and budget. You can also consider the offers and special features available at the time of buying.
What is the process for claiming maternity coverage?
You have two options for filing a claim for maternity cover. You can either pay the maternity expenses upfront and file a reimbursement later, or opt for the cashless claims facility. Here are the steps you need to follow irrespective of whether you choose cashless or reimbursement claims.
1. Inform your insurer about your hospitalisation plans. In case of urgent hospitalisation, you must inform them within 24 hours.
2. Fill out a claim form mentioning the actual medical expenses.
3. Submit the form with the medical reports, invoices, and other documents. A healthcare professional submits these documents in case of cashless settlements.
4. The insurer will verify the details and approve the claim request up to the sum insured amount.
5.In case of reimbursement claims, the insurer refunds you for the expenses within 3-4 weeks of raising the claim. If you opt for cashless claims, the insurer settles the bills directly with the hospital.