What You Need to Understand About Maternity Health Insurance in India?
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Table of Content
1. What Is Maternity Insurance?
2. Why Do You Need Maternity Insurance?
3. What Is Included Under Maternity Insurance Plans?
4. What Is Not Included Under Maternity Insurance Plans?
5. When to Purchase Maternity Health Insurance?
6. Features of Maternity Health Insurance
7. Benefits of Maternity Health Insurance
8. What Factors Should You Consider While Buying a Maternity Health Insurance Policy?
9. Who Can Benefit from Maternity Health Insurance Coverage?
10. Eligibility Criteria for Maternity Health Insurance
11. Documents Required to Claim Maternity Insurance
12. Claim Process to Avail Maternity Health Insurance Policy
13. A Buying Guide for Maternity Health Insurance Plans
14. Things You Must Know Before Buying a Maternity Health Insurance Policy
Bringing a new life and stepping into the journey of motherhood is exciting and filled with joyfulness. Becoming a mother brings in new responsibilities and care for the newborn. While this is an exciting phase of life, uncertainties may crop up, and it is always better to be prepared.
Considering the rising medical costs and increasing hospitalisation expenses can bring financial strains. Here maternity health insurance can serve the purpose well and ease out the financial constraints.
Here in this article, we will discuss more about maternity health insurance, its features, benefits, application procedures, claim-raising procedures and much more.
What Is Maternity Insurance?
There are various kinds of health insurance; maternity or pregnancy insurance is a rider or separate policy that covers all sorts of maternity-related expenses. It provides financial cover for normal deliveries, C-sections, newborn baby expenses, pre and post-natal expenses and more under the maternity cover. Nowadays, many corporations offer maternity insurance benefits to female employees.
Mostly insurance plans in India usually come with a waiting period of 9 months to 6 years at maximum. In this period the insured is unable to raise any claim, hence it is always advised to check the waiting period of the policy and opt for health insurance at least a few years before starting a family.
Why Do You Need Maternity Insurance?
These policies cover treatments received during pregnancy, delivery of the baby and other expenses. There are several features and benefits of maternity health insurance which are discussed as follows:
Maternity insurance provides financial protection to a new family from the rising costs of healthcare.
It covers all sorts of maternity-related hospitalisation expenses. Usually, the coverage starts from 30 days before childbirth and can extend to 60 days post-hospitalisation.
Newborn baby expenses are covered for up to 90 days under maternity insurance, safeguarding the family financially in the event of a diagnosis of critical or congenital ailments.
These policies/riders provide comprehensive coverage for pre- and post-natal expenses through maternity insurance. This includes medical costs associated with both Caesarean and normal deliveries, as well as post-delivery complications for the insured.
What Is Included Under Maternity Insurance Plans?
Listed below are the following benefits which are included in maternity insurance plans:
Expenses associated with pregnancy complications
Coverage for C-section delivery
New- born's vaccination expenses
New-born child expenses
Coverage for delivery cost
Reimbursement for in-patient hospitalisation expenses
Coverage for pre or post-natal care expenses
Stem cell preservation expenses
Coverage for medically demanded pregnancy termination costs
What Is Not Included Under Maternity Insurance Plans?
Listed below are the following benefits which are typically not included in maternity insurance plans:
Expenses incurred on pre-delivery consultation and medical tests
Expenses related to ectopic pregnancy
Coverage for post-hospitalisation expenses
Cash benefits from hospital
Coverage for regular medical check-ups
Coverage for pre-hospitalisation expenses
Coverage in case of surrogacy
When to Purchase Maternity Health Insurance?
It is always recommended to get maternity coverage well before the expected delivery in case of a planned pregnancy. This is because the majority of maternity covers come with a waiting period. The waiting period varies from insurer to insurer, usually, it can range from a minimum of 9 months to a maximum of 6 years.
Moreover, getting maternity coverage at an early stage is beneficial as it can help you get coverage for any of your pre-existing medical conditions. These can include high blood pressure, diabetes and other conditions that may need to be treated during delivery.
Hence it is always advised to avail maternity health insurance at least 2 years before starting a family.
Features of Maternity Health Insurance
Listed below are some of the key features of maternity health insurance offered by HDFC Life.
Particulars |
Coverage |
Day care treatment |
Available |
Ambulance Cover |
Available |
Cashless treatment |
Available in network hospitals |
Hospitalisation Cover |
Room rent, anaesthetist fees, operation theatre charges, doctor fees, normal delivery, C-section delivery |
Waiting Period |
9 to 36 months |
Pre and post-hospitalisation |
Pre-hospitalisation expenses of up to 30 days Post-hospitalisation expenses of up to 60 days |
New Born Cover |
Medical treatments, vaccination expenses |
Benefits of Maternity Health Insurance
Financial Assistance:
Maternity Health Insurance covers the cost incurred in a Caesarean or a normal delivery. Moreover, there can be several medical treatments for pre-natal and post-natal care which are all covered under the policy.
Newborn Cover
It offers coverage for newborn babies from day one for a total of 90 days. This includes expenses due to medical emergencies along with all the vaccinations.
Delivery Expenses
Obtaining a mediclaim plan with maternity benefits also covers pre-and post-natal expenses, delivery expenses, and ambulance charges. Any delivery type is included, whether it is a normal or Caesarean delivery.
What Factors Should You Consider While Buying a Maternity Health Insurance Policy?
Here are some of the factors which one must consider while buying a maternity health insurance policy:
To choose the best plan, look for one that offers financial coverage on various other medical expenses and not just hospitalisation coverage.
Before purchasing a policy, consider checking the premium discounts it offers.
Go through the list of network hospitals for cashless treatments, to ensure that you can get admitted to a network hospital during an emergency.
It is essential to carefully go through the terms and conditions of a maternity health insurance policy to understand its waiting period, sub-limits, inclusion and exclusions.
Compare the chosen maternity cover policy with other policies and choose the one with maximum benefits at an affordable cost.
Consider checking some of the must-have benefits such as new-age treatments, new-born baby cover, daycare procedures etc., before finalising a maternity health insurance policy.
Also, consider checking the claim filing procedure of the policy, and finalise the same only if it is quick and hassle-free.
Who Can Benefit from Maternity Health Insurance Coverage?
Any individual who satisfies the following parameters may want to avail maternity health insurance coverage and derive perks from the same:
Any woman of age below 40 years and married can benefit from the plan.
Any woman can benefit from the plan if the maternity cover is bought along with health insurance.
Any woman can avail the benefit of the cover for up to 2 deliveries.
Consider availing the maternity insurance at least 2 years before starting a family as there are waiting periods with this kind of coverage, which can range from 9 months to a maximum of 6 years.
Eligibility Criteria for Maternity Health Insurance
The eligibility criteria for Maternity Health Insurance vary from insurer to insurer but most insurers have age criteria for policyholders. The applicant’s age must be between 18 years to 45 years. Also, note that the majority of insurance companies offer maternity coverage for up to two deliveries.
Documents Required to Claim Maternity Insurance
Listed below are the documents required to raise a claim for maternity insurance:
Pre-authorisation form/insurance claim form (duly filled)
Policy documents
Hospital discharge details
Original medical treatment bills/reports bills/receipts
Doctor’s prescriptions and other consultation bills
Recent passport-size photo
KYC documents
Claim Process to Avail Maternity Health Insurance Policy
Cashless Claim
Step 1: The first step begins with initial intimation; in case of cashless hospitalisation reach out to your insurer within the first 24 hours.
Step 2: Then, you will have to fill out a pre-authorisation form to seek the insurer’s approval.
Step 3: The insurer will verify your request and approve or reject it as per stated norms.
Step 4: The approved claim will then be settled with the hospital directly.
Reimbursement Claim
Step 1: Pay the hospital bill and preserve all prescriptions and payment receipts.
Step 2: Register a maternity health insurance claim under the reimbursement category.
Step 3: In this step, you need to submit all required documents such as the payment receipts and medical bills, diagnostic reports, prescription and other relevant documents backing your claim.
Step 4: Your request will then be forwarded to the insurance company; upon successful verification, it will be approved or rejected by your insurer.
A Buying Guide for Maternity Health Insurance Plans
Here is the step-by-step guide helping you to purchase maternity health insurance coverage:
Step 1: To start with, firstly login to your HDFC life account. If it is your first time, consider signing up.
Step 2: Then click on options similar to ‘Apply Now’ or ‘Get Quote’ to get into the application process.
Step 3: Now, fill up the application form. Here, you are required to enter some of the basic details such as name, contact number, date of birth, gender, etc., and proceed.
Step 4: Select the policy type and the amount of premium you are opting for.
Step 5: Then, you have to enter some additional details such as your height, weight, residential address, nominee details, etc.
Step 6: You will be directed toward an interface where you will have to answer some basic questions regarding your previous and current health conditions.
Step 7: Next, you will have to confirm the above-entered details and proceed to the payment gateway.
Step 8: Pay the amount using your desired mode of payment.
Step 9: Upon successful payment, your transaction becomes complete and you will receive your policy documents in your email.
Things You Must Know Before Buying a Maternity Health Insurance Policy
Listed below are some of the key points which you must note before buying a maternity health insurance policy:
Newborn Cover: It covers all sorts of medical expenses incurred for a newborn baby for 90 days. It also includes all sorts of vaccinations required in the initial months.
Abortion or Termination: Some insurance providers offer coverage for abortion or termination up to two times.
Waiting Period: Typically maternity health covers come with a waiting period ranging from 9 months to 6 years. Hence, consider checking the waiting period of the policy before finalising the same.
Number of Children Covered: Also consider checking the number of newborns that the plan is covering. Most insurers cover expenses for up to 2 children.
Parenthood is one of the most anticipated moments in a person’s life. However, massive medical bills can cause worries and deplete your savings for the child’s future. Hence, maternity health insurance plans are recommended to ensure peace of mind and the best treatment options for the mother and newborn child.
FAQ's on Maternity Health Insurance
Can I get maternity insurance while pregnant?
Which health insurance is best for pregnancy?
How to claim medical insurance for maternity?
What is the minimum waiting period for maternity insurance?
Can I claim 3 maternity insurance policies?
Can husband and wife both claim maternity insurance in India?
What is the 12-month waiting period pregnancy cover?
Is the 3rd child covered under health insurance for pregnancy?
Yes, You can get maternity insurance while you are pregnant but usually, maternity insurance comes with a minimum waiting period of 9 months so it does not make sense to avail them.
There is no such thing as the best option as it totally depends on your overall requirements as a policyholder. However, considering essential factors such as newborn care, pre and post-hospitalisation coverage, waiting period, etc., will help you make an excellent choice.
You can claim maternity insurance either via the cashless or reimbursement method. For cashless claims, the policyholder is required to fill in a pre-authorisation form and once it is approved the bills are directly settled by the insurer. For a reimbursement claim, the medical bills have to be paid upfront and then, the policyholder can get their claims settled.
The minimum waiting period in maternity insurance is 9 months for most insurers.
Usually, most insurance providers offer pregnancy coverage for up to two children, hence only 2 claims are allowed on a policy.
Yes, both wife and husband are allowed to claim maternity health insurance in India.
A 12-month waiting period pregnancy cover means the policyholder can claim for the maternity insurance once the waiting period of 12 months is over.
Usually, the majority of insurance providers offer pregnancy coverage for up to two newborn children.
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