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Maternity Health Insurance
Maternity Health Insurance is designed to provide financial support and peace of mind during pregnancy and childbirth. ...Read More
Explore the range Health Plans by HDFC Life to cover your medical expenses
With Health plans from HDFC Life you can opt for medical insurance at affordable rates
What You Need to Understand About Maternity Health Insurance in India?
Table of Content
1. What Is Maternity Insurance?
2. What is a Maternity Health Insurance Plan?
3. Why Do You Need Maternity Insurance?
4. What Is Included Under Maternity Insurance Plans?
5. What Is Not Included Under Maternity Insurance Plans?
6. When to Purchase Maternity Health Insurance?
7. Features of Maternity Health Insurance
8. Benefits of Maternity Health Insurance
9. What Factors Should You Consider While Buying a Maternity Health Insurance Policy?
10. Who Can Benefit from Maternity Health Insurance Coverage?
11. Eligibility Criteria for Maternity Health Insurance
12. Documents Required to Claim Maternity Insurance
13. Claim Process to Avail Maternity Health Insurance Policy
14. A Buying Guide for Maternity Health Insurance Plans
15. Things You Must Know Before Buying a Maternity Health Insurance Policy
16. How long is the waiting period for maternity benefits?
17. How is the Cost of Maternity Health Insurance Calculated?
18. Summary
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.
What is a Maternity Health Insurance Plan?
Maternity insurance plans are designed to cover the medical expenses that are related specifically to pregnancy and childbirth. These plans with health insurance for women usually include the costs incurred by the insured during delivery, as well as prenatal and postnatal care. However, some maternity insurance plans may also cover newborn care.
It is important to note that when you are opting for a maternity insurance policy, you must note its waiting period. Most of these plans have long waiting periods ranging anywhere from 9 months to 4 years, depending upon the insurance company and plan you choose. Hence, choosing the right plan is important to help ease your financial burden during this critical life event. It ensures that both mother and baby receive the best possible care as you enter parenthood.
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:
Newborn Cover
Delivery Expenses
Ambulance Charges:
Cashless Facility:
Hospitalisation Coverage:
Simple and Fast Online Application Process:
No Claim Bonus:
Tax Benefit:
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.
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.
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.
In case of an emergency, maternity insurance plans typically cover ambulance charges, ensuring that you get to the hospital without worrying about the cost. This is a crucial benefit, especially in situations where every second counts.
A maternity insurance policy often provides a cashless facility at network hospitals. This means that you don’t have to worry about making upfront payments. The insurance takes care of it directly, allowing you to focus on your health and recovery.
Hospitalisation costs, whether before or after delivery, can add up quickly. Maternity health insurance covers these expenses, ensuring that both you and your baby receive the necessary medical care without the stress of high hospital bills.
Applying for pregnancy insurance has never been easier. Many providers offer a simple and fast online application process, making it convenient to secure the best maternity insurance plans without the hassle of paperwork or lengthy procedures.
If you don’t make any claims during the policy period, some maternity insurance plans offer a no-claim bonus. This benefit can reduce your premium in the following year or provide additional coverage, making your maternity insurance policy even more valuable.
Another advantage of maternity health insurance is the tax benefits it offers. Premiums paid towards pregnancy insurance are often eligible for tax deductions under Section 80D of the Income Tax Act2, providing financial relief beyond just medical expenses.
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.
How long is the waiting period for maternity benefits?
The waiting period for maternity benefits refers to the time you need to wait after purchasing any of the maternity insurance policies in India before you can actually claim the benefits. In India, this waiting period is a standard feature across most policies, designed to prevent misuse of insurance.
For most plans, the waiting period ranges from 9 months to 4 years, depending on the provider and the specific policy. This means that if you buy maternity insurance for married women today, you will need to wait at least nine months—and in some cases, up to 4 years—before your pregnancy-related expenses will be covered.
It is, therefore, essential to plan ahead and purchase your health insurance with maternity benefits well before you start planning to expand your family. That way, when the time comes, you are fully covered and will not have to worry about unexpected medical bills during pregnancy.
How is the Cost of Maternity Health Insurance Calculated?
The cost of maternity health insurance is basically the price you pay to purchase health insurance that includes maternity benefits. This cost is represented by the premium you pay annually, semi-annually, or monthly to keep the policy active.
Here are some factors that are considered while calculating the cost of your maternity health insurance:
- Age: Your age is a significant factor. Generally, the older you are, the higher the premium. This is because the risks associated with pregnancy and childbirth increase with age, making it more likely that you’ll need to use the coverage.
- Amount of Cover: The coverage you choose also impacts the cost. Higher coverage limits mean higher premiums. For example, if you opt for a more significant sum assured to cover potential pregnancy and delivery costs, you’ll pay more for the policy.
- Maternity Add-ons: Some insurance policies offer additional benefits, or "maternity add-ons," such as coverage for prenatal care, newborn care, or specific complications. Adding these to your health insurance with maternity benefits increases the overall cost of your policy.
- Medical History: Your medical history plays a crucial role. If you have pre-existing health conditions or a history of complications related to pregnancy, the insurer may charge a higher premium to account for the increased risk.
- Waiting Period: The length of the waiting period also affects the cost. Policies with shorter waiting periods typically have higher premiums because they offer quicker access to maternity benefits, which is considered a higher risk for the insurer.
- Network Hospitals: Insurers often have a network of hospitals where you get cashless treatment. If your policy covers a broader network of hospitals, especially top-tier ones, this might increase the premium due to the higher cost of care at these facilities.
- Renewal Terms: The terms of renewal can also impact the cost. Policies that offer benefits like no-claim bonuses or guaranteed renewals might come with higher premiums due to these added advantages.
Summary
Maternity health insurance covers pregnancy-related expenses, including delivery, prenatal, and postnatal care. Key factors influencing costs include age, coverage amount, medical history, and waiting period. Selecting the right plan, therefore, ensures financial security during childbirth. It also offers benefits like newborn care and tax deductions. Hence, planning in advance is crucial for optimal coverage.
FAQ's on Maternity Health Insurance
1. Can I get maternity insurance while pregnant?
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.
2. Which health insurance is best for pregnancy?
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.
3. How to claim medical insurance for maternity?
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.
4. What is the minimum waiting period for maternity insurance?
The minimum waiting period in maternity insurance is 9 months for most insurers.
5. Can I claim 3 maternity insurance policies?
Usually, most insurance providers offer pregnancy coverage for up to two children, hence only 2 claims are allowed on a policy.
6. Can husband and wife both claim maternity insurance in India?
Yes, both wife and husband are allowed to claim maternity health insurance in India.
7. What is the 12-month waiting period pregnancy cover?
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.
8. Is the 3rd child covered under health insurance for pregnancy?
Usually, the majority of insurance providers offer pregnancy coverage for up to two newborn children.
Related Articles
- Health Insurance for Parents: A Comprehensive Guide
- Health Insurance For NRI in 2024: Coverage and Benefits | HDFC Life
- Best Health Insurance For Self Employed in India | HDFC Life
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Francis Rodrigues
Francis Rodrigues has a decade long experience in the insurance sector, and as SVP, E-Commerce and Digital Marketing, HDFC Life, manages the online sales channel, as well as digital and performance marketing. He has had hands-on experience in setting up sales channels and functional teams from scratch over a career spanning 2 decades.
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Vishal Subharwal heads the Strategy, Marketing, E-Commerce, Digital Business & Sustainability initiatives at HDFC Life. He is responsible for crafting and ensuring successful implementation of the overall organisation strategy.
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