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Waiting Period in Maternity Health Insurance

Nowadays, couples plan for everything beforehand, be it purchasing a new house or expanding the family. Becoming a parent begins a new phase of life, often accompanied by hope and excitement. This, however, comes with many responsibilities for new parents. To meet the challenges of rising healthcare costs and ensure a smooth pregnancy journey, maternity health insurance is an invaluable financial instrument for expectant parents. ...Read More

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Waiting Period in Maternity Health Insurance

What Is Maternity Insurance?

Waiting Period in Maternity Health Insurance
October 23, 2024

Table of Content

 

Maternity health insurance is a distinctive form of health policy that offers extensive coverage for meeting pregnancy-related medical expenses. These policies cover the costs of delivery procedures (normal and C-section), hospitalisation, pre and post-natal care, expenses of a newborn baby, medical tests, and more. By opting for the right maternity insurance plan, a woman can achieve financial stability and raise her baby without worrying about finances. 

In recent years, many insurers in India have introduced maternity benefits as a rider or a separate health insurance policy specifically designed for female employees. Maternity insurance plans, in general, have a waiting period of 9 months to 6 years, on average, depending on the insurance provider. These kinds of insurance plans are helpful for expectant mothers hoping to get the best quality healthcare.

Why Is the Waiting Period in Pregnancy Insurance Important?

The waiting period for pregnancy insurance varies from one insurer to another. Let's look into the importance of the waiting period for maternity plans through the following points:

  • Cost Management for Insurers

    • Maternity-related expenses can be substantial and include delivery charges, pre and post-natal care, hospitalisation charges, and more. By including a waiting period clause, insurers can prevent the risk of incurring high-cost claims immediately after the purchase of the policy. This also keeps the cost of maternity policies affordable for most young parents.

  • Encourage Long Term Policy Commitment

    • Waiting periods cause policyholders to remain committed to maintaining insurance coverage for a prolonged period. As they are required to wait for some time to claim maternity benefits, policy buyers cannot immediately file claims after their purchase. This benefits both the insurer and the insured person in the long term.

  • Discourages Adverse Selection

    • Without any waiting period in maternity insurance, individuals might purchase a plan when they are likely to conceive. If this happens, insurers would be forced to discontinue maternity plans. However, with a long waiting period, people are more likely to purchase a suitable policy beforehand and reach an informed decision making.

What Is the Waiting Period for Maternity Coverage?

The waiting period for maternity coverage is the time when a policyholder cannot file claims for childbirth, pregnancy, delivery-related conditions or postnatal care. In other words, this period is the buffer time between buying a maternity insurance policy or a maternity rider and becoming eligible for its benefits. The waiting period for maternity varies from one health insurance plan to another. 

The initial waiting period is the period between the start date of the policy and when a policyholder qualifies for claims. This usually extends for a minimum of 30 days. Meanwhile, the maternity waiting period is the period between the end of the initial waiting period and the beginning of the maternity coverage. This lasts for between 9 months and 6 years, depending on the insurer.

Apart from these waiting periods, there are some policies with waiting periods applicable for pre-existing diseases. This kind of waiting period falls between the start date of the policy and when the coverage starts for medical-related conditions that have taken place already before the initial start date of the policy. The duration usually lasts from 2 to 4 years. 

Lastly, there are some policies with waiting periods applicable for only some particular diseases. This waiting period is the time between the start date of the policy and the date when the coverage starts for certain conditions. This duration is around 2 years. To our knowledge, there are no maternity plans and zero waiting periods in India at the moment.

Maternity Insurance with Immediate Coverage

With increasing medical expenses, opting for comprehensive health insurance providing pregnancy coverage has become necessary, especially for young adults. As mentioned, most health insurance plans come with a specific waiting period, and there is no health insurance without a waiting period for maternity coverage. 

The waiting period for most life insurance plans varies from 9 months to 6 years. Hence, if you are planning for a family, make sure to purchase the insurance plan in advance with a proper understanding of the plan's waiting period. Choose a suitable plan considering the time after which you will need the policy coverage.

Different Types of Waiting Periods in Health Insurance

Different types of health insurance plans have varied waiting periods, each with its own purpose and objectives. This kind of waiting period is designed specifically for managing risk and ensuring that policyholders are maintaining coverage for an extended period.

Let's explore the following types of waiting periods for maternity insurance:

  • Initial Waiting Period

    • An initial waiting period is included in almost all types of health insurance plans. This period typically begins from the very first date of purchasing the policy and lasts for 30 days or 90 days. During this timeframe, a policyholder cannot claim any insurance benefits.

    Maternity plans include this waiting period to prevent buying a policy when you are planning to conceive or are pregnant already.

  • Waiting Period for Pre-Existing Diseases

    • Maternity insurance policies mostly have a waiting period of 2 to 4 years, which is applicable for pre-existing diseases. If the policyholder has diseases relating to infertility or other pregnancy-related scenarios, she has to wait till the end of the waiting period to claim the benefits. This period is usually longer than the waiting period allotted at the beginning of purchasing a policy.

  • Maternity Waiting Period

    • This is the basic and most common type of waiting period included in a maternity plan. Typically, the waiting period for maternity coverage ranges between 9 months and 6 years, considering the plan chosen by the insurance provider.

  • Waiting Period for Certain Illnesses

    • Some maternity policies may cover critical diseases with different waiting periods for the diseases. This kind of illness coverage will be mentioned in policy documents. Thus, before finalising any maternity insurance policy, make sure to familiarise yourself with the specific terms and conditions relating to the policy.

How Can I Get Maternity Health Insurance with a Short Waiting Period?

If you are willing to avail immediate comprehensive coverage on a maternity health insurance policy, choose a maternity health insurance with the shortest waiting period. Having a short waiting period helps you meet maternity expenses from the date of purchasing the policy. If your policy has a short waiting period, it implies coverage for hospitalisation charges and consultation fees from the very first day of the policy.

Tips for Buying Maternity Health Insurance With a Short Waiting Period

Before purchasing a maternity health insurance plan with a short waiting period, it’s essential to look into some important factors. Let’s explore the tips you should follow to avail the benefits of health insurance:

  • Evaluate Your Preferences and Budget

    • Evaluating your tastes and preferences is a must while purchasing health insurance. Choose a plan that aligns with your budgetary and medical needs. Decide the coverage type and amount you need, along with the premium amount you are ready to pay.

  • Research

    • Research thoroughly the different maternity insurance providers offering plans with low waiting periods. Visit each and every insurer's website individually and check out the policy coverage with terms and conditions.

  • Compare

    • Make a thorough comparison of the different available policies online. Explore the benefits and the coverage amount each policy provides and compare their premium amounts. Apart from this, you can choose to buy an individual health insurance policy for you and your spouse or a family floater policy covering your entire family with maternity coverage.

  • Buy Online

    • Once you are sure which policy to choose from, you can buy it online. Before you decide to make the final purchase, make sure to go through the policy terms and conditions thoroughly.

How to Pick the Best Maternity Insurance?

Choosing the best maternity insurance requires a look into several factors. Look into the following factors in detail to reach an informed decision and pick the best plan as per your needs:

  • Coverage

    • While choosing a maternity health insurance plan, make sure to choose the one offering a wide range of benefits and comprehensive coverage. Opt for plans with a wide range of services that include delivery costs, pre and post-natal care, consultation charges, diagnostic tests, and more. With comprehensive coverage, mothers are expected to receive thorough medical attention without worrying about finances.

  • Waiting Period

    • Make sure to check out the waiting period of insurance plans before choosing. Some plans have a longer waiting period while others have short or no waiting period. This feature is invaluable for individuals planning to conceive or begin their parenthood journey as it ensures immediate coverage of maternity expenses.

  • Maximum Limit

    • Before finalising a maternity health insurance plan, check out the maximum limits to ensure complete coverage of maternity-related expenses. Providing adequate coverage helps a policyholder stay stress-free and receive financial security and stability during times of healthcare needs.

  • Premium

    • Choosing an affordable premium might be an important consideration, but it should not be the sole determinant when looking for a maternity health insurance plan. Maintain a balance between affordability and coverage and choose the right plan offering benefits at affordable premiums. Check out different insurers providing insurance plans and go for the most cost-effective plan.

Maternity Health Insurance Eligibility Requirements

Different health insurance policies offer different coverage benefits. To experience these comprehensive benefits, meeting the eligibility criteria laid out by the insurance companies is a must. Here are the required eligibility requirements for maternity health insurance:

  • Age

    • Insurance buyers must be within certain age limits. The minimum age for qualifying a plan is usually 18 years, while the maximum age is 45 years.

  • Limit on the Number of Maternity Claims

    • Some maternity insurance companies pose a limit on maternity claims for 2 children. This thereby implies that an individual can avail maternity benefits for only 2 pregnancies.

  • Exceptions for Loss

    • Some insurance companies offer exceptions in case of loss, such as stillbirth or miscarriage. In this case, the policyholder can avail maternity coverage beyond 2 deliveries.

  • Waiting Period

    • Before availing any maternity insurance plan, it is a must for every policyholder to fulfil the maternity insurance waiting period criteria. The eligibility criteria might vary from one health insurance company to another. Thus, make sure to go through the terms and conditions of the policy before proceeding to buy the insurance.

How Can You Shorten the Waiting Period?

The shorter your plan’s waiting period, the more beneficial is the plan. Let’s look into the ways of shortening the waiting period for maternity insurance in more detail:

  • Go for a maternity plan with the shortest waiting period. However, you might need to pay higher premiums.
  • Search for multiple maternity plans before choosing the right one. This is because different plans have different waiting periods. Prefer to choose one with a reduced waiting period, considering the other benefits included in the plan.
  • Plan your pregnancy in advance so that the waiting period is almost over by the time you are about to become a parent.
  • Opt for riders that cover pre-existing diseases and other conditions from the first day. You can access these riders by paying an extra amount. However, this benefit might not be included in all maternity plans.

Summary

To conclude, maternity health insurance plays an important role in providing comprehensive healthcare coverage for expectant parents. For these insurance policies, understanding the waiting period and choosing the plan accordingly is of utmost importance.

Explore different plans to make informed decisions and build up a strong financial foundation during the entire journey of parenthood. With proper planning and thorough research choose the best plan with the shortest maternity period for health insurance.

FAQs on Health Waiting Period for Maternity Insurance

1. How long is the waiting period for pregnancy?

The average waiting period for pregnancy coverage varies from 6 months to 4 years, depending on the insurance provider and the plan you have chosen. 

2. How to get maternity insurance without a waiting period?

Unfortunately, till now, there is no maternity insurance without a waiting period. Thus, planning for your family beforehand is very essential. 

3. Can I take maternity insurance if I’m already pregnant?

Almost all maternity health insurance plans consist of a waiting period, and pregnancy is categorised as an existing health condition. Hence, if you are already pregnant, you can opt for maternity insurance but will not get coverage from the very first day of purchasing the plan. 

4. Which insurance is best for pregnancy?

Purchase health insurance with maternity cover to avail wider coverage. This kind of insurance mostly covers expenses relating to hospitalisation costs up to 30 days pre-delivery and 60 days post-delivery, hospitalisation charges, and coverage for a newborn baby. 

5. How to calculate waiting period insurance?

Waiting period insurance is calculated by subtracting the starting date from the target date in days.

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Francis Rodrigues 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 Vishal Subharwal

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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