Pre & Post-Natal Expenses in Health Insurance | PolicyX
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Pre and Post Natal Expenses

Having a baby is the most joyous part of our lives. The feeling one experiences while holding their baby for the first time is priceless. Are you planning…

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Written by Simran Kaur Vij
Published: 16 Aug 2024
Updated: 19 Jul 2026
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Pre and Post-Natal Expenses

Having a baby is the most joyous part of our lives. The feeling one experiences while holding their baby for the first time is priceless.

Are you planning to start a family soon? If yes, then you must realize that bringing a new life into the world is a big responsibility. This new phase of life, while filled with excitement and happiness, also comes with significant expenses. To avoid worrying, it's essential to be well-prepared in advance.

With an effective Maternity Health Insurance plan, you can embrace parenthood with utmost pleasure.

Maternity insurance is a part of health insurance that offers coverage for all pregnancy-related expenses, such as delivery and newborn baby expenses, up to a pre-defined limit during the policy term.

What is Pre and Post-Natal Cover?

  • Pre-natal means 'Before Birth'.
  • Post-natal means 'After Birth'.

Pre and post-natal expenses fall under the category of maternity expenses. Such expenses can be covered if you have a health insurance policy that provides financial security against maternity-related expenses.

This cover includes prenatal costs such as medical check-ups, ultrasounds, various tests, and medicines, ensuring a smooth journey throughout your pregnancy.

Along with this, postnatal costs such as medical check-ups, treatments, and vaccinations for the baby are covered.

With pre and post-natal coverage, you can ensure that you and your child receive complete protection, not only during pregnancy but also before and after.

For women, the journey of pregnancy is emotionally, financially, and physically challenging. With the support of friends and family, she can be mentally and physically strong; however, to remain financially stable, a health policy with maternity coverage is essential.

Availability under Health Insurance

  • Usually available as a rider to the base health insurance policy.
  • Now, these maternity plans can also be purchased as a standalone policy.

Eligibility Criteria

  • Entry Age: 18 years
  • Exit Age: 45 years

Moreover, some health insurance companies have a cap on the number of maternity claims, typically up to two deliveries. Therefore, it is advisable to thoroughly read the Terms and Conditions before investing in any plan.

What if My Health Policy Does Not Offer Maternity Coverage?

Health insurance plans that cover maternity often come with inbuilt sub-limits. For example, if you have a health cover of 3-5 lakhs, you might get maternity coverage of around Rs. 25,000-50,000.

However, if you have a health insurance policy that does not cover maternity expenses, you can opt for a maternity benefit rider to your base health plan.

What is Covered under Maternity Health Insurance?

Prenatal or Pre-Delivery Expenses

In a comprehensive health insurance plan, you get coverage for all prenatal expenses such as medical check-ups, frequent medical scans, and ultrasounds to ensure the well-being of both baby and mother.

Delivery Expenses

Under an ideal maternity insurance policy, the insured gets coverage for all medical expenses, including delivery charges and labor.

Post-natal or Post-Delivery Expenses

Along with prenatal expenses, a comprehensive health plan will cover post-delivery expenses such as baby vaccinations, medications, and hospitalization.

Vaccination Cover

The list of vaccines covered under this plan includes:

  • BCG
  • OPV+IPv-B1/OPV
  • Hepatitis B-1
  • Hib
  • MMR-1
  • Measles
  • Tetanus Toxoid
  • HPV (only girls)
  • Typhoid
  • Meningococcal
  • DTPw booster-1 or DTPa booster-1

Exclusions of a Maternity Insurance Plan

Though there are many benefits to having maternity insurance, here are a few aspects that are not covered:

  • Any pre-existing illness that affects pregnancy.
  • Expenses incurred for infertility treatment.
  • Cost of medicines apart from those prescribed by the doctor.
  • Doctor's consultation and check-up fees.
  • Congenital diseases.
  • Claims raised after the allowed number of claims have been exceeded.

Claim Process to Avail Maternity Coverage

You can avail both cashless (when admitted to a network hospital) and reimbursement (when admitted to a non-network hospital) facilities.

You can follow the following steps to file a claim:

Inform the Insurer

When you are hospitalized for delivery, you must inform your insurer at the earliest.

Submission of Documents

Submit the duly filled claim form along with all the required documents.

Verification of Documents

The hospital will verify and forward your form to the insurance company for processing.

Claim Settlement

  • Cashless Claim: After verification of your documents, the company will settle your bill and pay directly to the hospital as part of the cashless claim payment procedure.
  • Reimbursement Claim: In case you opt for reimbursement, you will have to initially settle the hospital bills on your own. Post verification of documents and approval, the amount shall be transferred to your registered bank account.

Documents Required for Claim Process

  • Duly filled claim form
  • Policy documents
  • Discharge summary
  • Fitness certificate
  • KYC documents
  • Consultation bill
  • Original hospital bill
  • Pharmacy bill

Summing it Up

Pregnancy is an important phase of a couple's life. However, with the continuous rise in healthcare costs and medical expenses associated with pregnancy, having an effective maternity plan has become essential. Thus, to embrace parenthood without any financial strain, it is recommended to have a good financial backup to meet the requirements of both mother and baby.

Health Insurer Network Hospitals

Find network hospitals for top health insurers across India.

Frequently Asked Questions

No, for getting a Maternity cover you have to fulfil a Waiting Period clause, that may vary from Insurers to Insurer. Thus, you cannot get coverage under the plan if you are already pregnant.
If a child is born with any sort of deformity or any critical illness or injuries, it is known as a congenital condition which is not covered under any Health Insurance plans.
A Maternity plan should be bought soon after the wedding. However, this depends on a couple and their personal choices. You must inquire about the Waiting Period related to Maternity Benefits on Health Insurance and then choose to invest in a plan, as per your requirements.

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