The journey of a woman towards pregnancy is surreal which brings a new identity to her. On the contrary, pregnancy comes with lots of financial stress due to complications of maternity handling and skyrocketing healthcare charges. That's why, becoming a mother and getting prepared only on the physical grounds is not enough. You need to be prepared financially as well. Such that your pregnancy doesn't get challenging for you and your child, you should think of getting proper health care.
Therefore, to beat the unevenness of the situation, you need a special health insurance plan that covers both the mother and child during and after pregnancy. Maternity insurance is such a thing that can bear all your expenses related to delivery, pre & post-natal care, hospitalisation charges, and medical tests. But how can it be beneficial for you? When should you buy it? You will get to know more about maternity insurance in this article.
Maternity insurance is a crucial part of health insurance that comes as an in-built benefit or a maternity plan. It provides comprehensive coverage to the policyholder including all the medical expenses related to pregnancy. It protects the policyholder financially, from 30 days before the date of delivery to up to 60 days after the birth of the child.
But how does maternity health insurance work for your parenthood? Pregnant women who get admitted to the networking hospital of their insurance provider get the maternity benefit. This policy provides coverage for medical expenses incurred during pregnancy like delivery expenses, hospitalisation, pre & post-natal care, medical tests, medicines and other newborn baby expenses up to a certain period.
Buying maternity health insurance early makes a good decision for further family planning. It saves you from paying hefty bills over delivery, pregnancy care, newborn child care, etc. No matter from which company you buy the policy, all such health insurance plans covering pregnancy have the following features in common:-
Features of Maternity Health Plans | Descriptive specifications |
Eligibility | 18-45 years. This is a fact to consider that most insurance companies offer maternity coverage for up to two-time deliveries and not more than that. |
Waiting period | These plans usually have 1-3 years of waiting period, so it's recommended to buy a maternity care plan at your earliest. |
Comprehensive coverage | From neonatal care to doctor's consultation, delivery charges, hospital stays, medical and pharmacy bills, etc are all covered in the sum insured of your policy. |
Newborn/neonatal care and postnatal care | The plan covers pre-birth and post-birth medical care. This includes the neonatal and postnatal care of the baby, before delivery and post-delivery. |
Daycare procedures | Medical or surgical treatments that need 24 hours or less hospitalisation time of care are covered in maternity insurance plans. |
Ambulance service | Ambulance services in an emergency are covered if the insured gets a transportation facility ranging from rupees 750-2000 in each policy period. This charge may vary from policy to policy or insurer to insurer. |
In-patient coverage (IPD) | Surgeries or medical treatment ranging from 24 hours or more are covered in pregnancy care plans. These criteria also include hospitalisation, room rent, medication, pharma care, etc. |
Network hospitalisation | The insured can get cashless treatment at the networking hospitals of their insurance provider. The medical bills are generally settled between the insurer and the hospital management. You need not pay anything out of your pockets. |
Cashless treatment | The policyholder is entitled to receive free or cashless treatment at the networking hospitals of their insurance provider. Your insurer and the hospital will directly settle down all the incurred bills, and you need not pay any out-of-pocket expenses. |
Tax benefits | An insured individual can save the taxable amount of their income by availing of the tax benefits under Section 80D of the Income Tax Act. |
Affordable premiums | Premiums of maternity add-on plans are generally affordable but the coverage an insured gets is abundant. |
No-claim bonus | If you don't make any claim, you're likely supposed to be getting a no-claim bonus as an increased sum insured for the next year or annual renewal of the policy. |
Quick claim settlement | Maternity insurance plans are settled timely by the insurers such that the mother and the child can get the best delivery/medical care without any hassle. |
However, it may seem difficult to choose the best health insurance for pregnancy specifically. So, here are some of the best maternity health insurance plans that cover all the expenses related to your pregnancy and make it a smooth experience for you and your child:-
Regardless of what you consider an emergency in life, pregnancy care is something that we can predict in advance. There comes the best part of maternity care plans in health insurance. Here is your 'why' to buy maternity medical care insurance:-
Health insurance with maternity coverage has its own sets of inclusions and exclusions. Read the pointers mentioned below about what pregnancy care under the health plan covers and what's not covered in it:-
These are the potential coverages that a pregnancy healthcare plan provides to the policyholder:-
Both Normal and Caesarean deliveries are covered, given that the waiting period is already fulfilled.
Prescriptions, drugs, medical checkups, ultrasounds, and physician/doctor's fees are covered. Any complications in delivery are covered as well
Provides Medicare to the newborn child. All neonatal expenses are covered from day 1 to up to 90 days, including premature labour.
Vaccination expenses for mother and child are covered during or after the delivery.
ICU charges, room rent/hospital stays, nursing, surgery, etc are covered.
Covers specialised medical procedures of short span or care that aren't required for 24 hours or more
The cost of emergency ambulance services is covered under the health insurance that covers maternity care
All the expenses related to pre-and-post maternity hospitalisation are covered from 30 days before and 60 days after the delivery
However, there must be another side of the coin. So, there are some exclusions that a maternity healthcare plan does not cover:-
Treatment for infertility or any special case of conceiving pregnancy is not covered under the plan. The condition of surrogacy is generally excluded from these plans as well.
Health coverage under maternity insurance does not cover the complications of pregnancy arising due to pre-existing conditions like epilepsy, blood pressure, diabetes, etc
Genetic diseases such as heart disease and Down syndrome caused before or at the time of birth of the child are not covered
The medicines, tonics, health supplements and drugs that are not prescribed by your doctors are not covered
Late pregnancy above 45 years of age is excluded from the pregnancy insurance
Due to a specific condition, if you cannot avoid a premature termination or a late abortion will not be covered
Ectopic pregnancy is a condition that occurs when the fertilized egg gets implanted outside the major cavity of female uterus, and it starts growing there. This condition of pregnancy is considered to be complicated, so not covered under health coverage of pregnancy insurance
Here are a few points that you should consider checking out while buying medical insurance that covers pregnancy:-
However, a mediclaim insurance policy with additional coverage usually comes with higher premium options. But you should always opt for a policy that has comparatively low premium charges.
As we know, maternity expenses are cut-throat high every time you go through this phase. Choose a policy that provides you with an adequate amount such that you never go short of financial strength. Therefore, it is better to go for pregnancy insurance which covers all your medical expenses related to maternity care like medical tests, medicines, doctor's consultations, commodities during your pregnancy, and so on.
Choose a maternity plan that comes with a waiting period of not more than 2 years. It's always a wise decision if you buy medical insurance that covers pregnancy, even before your marriage or planning a baby. Such that you don't have to complete the waiting period when you need medical assurance urgently.
Maternity insurance from most companies comes with a sub-limit. Sub-limit is a pre-decided amount that is paid by the insurer. Beyond this limit, the exceeded medical expenses will be borne by the policyholder. The sub-limit amount varies somewhere between Rs. 25,000 to 50,000. And this amount goes up in case of caesarean delivery.
Before buying a policy, check through the claim settlement ratio or the number of claims that were settled by the insurer in past decades. Buying maternity insurance with a trusted and credible insurance company is a flex that ensures your smooth Medicare without worrying about hefty medical bills.
Health insurance with maternity cover benefits is supposed to be availed at any of the insurer's networking hospitals. This means that the medical bills occurring during maternity care should be settled between the hospital and your insurer where you need not pay from your account.
The best way to buy a maternity plan is, to compare multiple policies before buying one. These are the steps, with which you can buy health insurance with pregnancy coverage:-
Visit the official website of PolicyX.com or,
Reach out to the executives of our customer care.
On our official website, Click on the 'Health Insurance' tab which will open up a digital form for you to fill out.
Now search for the insurance provider of your interest, from where you want to buy a maternity plan.
Search for a maternity insurance plan that covers all your specified requirements and proceed.
Fill in all the necessary details such as the details of the family member you want health insurance coverage for, and your age and click on "View Plans".
After entering all the required details like- name, contact details, and other preferred details asked on the portal.
Select your city and click on "Proceed"
Click on "Get Free Quotes"
You will be directed toward a list of health insurance plans wherein you can compare the plans of your choice and pay for the one you want as per your needs and requirements.
Now you may proceed to 'Buy' and here you go! You have made a valuable purchase with us.
To avail of the maternity benefit under your health insurance, you will get cashless treatment at the insurer's networking hospitals. Or you would get a reimbursement for your incurred medical bills. Depending on your situation, here are the steps that you should follow to claim your maternity insurance:-
Once you are taken and admitted to the hospital, the first step involves informing your insurer about your admission to the hospital. Tell them every detail of the hospitalisation.
Fill in the claim form for settlement and sign it. Complete all the information that requires your approval and submit it to the TPA present at the hospital of the respective insurer.
Once you've submitted the claim form, you need to submit all the required documents for verification. These documents include your personal information like address proofs, Identity proofs, policy documents, etc.
Apart from the requested documents, you need to submit medical bills, and all the invoices related to hospitalisation, consultation, treatment, etc. In case, you've received treatment from a non-network hospital, these bills will get a reimbursement from the insurer.
Your insurer will probably send one of their agents to verify if the claim made by you is correct or wrong. Once you pass this verification procedure, you are one step ahead of getting your claim accepted.
If the claim is proven true, you'll receive the claim amount in the form of cashless treatment in networking hospitals or reimbursement in non-networking hospitals.
The documents that are required for claiming your maternity healthcare coverage are listed below:-
Stuck between where to consult while buying a pregnancy care plan? Here is why you should consult with PolicyX to buy a health plan for you:-
Planning towards parenthood is one of the most valuable experiences for a couple. It brings you joy and the gift of a new life as your newborn child. But securing this moment mentally and financially is an important aspect to consider. Maternity healthcare insurance is the ultimate way to proceed with this happiness of your life as it covers your spouse and child from financial burden. This article will give you a new way of making informed decisions about your pregnancy. However, if you have any further queries about maternity plans, reach out to our team of experts at Policyx.com.
Simran has an experience of 3 years in insurance content writing. She transitioned from hospitality to the insurance industry after her emerging interest in how vast insurance is. With her ability to write complex insurance concepts in a simple, relatable manner she keeps her audience hooked and solves their doubts smoothly.