Maternity health insurance is a specialized plan offering financial protection for expenses related to pregnancy, childbirth (normal and C-section), and postnatal care for both the mother and the newborn (typically up to 90 days). It covers prenatal check-ups, delivery costs, hospitalization, and often newborn care, including vaccinations.
Maternity health insurance is a specialized plan offering financial protection for expenses related to pregnancy, childbirth (normal and C-section), and postnatal care for both the mother and the newborn (typically up to 90 days). It covers prenatal check-ups, delivery costs, hospitalization, and often newborn care, including vaccinations.
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Anchita has over 6 years of experience in content marketing, insurance, and healthcare sectors. Her motto to make health and term insurance simple for our readers has proven to make insurance lingos simple and easy to understand by our readers.
Updated on May 08, 2025 13 min read
What is Maternity Health Insurance?
Maternity health insurance is specialised health insurance designed to cover the medical expenses associated with pregnancy, childbirth, and the post-natal period. It covers both the mother and the newborn child. In India, the cost of healthcare, particularly for maternity-related services, is rising continuously. To beat this inflation in the healthcare industry, securing a comprehensive maternity health insurance plan has become important for expectant parents.
It is suggested to buy a maternity health insurance plan before planning for the family. The reason for this? You will get to know soon when you read the complete article.
If you and your partner plan to start a family in the future, purchasing a maternity health insurance plan soon after marriage is a wise decision to cover the waiting period.
Young Couples Planning a Family
Couples under 35 who are considering parenthood should prioritise buying a plan well in advance of their family planning timeline.
Planning for a Second Child
If you already have a child and are planning for another, it's advisable to buy or review your maternity coverage well before trying to conceive again.
Working Professionals
Even if you plan to have children later in your career, buying a plan early can help you complete the waiting period and be prepared.
Can You Buy Maternity Insurance When Already Pregnant?
The answer to this question can be YES and NO both. Here is how.
Generally, it is difficult to get comprehensive maternity coverage once you are already pregnant because pregnancy is usually considered a pre-existing condition.
Some insurers might offer regular health insurance plans that may provide limited coverage for hospitalisation during delivery, but they will likely not cover prenatal or postnatal care and will have waiting periods for maternity-specific benefits.
A few specific plans might offer maternity coverage to pregnant women, but these often come with conditions, such as specific gestational age limits at the time of purchase or longer policy tenures. These plans might also have limitations on the extent of coverage.
How to Choose the Best Maternity Health Insurance Policy?
You need to consider several factors carefully before choosing the best health insurance plan. These factors will help you meet your specific needs and provide adequate financial protection during this important phase of life. Here, we present a comprehensive guide on how you can choose the top maternity health insurance plan.
Assess Your Needs and Plan
Timing of Pregnancy
If you are planning a family, buy the policy well in advance (at least a year) to serve the waiting period.
Number of Children
Consider if the policy covers more than one delivery if you plan to have multiple children. Some policies have limits on the number of claims for maternity benefits.
Expected Delivery Type
While most policies cover both normal and C-section deliveries, some might have sub-limits for each. Understand these limits by talking to your insurer directly or by going through the policy documents.
Preferred Hospitals
Check if your preferred hospitals are in the insurer's network for cashless treatment.
Waiting Period
This is the most critical factor. Maternity coverage typically has a waiting period ranging from 9 months to 4 years. Opt for a plan with the shortest possible waiting period that aligns with your family planning. Be aware that there are generally no zero-waiting-period maternity plans available in India for individual policies.
Coverage Amount (Sum Insured)
Choose a sum insured that adequately covers the estimated costs of maternity and newborn care in your city, considering potential complications and rising medical inflation. Be aware of sub-limits for specific expenses like delivery or room rent, which might be lower than the overall sum insured.
Understand Exclusions and Inclusions
Several inclusions and exclusions come with every plan. Before saying yes to any maternity plan, check out what your plan covers and what not.
Check Premium
Obviously, the budget is the main constraint. Compare premiums from different insurers for the coverage offered. Balance comprehensive coverage with affordability. Consider the policy tenure (1, 2, or 3 years) and any potential discounts for long-term policies or for being healthy.
Network Hospitals
Check if the insurer has a wide network of hospitals in your area, including those you prefer, to facilitate cashless treatment.
Claim Settlement Ratio
Choose an insurer with a high claim settlement ratio for a hassle-free claim process. Look for features like cashless hospitalisation and quick claim approvals. You can check the claim settlement ratio of each company at the PolicyX data labs.
Renewability
Ensure the maternity policy is renewable to continue coverage for future pregnancies (if applicable) and other health needs. We, at PolicyX, take care of the renewability, and we help you with the complete renewal process for free.
Eligibility Criteria
Check the age eligibility for the policy. Typically, women between 18 and 45 years are eligible for maternity health insurance.
Compare Different Policies
Don't just focus on the premium. Compare the coverage, waiting periods, exclusions, and other benefits offered by different insurers. Read the policy documents carefully to understand the terms and conditions, including any sub-limits and co-payment clauses. Use online insurance comparison portals like PolicyX.com to get quotes and compare features of various maternity health insurance plans.
Consider the Insurer's Reputation and Customer Service
Research the insurer's reputation, claim settlement process, and customer service quality. Read online reviews and check the insurer's ratings on Google and other platforms.
Disclaimer: This is not an exhaustive list, and the "best" policy depends on your respective needs and circumstances. Always compare the latest policy details and consult with an insurance advisor before making a decision.
By carefully evaluating these factors and comparing different policies, you can choose the best maternity health insurance plan that provides you with adequate coverage and peace of mind as you embark on your journey to parenthood.
Here are the inclusions that will help you understand the coverage of maternity health insurance and what it includes.
Prenatal Care: Doctor visits, tests, and scans during pregnancy.
Delivery Expenses: Both normal and C-section delivery charges, including surgeon fees, operation theatre costs, room rent, and nursing charges.
Postnatal Care: Follow-up visits and medications for the mother after delivery.
Newborn Coverage: Medical expenses for the newborn baby for a specific period (usually up to 90 days), including vaccinations and treatment for congenital disorders. Some policies might even cover the newborn from day one.
Hospitalisation Expenses: Room rent, nursing charges, and other in-patient services.
Ambulance Charges: Coverage for ambulance services in case of emergencies.
Complications: Coverage for unexpected complications during pregnancy or childbirth.
Outpatient Expenses: Some policies might cover outpatient expenses like diagnostic tests and doctor consultations related to pregnancy.
Assisted Reproductive Treatments (ART): A few comprehensive plans might cover IVF treatments after a longer waiting period.
Stem Cell Preservation: Some niche plans might cover the cost of stem cell preservation.
Exclusions of Maternity Health Insurance
Here are the situations that your maternity health plan will not give coverage for:
Expenses incurred before the waiting period is over.
Pre-existing conditions related to pregnancy (if you buy the policy after conceiving).
Voluntary termination of pregnancy (unless for medical reasons).
Ectopic pregnancy (may be excluded in some policies).
Cosmetic procedures.
Supplements (vitamins, tonics) and routine check-ups that are not directly related to complications or delivery.
What are the Benefits of Buying Maternity Health Insurance?
Buying maternity health insurance offers a multitude of benefits for expecting parents, providing not only financial security but also peace of mind during pregnancy, childbirth, and the postnatal period. Here's a detailed breakdown of these benefits.
Financial Security and Reduced Out-of-pocket Expenses
Coverage of Delivery Costs
Childbirth, whether normal or via Cesarean section, can be expensive, as much as Rs 1 Lakh in private healthcare facilities. Maternity insurance covers a significant portion or even the entire cost of hospitalisation, doctor's fees, operation theatre charges, nursing expenses, and medication related to the delivery.
Prenatal Care Coverage
Regular check-ups, diagnostic tests (like ultrasounds and blood tests), and consultations with gynaecologists during pregnancy are essential. Maternity insurance typically covers these prenatal expenses, reducing the financial strain of frequent medical visits.
Postnatal Care for Mother
The mother requires medical attention and follow-up visits after delivery. Maternity insurance often includes coverage for these postnatal consultations and any necessary treatments.
Newborn Baby Coverage
Most maternity policies extend coverage to the newborn baby for a specific period (usually up to 90 days or even longer). This includes vaccination costs, doctor visits, and treatment for any illnesses or complications the newborn might face. Some policies even cover congenital disorders.
Coverage for Complications
Unexpected complications during pregnancy or childbirth can lead to substantial medical bills. Maternity insurance provides a financial safety net to handle these unforeseen expenses.
Access to Quality Healthcare
Cashless Treatment at Network Hospitals
Many maternity insurance plans offer cashless treatment at a wide network of hospitals. This means you don't have to pay out of pocket for covered expenses; the insurance company directly settles the bill with the hospital. This significantly reduces the immediate financial burden during a stressful time.
Choice of Hospitals
Depending on the policy and network, you may have the option to choose a hospital that suits your preferences and provides quality medical care.
Better Medical Facilities
With the assurance of financial coverage, you are more likely to opt for hospitals with better facilities and experienced medical professionals, ensuring quality care for both mother and child.
Peace of Mind and Reduced Stress
Focus on Health, Not Finances
Knowing that a significant portion of the medical expenses is covered allows expecting parents to focus on the health and well-being of the mother and the baby rather than worrying about mounting hospital bills.
Financial Planning
Maternity insurance helps in better financial planning for the arrival of the baby, as you have a clearer estimate of the healthcare costs involved.
Reduced Emotional Burden
The stress associated with managing medical expenses during pregnancy and childbirth can be emotionally draining. Insurance helps alleviate this burden.
Additional Benefits (Depending on the Policy)
Ambulance Charges
Some policies cover the cost of ambulance services in case of emergencies during pregnancy or labour.
Outpatient Expenses
Certain plans might include coverage for outpatient consultations and diagnostic tests related to pregnancy.
Assisted Reproductive Technology (ART) Coverage
A few comprehensive plans cover the costs of IVF treatments after a long waiting period, which can be a significant benefit for couples facing fertility issues.
Stem Cell Preservation Costs
Some innovative policies might cover the expenses related to the stem cell banking of the newborn's umbilical cord blood.
Lactation Consultation
A few modern plans are starting to include coverage for lactation and related consultations to support new mothers.
Birthing Classes
Some policies might offer coverage or discounts for prenatal training and birthing classes.
Paternity Benefits (Rare)
While uncommon, some very comprehensive plans might offer limited benefits for the father.
Tax Benefits
Premiums paid towards health insurance policies, including those with maternity benefits, may be eligible for tax deductions under Section 80D of the Income Tax Act in India, subject to certain limits.
All in all, obtaining maternity health insurance provides a crucial financial safety net, ensuring access to quality healthcare, reducing stress, and offering various additional benefits that can significantly ease the journey into parenthood. It's a proactive step towards securing the health and financial well-being of your growing family.
Eligibility Criteria for Maternity Health Plans
You can buy this plan for yourself, or be eligible for maternity health insurance plans if you are:
A women
18 years or older
Mother of a child of 91 days who is looking to buy insurance for the child.
A citizen of India.
How to Buy Maternity Health Insurance?
Step 1
Visit the PolicyX health insurance page, and enter your details such as name, age, number of members to be covered, and city.
Step 2
Click on 'Get free quotes' and compare maternity health insurance plans as per your needs.
Step 3
Select and pay premiums online for the purchased maternity health insurance plan of your choice.
Step 4
Our team of insurance experts at PolicyX will provide you with all the assistance required regarding claims and other queries post-purchase of your maternity health insurance plan.
How to Claim for Maternity Health Insurance?
Filing maternity health insurance claims might seem confusing, but in reality, it is an uncomplicated process. All you need are your essential documents, prescriptions, medical reports, etc., and follow the given steps below:
Step 1
Visit the PolicyX and select the ‘Claim' option. Then click on the ‘Claim Intimation' to check out the form.
Step 2
Now select ‘Health Claim' and provide the information, which includes the policy number, date of birth, and other details they ask for.
Step 3
Now select the ‘Claim Type', whether you want to opt for a cashless claim or reimbursement. Click on the authorise and you will receive the OTP on the verified number.
Step 4
Get verified with the OTP and fill in the required hospital admission information, select the hospital, and fill in the hospital details in case of a non-network hospital.
Step 5
Upload the documents asked for and click on the ‘Review' button.
Step 6
After clicking on the review button, you need to submit the intimation for the company to review. You will receive a claim intimation number, which you need to note down for future purposes.
Documents Required While Filing Maternity Claim
The following are the documents that are required for claiming your maternity healthcare coverage:
Filled out and signed claim form
Copy of policy documents
Doctor's advice on hospital admission
Hospital discharge summary
KYC documents
Certification of fitness from doctors
Consultation bills
The original hospital bill
Any prescription and pharmacy bills
Other attachments that are requested by the insurer
Bottom Line
Maternity health insurance is a crucial financial shield for expectant parents in India's rising healthcare costs. Covering prenatal to postnatal care for both mother and newborn, these plans ensure access to quality healthcare without financial strain. Buying early is key due to mandatory waiting periods. Offering financial security, cashless treatment at network hospitals, and peace of mind, these policies are a prudent investment in your growing family's well-being.
As awareness grows, maternity insurance is becoming an increasingly vital component of family planning, offering invaluable support on the journey to parenthood.
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Maternity Health Insurance: FAQS
1. What is maternity health insurance?
Maternity health insurance is a specialised type of health insurance that covers medical expenses related to pregnancy, childbirth (both normal and C-section), and postnatal care for both the mother and the newborn baby for a specified period.
2. What is the minimum waiting period for maternity insurance?
Usually, the waiting period for maternity health insurance is 30 days. However, the waiting period for maternity health insurance depends on the specific plan you choose.
3. Is there any maternity insurance plan with a zero waiting period?
Generally, no. Most individual maternity health insurance plans in India have a waiting period ranging from 9 months to 4 years.
4. Can I buy maternity insurance after I am already pregnant?
It's difficult to get comprehensive maternity coverage after conception, as pregnancy is usually considered a pre-existing condition. Some regular health plans might offer limited delivery hospitalisation coverage with a waiting period, but comprehensive prenatal and postnatal care might not be included.
5. How much sum insured should I opt for in a maternity health insurance plan?
The ideal sum insured depends on the cost of childbirth and related medical expenses in your city and your preferred hospitals. Consider potential complications and rising healthcare costs when deciding.
6. What is the waiting period for maternity health insurance?
The waiting period is the time you need to wait after purchasing the policy before you can claim maternity benefits. It typically ranges from 9 months to 4 years, depending on the insurer and the plan.
7. Does maternity insurance cover both normal and C-section deliveries?
Yes, most comprehensive maternity health insurance plans cover both normal and Cesarean section deliveries. However, some policies might have sub-limits for each.
8. Is the newborn baby covered under maternity insurance? For how long?
Yes, most maternity policies provide coverage for the newborn baby for a specific period, usually up to 90 days after birth. This often includes vaccination costs and treatment for congenital disorders. Some policies might cover the newborn from day one.
9. What is cashless treatment in maternity insurance?
Cashless treatment allows you to get admitted and treated at a network hospital without having to pay upfront for the covered medical expenses. The insurance company directly settles the bill with the hospital.
10. Are there any tax benefits on the premium paid for maternity health insurance?
Yes, the premiums paid towards health insurance policies, including those with maternity benefits, may be eligible for tax deductions under Section 80D of the Income Tax Act in India, subject to certain limits.
11. Does maternity insurance cover infertility treatments like IVF?
Some comprehensive maternity health insurance plans may cover the costs of Assisted Reproductive Technology (ART) like IVF, but typically after a longer waiting period and often as an add-on or under specific conditions.
12. Is the third childbirth covered under maternity insurance plans?
No, most of the health insurance plans provide coverage for only two living children.
Health Insurance Companies
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Simran has over 3 years of experience in content marketing, insurance, and healthcare sectors. Her motto is to make health and term insurance simple for our readers has proven to make insurance lingos simple and easy to understand by our readers.
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