Maternity Health Insurance -Everything You Need To Know | Pazcare

Understanding maternity insurance and group health insurance with maternity cover. Know what is covered and not covered in maternity insurance

Maternity Insurance

Pregnancy is a significant phase of life for many people. In order to experience a pressure free parenthood it is important to plan both mentally and financially. Maternity related expenses like hospitalization charges, newborn baby expenses have become a costly affair these days.

Hence, proper financial planning by opting for proper health insurance with maternity cover can take the financial burden off your head.

Understanding Maternity Health Insurance

Maternity health insurance is an add on cover that one can opt for in an Individual Health Insurance plan or Family Health Insurance Plan. This health insurance with maternity cover can cover your maternity related expenses like the delivery costs, both C-section and normal during the policy tenure up to the sum insured.

Who can opt for maternity insurance in India?

Anyone with an existing health insurance or is planning to take it in the future can opt for health insurance with maternity cover in India. This plan will not only benefit the policyholder but also the spouse in the time of need. For instance, if the husband is the policyholder, opting for maternity health insurance can cover his wife.

Importance of Maternity Insurance

The medical expenses are continuously increasing these days. According to Business Today, the healthcare inflation rate in India is 15% a year.

Now this is too technical, isn’t it? Now let's cut down to the basic facts

  • In the urban areas, the charges for a normal delivery can range from Rs. 50,000 to Rs. 75,000.
  • The average cost of a C-section delivery can range from 1.5 lakh to 2 lakhs in the urban areas.
  • According to Forbes magazine, most couples around the world are delaying childbirth due to their financial constraints.

Now these costs highly depend on the area of residence and the city you live in.

Also, opting for the best health insurance with maternity cover can provide you with great financial security during pregnancy and childbirth. It can cover your hospitalization expenses, delivery expenses and sometimes your newborn baby expenses up to 90 days are also covered.

Not only that, opting for a health insurance policy means you can also save on your taxes. Under the section 80D of the Income Tax act of 1961, one can avail tax benefits in health insurance for paying the premiums.

Maternity insurance

How to choose the best maternity insurance?

One can choose the best maternity cover health insurance by considering the following factors in mind. You can compare health insurance plans by various factors, but these remain the basic points of comparison for maternity health insurance.

Maternity related hospitalization charges coverage

A maternity health insurance covers hospitalization expenses 30 days before the delivery and 60 days after delivery. However, the number of days covered during this period can vary from one insurer to another.

Coverage of delivery

The maternity cover in health insurance covers the delivery expenses, normal or c-section delivery both are covered in the plan. However, if the cost exceeds the sum insured then, the rest may be paid by the policyholder. In some cases one can opt for a co-pay health insurance scheme.

Newborn baby coverage

The health insurance with maternity cover also extends the coverage for the newborn baby from day one, for up to 90 days without any additional premium. This may also include premature labor, vaccination expenses depending on your insurer.

Cashless claim settlement

A most important factor in any health insurance maternity cover is the ease of settling claims. Make sure the insurer has a good network of Third Party Administrators (TPA) and network hospitals for cashless claim settlement. If it is not a network hospital, then make sure your insurer has an easy reimbursement claim settlement option.

What’s not included in a maternity insurance?

There are a few expenses that may not fall under the health insurance with maternity cover. However, this may be subjective to the insurer.

Infertility treatment expenses

Most health insurance companies do not cover the expenses due to infertility treatments or IVF procedures under the maternity health insurance. Make sure you read the policy related documents carefully as there are a few insurers who may cover these expenses also.

Doctor’s consultation fees

Under the maternity insurance, the consultation fees for the regular gynaecologist visit are not covered.

Cost of medicines prescribed apart from the doctor

In most cases your maternity health insurance may cover the cost of medicines prescribed by your doctor. However, other medicines like supplements which are taken additionally may not be covered. This maternity insurance plan may not cover non-allopathic medicines or treatment unless specified.

Stem cell storage charges

The charges against collection and storage of stem cells are not covered by the maternity cover health insurance.

Health insurance companies providing maternity insurance plans

A good understanding of maternity insurance plans offered by various health insurers is required before making any financial decisions. Here is a list of a few health insurance companies providing maternity insurance plans.

SBI maternity insurance

SBI maternity insurance comes under the SBI Arogya Premier Plan. Anyone aged between 18 years to 65 years are eligible to purchase this plan. The SBI maternity insurance waiting period is around 9 months. After this waiting period this policy covers maternity related expenses. The sum insured starts from 10 lakhs and goes upto 30 lakhs. Another advantage of this policy is that people up to 55 years of age with no medical history do not require a medical checkup.

Star health insurance for maternity

The Star health insurance for maternity comes under a policy called Star wedding gift insurance policy. Any couple aged between 18 to 40 years are eligible to purchase this policy. There are two options available in this policy. This plan covers up to two deliveries including normal and c-section deliveries. It also covers hospitalization expenses, pre and post natal expenses, post delivery complications for the mother and newborn baby expenses. However, it comes with a waiting period of 3 years and the maximum sum insured is 10 lakhs.

Care health joy health insurance plan

It was previously known as Religare joy maternity insurance plan. Under this option called Care health joy today plan, one will be able to claim the maternity expenses after a waiting period of 9 months. However, under Care health joy tomorrow plan one has to wait for a span of 2 years to cover the maternity expenses.

Maternity cover in group health insurance policies

Many organizations offer maternity cover in group health insurance policies for their employers or their spouses. However, the maternity limit varies from one policy to another depending upon the insurer. A majority of group health insurance plans offer an add-on maternity cover with a sub limit. It covers expenses related to hospitalization, delivery expenses, pre and post natal expenses and 90 days newborn baby expenses. Some policies can even cover the newborn vaccination costs too. However, this can vary among different health insurance companies in India.

Frequently asked questions

What is maternity cover in health insurance?

A maternity cover in health insurance is an add-on cover that one can opt for in an existing health insurance policy to cover the policyholder or the spouse.

Is the second childbirth covered by maternity health insurance?

The second childbirth will be covered by maternity health insurance if you have an add on maternity cover in your health insurance. This covers up to the prescribed sum insured in the policy.

What is the Star Health Insurance maternity limit?

In Star Health Insurance, the maternity insurance comes under the Star Comprehensive Insurance Policy. The maximum sum insured in this policy is Rs. 5 Lakhs.

Is the newborn baby covered in health insurance with maternity cover?

Yes, the newborn baby is covered from day 1 to 90 days in health insurance with maternity cover.

Can I opt for maternity cover in health insurance during pregnancy?

The health insurers consider pregnancy as a pre-existing condition and hence there is a waiting period for it. Hence, it is advisable to purchase a maternity cover in advance.

What is covered in maternity health insurance?

In maternity health insurance, maternity related hospitalization, delivery expenses and newborn baby expenses are generally covered.

How to claim maternity insurance?

There are two ways to claim maternity insurance. They are cashless claims and reimbursement claims. In a cashless claim, the insurer directly settles the claim to the network hospital. Under a reimbursement claim, the policyholder pays the bills during hospitalization and later reimburses it from the insurer. The health insurance claim process depends upon the type of hospital you choose, a network or a non-network hospital.

Read: What is Domiciliary Hospitalization?

Group health insurance with maternity cover

Offer your employees the benefit of health insurance with maternity cover. Pazcare offers group medical insurance plans that comes with an add-on maternity coverage. The plan offers coverage to most maternity related expenses like hospitalization charges, delivery expenses, newborn baby cover up to 90 days. Not only this, you can step up the employee benefits experience by including corporate wellness programs in your benefits plan. The wellness programs include unlimited doctor consultations, personalized therapy sessions, healthcare packages specially curated for women, regular health check-ups at discounted prices. To know more about group health insurance and its benefits, read the group health insurance guide curated by Pazcare.

Talk to our team to get more insights and competitive quotes for your team.

Get in touch

Have questions? We are here to help

No items found.
20,000 HRs have!
Subscribe here.

What you will receive in your inbox?
  • Guides on employee insurance and wellness
  • Surveys and reports
  • Updates on free wellness webinars
  • Features from Champions of HR - A Thought Leadership Initiative