Guide to Group Health Insurance With Maternity Cover
Guide to Group Health Insurance With Maternity Cover


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Group Health Insurance With Maternity Cover - Maternity Insurance Coverage With No Waiting Period

Pregnancy is a significant phase of life for many people. In order to experience 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.

Maternity insurance India

Interestingly, not a lot of countries don't offer maternity insurance as maternity is a joyous occasion. However, in India, maternity is a popular insurance.

In India, 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.

Maternity insurance without waiting period

Maternity insurance bought individually from an insurer has 2 to 4 year waiting period. Some insurers give a lesser waiting period but the premium will be higher. Maternity coverage in group health insurance is the only maternity coverage that has no waiting period. Employees and their spouse can use the group medical policy from day 1.

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. In group mediclaim insurance policy for employees, mostly the maternity cover is added as an add-on cover to the existing corporate medical insurance policy.

Importance of maternity insurance policy

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.

What is covered under maternity insurance in a group medical policy?

The below are the the common inclusions of a maternity insurance in group medical 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 is not covered under maternity insurance in a group medical policy?

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 in your employee health insurance.

Frequently asked questions

What is called maternity insurance?

Maternity insurance is insurance that covers expenses related to maternity like hospitalization, C-section, delivery expenses, newborn expenses etc.

Is maternity covered in group health insurance?

Maternity is not covered in group health insurance by default. It is an add-on cover that you can buy and add to your base group health policy.

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.

What is covered in maternity health insurance?

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

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