Maternity cover

What is maternity cover?

Maternity cover is a feature in health insurance that covers medical expenses related to pregnancy and childbirth. This includes costs incurred before delivery, during childbirth, and after delivery, along with limited coverage for the newborn baby.

Maternity cover is often offered as part of employee benefits, helping working parents manage the high costs associated with maternity care without financial stress.

Role of maternity cover in group health insurance

In group health insurance, maternity cover plays a key role in supporting employees during major life milestones. Employers can include maternity cover health insurance to improve employee retention, promote workplace inclusivity, and support women returning to work after childbirth.

Why maternity cover is important for working parents

Pregnancy and childbirth involve significant medical expenses. Group health insurance with maternity cover helps working parents plan better, reduces out-of-pocket costs, and ensures access to quality healthcare during and after pregnancy.

How maternity cover works in group health insurance plans

• Employers choose whether maternity cover is included in the base policy or as an add-on
  
• Coverage limits and waiting periods are defined in the policy
  
• Employees can use network hospitals for cashless maternity claims

Difference between base coverage and add-on maternity benefits

• Base coverage may include maternity benefits by default
  
• Add-on maternity cover insurance is purchased separately at an additional cost
  
• Add-ons usually have defined sub-limits and conditions

What does maternity cover include?

Pre-natal consultations and diagnostic tests

Maternity cover in group health insurance typically pays for doctor consultations, ultrasounds, blood tests, and other diagnostic tests required during pregnancy.

Delivery expenses, including normal and caesarean delivery

Costs related to hospitalization, doctor fees, operation theatre charges, and nursing care for both normal and C-section deliveries are covered, subject to sub-limits.

Post-natal care for the mother

Post-delivery hospitalization expenses, follow-up consultations, and medical treatment related to childbirth complications are covered under maternity cover.

Newborn baby coverage under group health insurance

Many group health insurance plans provide newborn baby coverage from birth for a specific period, covering medical treatment and hospitalization expenses.

What is not covered under maternity cover?

Waiting period restrictions

Most maternity cover insurance policies have a waiting period before benefits can be claimed.

Infertility or assisted reproductive treatments

Treatments such as IVF, IUI, pregnancy loss or other assisted reproductive procedures are generally excluded unless specifically covered.

Non-medical or consumable expenses

Items like toiletries, food charges, and personal consumables are usually not covered.

Policy-specific exclusions in group health insurance

Coverage exclusions may vary based on the insurer and policy terms, including limits on the number of deliveries.

Key factors HR should check before offering maternity cover

Sub-limits on maternity expenses

Check the maximum amount payable per delivery under the maternity cover in group health insurance.

Waiting period clauses

Group health insurance may offer shorter or zero waiting periods compared to individual maternity insurance policies.

Newborn coverage duration

Review how long the newborn baby is covered after birth and whether formal enrolment is required.

Network hospital availability

Ensure adequate network hospitals for cashless maternity claims.

Is maternity cover mandatory under group health insurance?

Legal provisions related to maternity benefits

While maternity benefits are mandated under labour laws, maternity cover in group health insurance is not legally mandatory but commonly offered by employers.

Design a group health insurance plan that truly supports working parents. With Pazcare, you can customize maternity cover,, and offer seamless maternity care across a wide hospital network. Talk to our experts to build a plan for your team.