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Health Insurance-Maternity Benefits

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31 May, 2021 by  Sanjay P

Dear All,


I planning to purchase an health Insurance covering me and my spouse and having following doubts

1.Is it advisable to buy policy covering Maternity Benefits (How useful is it?How much of the expense is usally taken care)

2.For us,is it advisable to buy a family floater or an individual plans seperatly for both of us?


Thank you,

Sanjay P

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Health Insurance

2 Answer

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31 May, 2021

Dear Sanjay

Would depend on your age and your plans for family . My answer is given below :

1. There is a minimum waiting period of 2 year or more which means you can not claim maternity benefit till completion of 2 years . Only after 2

years , maternity benefit is allowed.


2. Maximum maternity claim is limited to Rs 75000, this include all expenses related to maternity . You will not be able to claim more than Rs 75000.


3. It is very useful because it covers expense upto Rs 75000 and also automatically new born in basic family sum assured .


4. Advise family floater of Rs 5 lakh and you can supplement with super top up of Rs 20 lakh.

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31 May, 2021
Sanjay P
Dear Shailesh, Thank you so much for replying. I think the waiting period could be a concern given most of the policies have around 2-3 years plus. Would require your clarrification on certain questions :- As per your point 4 you advise 5 L family floater cover with super top up of 20L ,is this available to any of the person part of the policy at any given point.As this turns out cheaper,I just wanted to understand why do companies sell higher SI seperatly if all one can do is just purchase a lower floater cover with a super top up.Is there any scenario where the super top up cover wont be applicable. 2..Also whats your take on buying insurance from private players in comaprision with players such as NEw India Assurance or Oriental Insurance Which one would you suggest with respect to claims processing,cashless and coverage perspective.Any particular private player that I can consider . Thank you so much sir !!
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31 May, 2021

Hi Sanjay,


Family floater works well for young families. For the same amount of cover taken as a family floater versus taking it individually, you save more than 25% on premium.


Maternity cover has a limited utility in health insurance. Most health insurance plans cover upto 2 maternity cases and they have a limit varying from 25,000/- to 1,00,000 on maternity & new born baby expenses. There is also a waiting period of 2 to 4 years for maternity benefits to kick in. Considering you pay a significantly higher premium for a maternity plan (and pay it for 3/4 years before you can avail any maternity benefit), I see very little utility here.


In case you work somewhere, you can also check if your company provided group health cover has maternity included. That may help.


Regards

Asad Akbar

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31 May, 2021
Sanjay P
Hi Asad, Thank you for replying. Yes I understand from the point of view of waiting period ,it really does not make so much sense. Also I had few more questions :- 1. From the view of family floater plan ,is it that the entire SI at any point will be available to either my wife or me, for example if there is a 10L cover that i have taken ,at any point is 10 L available for either of us or it is split between me and my wife in a ration such as 50-50 or 60-40? 2.Also whats your take on buying insurance from private players in comaprision with players such as NEw India Assurance or Oriental Insurance.Which one would you suggest with respect to claims processing,cashless and coverage perspective? 3.Also for me (31)and my wife(27) what is the coverage you suggest at current scenario to be taken for health Insurance. Thank you so much !!You guys are wonderful !
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