08 Apr, 2022 | Health Insurance

Does The Maternity Benefit In Health Insurance Cover Both Mother And Child?

Aakansha Jain
By Aakansha Jain
Budding Content Developer at Beshak
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Introduction

Planning a child will undoubtedly be one of the most beautiful yet challenging times in your life. Challenging because the costs associated with pregnancy have gone up exponentially and they start from the day you get pregnant and can be never-ending. Becoming a parent is one of the most magical things in life, and stressing about finances should be the last thing on your mind at that time - which is why you should be prepared beforehand for one of the most important chapters in your life by investing in a maternity health insurance plan. 

In this article, we discuss the maternity benefit in health insurance - how health insurance with maternity benefits works, when you should consider buying it, the conditions you should be aware of before purchasing it, and the types of expenses it will cover.

So, let’s jump right in! 

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What Is Maternity Insurance?

Maternity insurance offers protection against the medical and health-related expenses associated with pregnancy. In some policies, it is available as a separate rider or an add-on benefit which you can voluntarily opt for by paying an additional premium. Expenses related to both normal and caesarean deliveries are covered under the maternity benefit in health insurance

There, however, might be some conditions related to how much you can claim, what types of expenses you can claim for, etc. 

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General Conditions For Coverage Of Maternity Expenses Under Health Insurance

Here’s a quick rundown of some common conditions for coverage of maternity expenses under health insurance.

1️⃣ Separate limit

Most health insurance policies may mention a specific limit for maternity-related expenses, which may vary from INR 30,000 to 10 Lakhs depending on the product and the base sum insured you choose. Your policy will offer coverage only up to this limit. Any extra expenses incurred beyond this limit will have to be borne by you.

Say you have a health insurance cover of INR 5 Lakhs, and the maternity insurance coverage limit in your policy is INR 50,000. Now, irrespective of the expenses incurred, your health insurance will only provide a cover of up to INR 50,000 for maternity-related purposes.

2️⃣ Various expenses covered

The maternity benefit will cover the expenses of both normal and caesarean deliveries. Some policies may also cover pre and post-natal expenses incurred for medicines, ultrasound, regular checkups, doctor's consultation fee, etc. 

Generally, expenses incurred 30 days prior to the delivery of the baby, and 60 days post-delivery are covered by most health insurance policies. The number of days, however, may differ from insurer to insurer. 

3️⃣ Waiting period 

This is a very important point to note. You don’t get a maternity health insurance cover immediately on buying the policy. The waiting period for maternity benefit in your health insurance policy may vary from  9 months to 4 years depending on the product you select. You won’t be able to make a claim for any maternity-related expenses during this period.

4️⃣No. of deliveries covered

Some insurance policies may also have a limit on the number of deliveries you can use the maternity benefit for. For instance, there are some policies that cover a maximum of two deliveries under the maternity benefit.

5️⃣ Other conditions

If you’re taking the health insurance with a maternity cover, you should know that a few insurance companies have a condition that you can opt for the maternity benefit only if you and your spouse are covered under the same floater insurance policy.

Please note: The above conditions and limits may vary across insurance companies. Ensure you go through your policy document before you opt for this benefit.

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Will The Newborn Baby Be Covered Under The Policy?

Besides offering coverage for the to-be mother, some insurance policies also cover the newborn baby for a fixed period of time. In many policies, the newborn baby automatically gets added to the floater policy of the parents. 

While some plans cover the newborn baby from day 1 until the next renewal, there are plans that cover the baby from day 1 to day 90. Post this, the newborn baby will have to be added to the policy by paying an additional premium. 

Further, in some policies, the newborn baby will be covered up to the policy sum insured, while others may mention a specific limit up to which the expenses related to the baby will be covered. 

Please note: The above conditions may vary across policies. So, ensure you go through your policy document before you make the purchase.

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Will The Policy Cover Expenses Related To Vaccination Of The Baby?

Yes, there are some health insurance plans that cover expenses pertaining to timely vaccinations of the newborn baby. In some policies, these expenses may be covered only for the first year, while others may cover the expenses for more than one year - this will depend on the plan you buy. 

Also, some insurers may impose a limit up to which they will cover the vaccination-related expenses, whereas other policies will mention a list of vaccines that will be covered. Ensure you go through this list and check if all the important vaccines for newborns are covered - before finalizing the plan. 

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When Should You Consider Purchasing A Maternity Cover?

Insurers apply a waiting period on maternity covers. If you buy a health insurance with maternity cover when you’re already expecting a baby or just two to three months before you become pregnant, you won’t be allowed to make a claim under the benefit. 

So, in our opinion, you should ensure the waiting periods that come with the maternity benefit under your policy are completed by the time you need to make a claim under the benefit. You may consider investing in a maternity cover if you - 

  1. Recently got married and plan to have children in the near future.
  2. Are planning to get married and have children in the foreseeable future.
  3. Already have a kid and plan to have a second child soon.
  4. Plan to have a child 4-5 years down the line, not immediately. 

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Comparison Of The Best Maternity Insurance Plans Available In India

Here’s a quick comparison of the maternity benefit available with some top health insurance policies in India.

 

Care Insurance - Joy

ICICI Lombard - Health Elite

Niva Bupa - Health Premia

Star Health - Comprehensive

Maternity Benefit Limit

Max upto ₹50,000

Normal Delivery: Max upto ₹25,000

Caesarean Delivery: Max upto ₹50,000

Max upto ₹2 Lakhs

Normal Delivery: Max upto ₹50,000

Caesarean Delivery: Max upto ₹1 Lakh

Number of deliveriesNo limit. Till the maternity sum insured is not exhausted.Upto 2 deliveriesUpto 2 deliveriesUpto 2 deliveries
Age between which the maternity benefit can be availed18 to 45 years21 to 65 years18 to 65 years18 to 65 years
Pre and post-natal expensesCoveredCoveredNot coveredCovered
Waiting period for maternity benefit9 months36 months24 months24 months
Cover limit for newborn babyMax upto ₹50,000Max upto ₹1 LakhUpto the sum insuredMax upto ₹2 Lakh
Vaccination expenses of the newborn babyNot coveredNot coveredCoveredCovered

Got a question related to health insurance with maternity cover? 

Post it on the Beshak Insurance Forum & get answers from vetted experts!

Key takeaways
  1. The maternity cover is available as an add-on benefit in most health insurance policies and both normal and caesarean delivery expenses are covered.
  2. The expenses will be covered up to a limit specified in the policy - and pre and post-natal expenses may be covered too. 
  3. The insurer may apply a waiting period for maternity insurance before one can avail of the maternity benefits under their health insurance policy.
  4. A few policies have a condition that maternity benefit can be availed only if you and your spouse are covered under the same floater plan.
  5. Many policies also offer insurance coverage for the newborn baby for a fixed period.
  6. Expenses related to the vaccination of the newborn baby are covered by a few policies. Some insurers may give a list of vaccines while others may cover the vaccination-related costs up to a specific limit. 
  7. You won’t be able to make a claim under the maternity benefit if you opt for it when you’re already expecting a baby or just two to three months before you become pregnant. 
  8. So, you must buy a health insurance plan with the maternity benefit if you’re planning to have kid/s in the future to ensure that the waiting periods are taken care of.
Aakansha Jain
Written by,
Aakansha Jain, Budding Content Developer at Beshak

Aakansha is a Content Ideator and Writer at Beshak. With her easy-to-understand content, she makes insurance simple for everyone. She comes with a strong background in finance and commerce and wants to help families make positive insurance decisions that are good for a lifetime.

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