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Rediff.com  » Getahead » 6 important things you must know about maternity insurance

6 important things you must know about maternity insurance

Last updated on: May 21, 2017 08:11 IST

Maternity insurance ensures that you can enjoy the happiest moments of your life without any financial worries, says Harjot Singh Narula

The feeling of motherhood certainly involves a lot of joy and excitement, but it also brings responsibilities to raise your child as a parent.

After conceiving, couples usually get worried about having a healthy pregnancy along with aggravating medical expenses owing to regular diagnostic tests, medicines, hospitalisation expenses, delivery expenses, etc.

As, the healthcare cost is rising at a double-digit pace, delivery of a child has become an expensive affair. The cost of delivery in a multi-specialty hospital could cost you around Rs 50,000 to Rs 2 lakh.

Planning for maternity related expenses in advance through a maternity insurance cover can be one of the useful solutions to combat the expenses related to pregnancy and childbirth.

Maternity insurance ensures that you can enjoy the happiest moments of your life without any financial worries.

However, there are some important aspects associated with the maternity insurance which will allow you to take a right decision regarding this kind of insurance cover.

1. Coverage

A maternity insurance usually covers the following expenses:

a. Hospitalisation expenses

Hospitalisation expenses (for a minimum of 24 hours continuous stay) owing to maternity such as hospital room charges, nursing, anesthetist/medical practitioner/surgeon charges, ambulance charges, etc. are covered.

b. Pre & post hospitalisation expenses

Medical expenses on investigation tests, medicines, consultation fees, etc. done 30 days before hospitalisation are covered. Post-hospitalisation expenses such as a follow up visit charges, etc. are also covered for usually 60 days post discharge from the hospital.

c. Pre & post natal expenses

It covers costs related to ultrasound, medicines, doctor's consultation fee, regular checkups, etc. It also includes expenses incurred owing to pre & post delivery medical care for the mother.

d. New born baby cover

New born baby cover is available from day 1 to 90 days of childbirth. It covers the expenses incurred related to health care needs of the baby (including complications) up to a limit specified under the policy.

e. Ambulance expenses

Ambulance expenses to ferry the mother-to-be are also covered in most of the maternity insurance plans.

2. Available as add-on/Inbuilt benefit

Maternity cover is available either as an add-on benefit or inbuilt under a health insurance plan. There are some health insurers offering maternity insurance as an inbuilt benefit or it can be opted as an add-on benefit along with your regular health insurance plan by paying an extra premium.

1. Easy Health Individual Plan (exclusive and premium variant) from Apollo Munich offers inbuilt coverage for maternity expenses, including pre & postal expenses.

2. Joy Today/Tomorrow from Religare Health is a specially designed maternity insurance product offering comprehensive coverage for maternity and newborn related medical expenses.

3. Waiting period

Maternity health plans have a long waiting period. Typically, maternity benefit can be availed with a waiting period of 2 to 4 years of continuous policy coverage.

  • Joy Maternity & Newborn Cover from Religare Health offers maternity insurance with the least waiting period of 9 months
  • Star Comprehensive Insurance Policy from Star Health offers maternity benefits after a waiting period of 3 years

It's wise to buy a health policy providing maternity cover as soon as one gets married, so the waiting period gets completed by the time you need the coverage.

4. Sub limits

Health insurance policies providing maternity cover usually put a limit on the coverage amount available for maternity-related expenses. You can't avail the whole of the sum insured available in a health plan towards covering maternity expenses.

  • Joy Health Plan from Religare Health offers maternity cover up to Rs 50,000 and Newborn cover up to Rs 50,000 upon opting 5 lakh sum insured.
  • Star Wedding Gift Insurance Policy from Star Health covers Child Delivery Expenses up to Rs 20,000 for normal delivery, Rs 25,000 for C-section, pre natal expenses are capped up to Rs 2,000 & post natal expenses are capped up to Rs 4,000.

It is thus advisable to check the sub-limits applicable under a health plan before buying. As the delivery expenses in a metro city in a private hospital may go up to Rs 1 lakh or more in most of the cases, you need to have an ample coverage for the same.

5. Premium

The premium charged by an insurer for a maternity cover is usually higher than a regular health insurance policy and is expensive in nature. But the coverage it provides helps you to take care of maternity-related expenses in a hassle free manner.

Joy Today Plan from Religare Health charges you an annual premium of Rs 23,891 and Rs 17,705 choosing sum insured as 5 lakh and Rs 3 lakh respectively for an age group of 18-45 years.

It thus becomes essential to make a thorough cost-benefit analysis before buying a maternity cover.

6. Exclusions

  • Maternity insurance comes with a bundle of exclusions which are barred from the coverage scope such as:
  • Restriction on the maximum entry age of the insured for availing benefit of maternity cover is 45 years
  • Medical expenses incurred towards ectopic pregnancy are not covered
  • Medical expenses incurred on voluntary medical termination during first 12 weeks from the date of conception are not covered
  • Insurer does not provide cover, in case the insured is already pregnant
  • Congenital diseases, etc.

Conclusion

It is imperative to understand the maternity cover holistically regarding benefits, cost, coverage, exclusions, etc. Before buying a policy, it is imperative to read through all the features, benefits, term & conditions to ensure that you are covered against all emergency situations related to pregnancy and delivery.

Opt for a plan with robust sum insured to ensure the adequate amount of coverage considering the medical inflation.

In case you have a group health policy, check for the maternity related cover under it as most of the group health plans comes with zero waiting period for maternity related claims.

Disclaimer

The benefits, coverage, premium, exclusions may differ from one plan to another. Please read the policy terms & conditions carefully before buying.

The maternity plans mentioned in this article are purely for the understanding of the content only

Photograph: PTI Photo

Harjot Singh Narula is founder and CEO, ComparePolicy.com

Harjot Singh Narula