2 Health Insurance Plans with Maternity Coverage
Published On Apr 09, 2019 5:30 AM By Prashant Srivastava
Maternity treatments are skyrocketing.
It may cost anywhere between Rs. 50,000 to Rs. 4-5 lakhs.
Bearing this expense may be an expensive affair.
Given that, a health insurance plan with maternity coverage sounds to be much of a catch.
Let’s dig deeper.
Health insurance, having maternity features, provides cover for delivery and newborn expenses for the mother and her infant.
After all, motherhood is the most significant phase in the life of every woman. You should be prepared well in advance to embrace it with ease.
Motherhood is a constant call to be on my feet, to deal with the challenges, and to learn everything I possibly could to do it right.” Anonymous.
Here is a list of top 2 health insurance plans with maternity coverage you can buy online.
Royal Sundaram’s Family Plus is comprehensive health insurance, offering maternity coverage. Designed especially for large families, the plan covers up to 19 members in a family with the individual sum insured for each member.
The plan also has a common floater sum insured in the same policy that can be used by anyone or more of the family members. To avail the benefits of the maternity cover, at least one adult member needs to be covered at the time of the first inception under the same Family Floater Policy.
Family Floater Policy under Family Plus pays medical expenses for the delivery of a child only after two years of continuous coverage of the mother since the inception of the first policy. It’s worth remembering that the waiting period of 24 months starts only after two adults are covered under the Family Plus plan.
Family Plus of Royal Sundaram lets you have several benefits:
- A product, which has a combination of both Individual + Floater Sum Insured
- Maternity benefits with nutritional allowance (24 month waiting period applies to avail the maternity cover benefits)
- Maternity cover for up to 2 deliveries (INR 50,000)
- New Born Baby Cover on Base Sum Insured of the mother
- Vaccination for New Born in the first year up to INR 10,000
- Nutritional Allowance for mother post-discharge up to INR 10,000
- Vaccinations are covered until the next policy anniversary. After the anniversary, the newborn baby should be included in the policy for the coverage to continue.
- Coverage or all day-care procedures up to the sum insured amount
- Pre and post hospitalization coverage (60/90 days, covered up to the sum insured)
- No capping in terms of room rent, disease-specific sub-limits, etc.
- Reload facility to double your base sum insured without any additional costs
- No Claim Bonus benefits. You can double the base sum insured in 5-claim free years
- 20% of Base Sum Insured up to a max of 100%
- No restriction on maximum age entry
- Tax benefit under section 80 (D) of Income Tax
Other benefits include inpatient hospitalization expenses up to the Sum Insured, ambulance cover of up to Rs. 4,000, 100% reload of the base sum insured if the NCB and total sum insured is completely exhausted, domiciliary hospitalization expenses up to the sum insured amount.
It is important to learn that Nutrition Allowance under this policy covers the costs of supplements, nutritional food and medicines advised by a doctor to a mother (post-birth of the child). This includes nutrition enriched diets, vitamins, calcium tablets, tonics, fresh/dry fruits & vegetables
The Nutrition Allowance benefit is available in the form of a fixed deposit. It is payable after a period of 2 months from the date of discharge of the mother after she delivers a baby. Maximum liability under Nutrition Allowance is Rs. 10,000.
What is not covered
There are certain things that are not covered under the Family Plus plan. They are:
- Diagnostic tests and follow-ups during 9 months of pregnancy
- Doctor’s visit for regular health checkups
- Expenses on vitamins or tonics unless it’s a part of the treatment
ProHealth Insurance - Plus Plan
ProHealth Plus Plan is one of the valuable insurance policies of ManipalCigna. This is an optimum plan for your valuable future. Under this plan, you can get coverage of up to Rs. 15,000 for normal delivery and Rs. 25,000 for a C-section per event. However, you can avail maternity coverage only after 48 months of your enrollment with the insurer.
ProHealth Insurance - Plus Plan lets you enjoy several benefits. Some of the key benefits include:
- In-patient hospitalization - This includes coverage for surgeon’s fees, anaesthesia, nursing, blood, oxygen, surgical appliances, operating theatre charges, ICU, medicines, drugs, and consumables up to the sum insured. Suite or higher category rooms are not covered under this policy.
- Pre-hospitalization - Pre-hospitalization includes doctor’s fees, diagnostic tests and costs of medicines. However, pre-hospitalization is covered for up to 60 days before your hospitalization.
- Newly born baby expenses - The policy also covers newly born babies. If your newborn needs hospitalization, then the expenses of the medical treatment are covered up to the limits of the sum insured under the maternity coverage.
- First-year vaccinations - This plan also provides coverage for your newly-born baby. It provides cover for the first-year vaccinations expenses of the newborn. However, you can only get this cover after a waiting period of 48 months.
Note - In case, the policy expires before the baby becomes one year old, the vaccinations are still covered until the baby completes 12 months of his/her age.
- Ambulance cover - Ambulance expenses are covered up to INR 3000 every time you get hospitalized.
- Daycare treatment - Radiation therapy, dialysis, cataract surgery among others are covered under this policy. 546 other listed daycare procedures are covered. However, this benefit is only available after being hospitalized for a minimum of 24 hours.
- Normal and Caesarean deliveries - The policy covers expenses incurred in Normal and Caesarean deliveries - up to Rs. 15,000 for normal delivery and Rs. 25,000 for Caesarean.
- Non-allopathic treatment - ProHealth Insurance - Plus Plan also includes AYUSH Cover i.e. coverage for non-allopathic treatments like Yoga & Naturopathy, Ayurveda, Unani, Homeopathy. AYUSH Cover is available for hospitalization due to accident or illness.
Note - The hospitalization required for rejuvenation or pleasure or as a preventive aid like Panchakarma, beauty treatments, detoxification, purification, etc., is excluded.
- Reduction in the maternity waiting period - The waiting period for Maternity Expenses is 48 months. However, you can get it reduced to 24 months under this benefit. Choose the ‘Reduction in Maternity Waiting Period’ option and you will reduce the maternity waiting period, first-year vaccinations cover, as well as newborn baby cover. You can get this benefit by paying an additional one-time premium.
- Expert opinion: Under the ProHealth Insurance - Plus Plan, you can get an expert opinion on critical illness from a network of medical practitioners. The policy covers expenses incurred in getting the opinion of medical experts.
Things to Know about Maternity Expenses:
The Maternity Expenses are available up to the limits for Maternity Sum insured specified in the Schedule for the delivery of a child. Or, it can be availed for the expenses incurred during the Policy Year, or lawful termination of pregnancy up to maximum 2 deliveries or terminations during the lifetime of an Insured Person between the ages of 18 years to 45 years
- The maximum liability per delivery or termination is subject to the limits (read the policy wording thoroughly)
- You need to be continuously covered by this policy for at least 48 months. If you have chosen ‘reduction in maternity waiting period’, then the waiting period limit will be 24 months.
- Maternity cover is available for up to 2 deliveries only.
- Maternity Sum Insured under Maternity Expenses is available in addition to the Sum Insured.
Royal Sundaram and ManipalCigna are the two popular health insurance companies in India that include maternity coverage in their plans. Before choosing either of the above two plans, it is essential to read the policy wording carefully.
Read what is included and excluded in the policy. Consider in what cases your claim may get rejected. Know about the total sum assured, network hospitals, waiting for period, entry and exit age, and much more.
Once you’re sure of finding the most suitable plan with the maternity coverage for you, go ahead and buy it. If you choose the best health insurance, you will not just have peace of mind, but also avail of the best treatment.
Top 4 Maternity Insurance Plans and Their Benefit