Cesarean Delivery - Is It Covered by a Health Policy?

When it comes to buying health insurance, people usually ask:

Is Cesarean delivery covered under the plan?

And the answer is ‘yes.’

The cesarean delivery is covered under health insurance plans, subject to the policy you have.

Some health insurance companies in India have launched health insurance policies that cover maternity costs. They cover both normal deliveries as well as cesarean deliveries.

Precisely, Cesarean delivery has become more common these days. It is chosen either to handle severe cases or if the patient cannot bear the pain and tends to undergo the C-section procedure. This delivery procedure is expensive, ranging from Rs.30, 000 to Rs.1 lakh.

Thanks to the maternity insurance that covers the Cesarean delivery. It’s a great relief for parents in terms of finances.

Though a large number of health insurance policies cover maternity expenses, choosing the right one can be daunting.

Given that, we have listed out different maternity insurance policies and smart guides to choosing the right one. Have a look.

Popular Maternity Insurance

The list of popular maternity insurance plans covering cesarean delivery includes:

1. Max Bupa Heartbeat Individual and Family Floater (Gold Plan)

A plan by Max Bupa. It offers Rs. 40,000 to Rs. 1, 00000 maternity coverage depending on the sum assured ranging from Rs 5 lakh to Rs 50 lakh. The waiting period for maternity coverage under this policy is 2 years. There are two other variants in the same category namely Heartbeat Family First – Silver Plan with the maternity coverage of up to Rs 35, 000 and Heartbeat Family First – Gold Plan with the coverage amount of up to Rs 50,000 respectively.

2. Star Wedding Gift Insurance

This Wedding Gift Insurance product of Start Health Insurance offers Rs.20,000 or Rs.25,000 for the expenses incurred in the Cesarean delivery. The waiting period to avail the benefits is 3 years.

3. Care Joy Health Insurance

This Care Joy health Insurance plan provides you coverage of Rs.35,000 to Rs.50,000 for the expenses of Cesarean delivery, depending on the sum assured ranging from Rs. 3 lakh to Rs. 5 lakh. There are two variants of this c-section coverage in health insurance plan products, Care Joy Today and Care Joy Tomorrow. Care Joy Today has 9 9-month waiting period, whereas Care Joy Tomorrow has a waiting period of 24 months before you can avail of the maternity benefit of the product.

Having a health policy that covers Cesarean delivery is a great relief. There are some points you need to keep in mind when buying maternity insurance.

Coverage Amount Under Mediclaim For Cesarean Delivery

Coverage means the ‘amount’ of the policy purchased. While looking out for a plan, be sure the capping on the maximum allowable amount covers a Cesarean delivery.

Remember, this capping varies depending on the Sum Assured amount you choose and the plan variant. That’s why it is vital to check the allowable limit before going for the delivery. This will enable you to know the extent of the bill your health policy will cover.

Cesarean Delivery Covered by Health Insurance Waiting Period

One hard truth is that a health plan with the ‘maternity coverage feature’ covers a C-section procedure after a waiting period. So, before opting for a plan, consider the waiting period, which can range between 2-6 years. A good maternity plan comes with a longer waiting period.

As mentioned above, Apollo Munich Easy Health covers Cesarean deliveries after a waiting period of 3 or 4 years, whereas Care Joy Today covers it after 9 months. Other than the Care Joy Policy, SBI Arogya Premier Policy and Bharti AXA Smart Super Health Insurance come with a waiting period of 9 months.

Maternity Coverage

Besides Cesarean delivery coverage, some other maternity coverage is also covered under the Health insurance policy. Generally, health insurance policies cover many complications during childbirth, such as pre-natal expenses, post-natal expenses, and ambulance costs.

Apart from all these, some policies do also provide coverage for the newly born baby till policy renewal along with the baby’s related vaccination expenses.

Policy Premium

To be precise, the premium paid for the health policies that cover Cesarean delivery is higher than the premium for non-maternity insurance. So, don’t get distressed about getting maternity insurance at a higher premium. However, make sure the product you are choosing covers everything discussed above.

Things to Check Before Buying Health Insurance Covering Maternity Benefits

If you are all prepared to buy maternity insurance, make sure you keep the below-mentioned aspects in mind to make a worthwhile decision:

• Pre & post hospitalization expenses cover
• Pre & post-natal expenses cover
• Inpatient hospitalization & delivery charges
• Newborn baby expenses cover
• Vaccination expenses of the newborn baby

To conclude, a delivery done with the C-section procedure rakes up the hospital bills. So, it’s essential to avail a plan with maternity insurance features. There are a few health insurance plans (mentioned above) that provide coverage for Cesarean delivery. So, buy them today and double the happiness of motherhood.

Frequently Asked Questions Regarding Maternity Insurance in India

Q. Can you get health insurance covering maternity if you are already pregnant?

If you are already pregnant and want to buy health insurance to cover maternity benefits, you will have to face the waiting period. Furthermore, since the waiting period is generally about three to four years, it may not serve your purpose. Therefore, women are advised to buy health insurance covering maternity benefits much before they start family planning. At the least, the waiting period is 9 months. The key rule to enjoying the benefits of maternity insurance is being early in maternity insurance purchase.

Q. Is pregnancy considered to be a pre-existing condition in health insurance?

Yes! Pregnancy is considered a pre-existing condition in health insurance. Most health insurance companies do not provide maternity insurance if the policy buyer is already pregnant.

Q. What does maternity insurance cover?

Maternity insurance provides cover for all medical expenses up to a certain pre-specific limit for delivery. It must be noted that both, normal as well as C-section deliveries are provided cover for. Certain health insurance companies may also include the cost of termination due to complications under their plans. It must be kept in mind that some health insurers offer pre and post-natal expenses as well as newborn baby coverage for a specific amount of maternity insurance.

Q. What does maternity insurance not cover?

It is important to understand that specific exclusions in a maternity insurance plan differ from insurer to insurer. Nonetheless, some of the common exclusions include the purchase of vitamins & tonics, a cap on the age of the policyholder, and many more like such.

Q. How is the calculation of maternity insurance premiums done?

Before you buy a plan covering maternity benefits, learn that the premium payable on the same will be higher as compared to a regular health insurance policy. Health insurance companies keep the premium cost of maternity covers high as the certainty of a claim being filed is absolute. Yet another significant point to keep in mind is that the premium for maternity insurance increases with age. Therefore, it is better to buy maternity insurance or a health insurance policy covering maternity benefits much in advance.

Also, Read:

Pick a Health Insurance Plan That's Right for You

Top Health Insurance Plans With Ambulance Cover