Maternity Health Insurance Plan- All You Need to Know About the Plan
Published On Mar 26, 2019 5:30 AM By Mandeep Kaur Saini
Maternity or pregnancy is an essential phase of life not only in a woman’s life, but in her husband’s life as well, and to make this phase more special what a couple requires is the proper planning in advance to embrace parenthood. We all know that in this current century one cannot overlook the maternity cost involved as even a normal delivery in a decent hospital along with the hospitalization and other bills could range anywhere between INR 80,000 to INR 2 lacs, and the cost of caesarean is much more than the normal delivery.
Moreover, according to recent medical reports, the average age of women getting pregnant has risen from early 20’s to 32 years, which has led to complicated pregnancies. Significantly, the ratio of caesarean delivery stands almost double the normal delivery with the ratio of 65:35, respectively, which has resulted in even more maternity medical charges.
These shocking reports show how getting maternity health insurance is of utmost importance as only an adequate maternity cover can safeguard you against all the stress during one of the happiest periods of your life by protecting your wife and baby without worrying about the medical cost, as a good plan covers everything from a hospital stay to delivery costs to medical tests and medicines.
To help out the parents-to-be, many health insurance companies have come up with the perfect health insurance plans that include a comprehensive maternity plan in it from which one can choose as per their needs and requirements. The best part is that some insurance companies provide maternity benefits as an additional service or rider and lower the burden on your pocket. Additionally, in a majority of corporate group policies, maternity health insurance is an add-on benefit with a sub-limit of not exceeding INR 50,000.
Let us now look at the benefits of maternity health insurance, inclusions, exclusions, things to keep in mind before buying it, and topmost plans that include the best maternity health features.
Importance of Maternity Health Insurance
One must prepare suitably for the cost related to pregnancy and the baby’s delivery as it is the primary responsibility of the parents-to-be. With the rise in medical inflation, one has to prepare well in advance for all the expected as well as the unexpected expenditures, and this reason makes it important to buy maternity health insurance at the right time for not only the baby’s protection but the mother’s protection as well. Below mentioned are a few pointers which prove the importance of buying one:
Cover your Maternity Expenses: Most of the regular medical health insurance policies do not cover maternity expenses and thus are of no use and it becomes the parent’s need to buy a health insurance plan which includes the best maternity benefits covering all the pregnancy-related, delivery and newly born charges by providing a plethora of other maternity benefits as well.
Protection against the Healthcare Inflation: With healthcare inflation of around 18% each year, the cost of hospitalization is expected to be more than twice within the next 5 years which makes buying maternity insurance right now a perfect money-saving plan.
Pre and Post Hospitalization Expenses along with the Hospitalization Charges: This is one of the most important reasons which makes it important to buy as it covers pre and post-hospitalization expenses wherein pre-hospitalization expenses are covered up to 30 days before the date of admission. Expenses such as nursing and room charges, baby’s vaccination, doctor consultation, surgeon’s fee, ambulance charges, and anesthetist consultation are also covered.
Things to Keep in Mind before Buying Maternity Insurance
One should think hard and research thoroughly before buying maternity health insurance in India as a good plan can do wonders for you. Here is a list of 5 things you need to keep in mind before buying maternity insurance.
Inclusion of Maternity cover in your other health insurance plans: The first thing you need to know is that maternity health coverage is not available as a separate insurance plan as it is usually added on to the group and individual health insurance plans. But before buying these plans, you should always check whether those plans cover maternity benefits or not as there are chances that maternity coverage is not offered in that individual or group health insurance plan. To know about it before buying a plan, talk to your insurance company about this, and if the maternity cover is not a part of that plan then shift to another policy that comes with such coverage.
Look out for what all your maternity insurance covers: Maternity costs, which start from the initial stage of getting pregnant to post-delivery, are quite high. Visits to the gynecologist, medical examinations, medicines, and other pregnancy-associated purchases are endless, and the soaring medical costs add to the difficulty. Therefore, before buying a plan, never forget to check the inclusions and exclusions of your plan. Some health plans cover hospital stays and associated procedures but do not include the costs of medicines and miscellaneous items. It is always best to pick up the right & perfect plan so that expenses won’t burn a hole in your pocket.
Consider the sub-limits: Most of the health insurance plans that provide maternity coverage limit their maternity pay-outs. So, even if your health insurance plan has coverage of a few lakh rupees, your maternity coverage will be considerably less and will have sub-limits, that is, the amount provided to you for pregnancy expenses will have certain limits. For example, for normal deliveries, sub-limits are generally between INR 15,000 and INR 25,000, and in the case of caesarean deliveries, the sub-limit is somewhere between INR 25,000 and INR 50,000. You need to keep your eyes and mind open when incorporating maternity insurance in your health plan as sub-limit is one of the most important factors to consider when buying a plan.
A waiting period of your maternity insurance: Maternity insurance comes with a longer waiting period, which can be a problem for most of the couples. In almost all the cases, the waiting period is between two and four years, and before that, you cannot take any maternity-related claims and in some policies, it is extended up to six long years, which makes it essential to buy maternity insurance as early as possible, long before you are planning to have a baby or have a baby.
Note: In case you are already pregnant, you might be denied maternity insurance as it will be treated as a pre-existing condition and these conditions are usually not included in any of the medical plans, therefore, look out for these clauses and choose carefully.
Cost of the Premium: Plans that include maternity insurance mostly come with high premium rates. But with spending some time researching and comparing policies, seeking the help of friends and those who have already taken the maternity insurance in India can help you to choose the best plan that suits you the most.
We should remember that maternity insurance forms a reliable safeguard against skyrocketing medical bills; therefore, no matter how high the premium is, it is always worth it to take maternity insurance.
Key Features and Benefits of Maternity Health Insurance Plans
The salient features, along with the benefits of health insurance for maternity coverage, are listed below:
Features and Benefits
Usually between 2 years to 4 years.
In the case of Group Insurance policy, it can be 9 months with a sub-limit of not exceeding INR 50,000.
Note: Certain maternity insurance plans also provide additional coverage for specific day-care procedures and other treatments.
In case of Emergency, several insurance providers cover emergencies for up to INR 50,000
Premium Depends on
Premium, which is typically higher than basic policies, because the claim ratio is 100% in maternity health insurance, depends upon various factors as listed below:
*Note: Specific features and coverage limits varies from plan to plan
Top Maternity Health Insurance Plans
Below-mentioned is a few popular plans available in India that provide maternity coverage:
Royal Sundaram Master Product – Total Health Plus
Total Health Plus plan offered by Royal Sundaram General Insurance is a complete insurance package that provides maternity benefits starting from INR 30,000 (in case of Gold Plus) to INR 50,000 (in case of Platinum Plus). The plan covers maternity hospitalization and any complications arising before or after the delivery.
However, one can only avail maternity benefits after a waiting period of 3 years or 36 months. So to cover pregnancy hospitalization cost, you should plan your pregnancy accordingly.
Max Bupa – Heartbeat Family Floater
Heartbeat Family Floater plan offered by Max Bupa Health Insurance provides maternity coverage and also the coverage for the newly born (also cover vaccination expenses of the baby for the first year if one adds the baby in the policy for the next policy year) in all of its three plan types, that is, Silver, Gold and Platinum.
All these three types of sub-plans offer the benefits up to two deliveries, provided that the couple has been covered under the policy for two continuous years.
ManipalCigna Health Insurance – ProHealth Plus Plan
ProHealth Plus Plan offered by ManipalCigna offers maternity, expenses of the newly born and vaccination coverage. The maximum health cover on this plan is INR 10 lacs. The plan usually provides coverage up to INR 15,000 for normal deliveries and INR 25,000 for caesarean deliveries. This maternity coverage is available only after 4 years or 48 months of the waiting period. The plan also provides coverage for the first year vaccination expenses for your newborn child.
FAQs on Maternity Health Insurance
1. Are maternity benefits covered by all the health insurance companies?
No, as maternity benefit is not one of the key features of regular insurance policies as these health policies are made by keeping in mind the coverage for emergency treatments or surgeries. Therefore, maternity benefit is an additional feature which is not covered by all the health insurance policies, but still, there are many companies in India which have added this feature in their health plans that too by providing multiple benefits to the parents to be.
2. Is the cost of vaccination for the newly born covered under a maternity health insurance plan?
Yes, a few insurers do provide coverage for vaccinations for the newly born and one should check it beforehand that whether the opted plan covers the vaccination or not and should choose accordingly.
3. What is the best time to purchase a maternity health insurance policy?
As we all know that the maternity benefits cannot be availed of immediately after the policy is issued and one has to wait for a minimum of 2 years and a maximum of 6 years to avail of the benefits, therefore, it is best to purchase a policy well in advance, that is, the time when you start planning to conceive.
4. Will my second pregnancy be covered if I had purchased a policy during my first pregnancy?
Though your first pregnancy might not have covered because of the waiting period, therefore, your second pregnancy will surely be covered, provided you have completed the waiting period by then.
5. Will the maternity expenses are covered if I visit another country for childbirth
The answer is no, as health insurance companies generally set a boundary, and only within those boundaries, the benefits can be availed. Health insurance companies do not provide financial protection for medical expenses incurred for any treatment outside the country, especially in the case of maternity expenses or benefits.
6. Can we cover the other members of the family under a maternity health insurance plan?
Maternity health insurance is a feature that is generally an add-on or an optional feature so if the option is available under the family floater plan that you are looking at; then you can cover your spouse, child, or parents under the same plan.
So, after going through the above article, it is clear that bringing a whole new life into this world is certainly no cake-walk as increasing medical inflation can literally lead to financial instability. Therefore, a couple must plan well in advance and choose the best maternity insurance with the best-suited maternity features to safeguard their financial future so that the maternity expenses won’t turn out to be a nightmare but a memorable and cherishable experience for everybody.
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