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Is Pregnancy Covered In Health Insurance?

Published On Aug 05, 2022 10:00 AM By InsuranceDekho

Apart from the medical issues that accompany pregnancy, financial expenses are also a cause of concern for many families. This is where the utility of maternity health insurance comes to the fore as it is a health insurance plan offered by various insurers and is specifically targeted toward women who are planning to have a family in the near future.

Is Pregnancy Covered In Health Insurance?

What Exactly Is Maternity Health Insurance?

Maternity insurance, in simple words, refers to the insurance coverage that females receive concerning the medical expenses that accompany pregnancy as well as post-pregnancy procedures and treatments. Now, corporate enterprises also offer such facilities for their female employees by subscribing to maternity insurance policies for their benefit. However, these policies generally have a fixed upper limit, and upon exceeding that, the mother will have to pay out of her pocket.

Benefits Of Maternity Insurance

Now the big question – what benefits can you receive from investing in quality maternity insurance? Here are some of the most interesting benefits of maternity health insurance: -

  • Maternity insurance can be your lifesaver in the case of unplanned pregnancies and also during planned pregnancies when the couple or the mother is/are not financially secure to bear the financial burden of all of the pregnancy-related costs. In fact, according to studies, the cost of delivery in a hospital can sometimes run into lakhs of rupees, depending on the situation. Maternity insurance provides much needed financial support in such situations.
  • Many expenses will arise in the baby's natural course post-delivery, such as those related to vaccinations and basic sanitation necessities. Having maternity insurance can help you avoid the full burden of all the expenses and at the same time, keeps your financial condition healthy and secure.
  • While most maternity insurance policies only cover the cost of up to two deliveries and babies, maternity insurance also offers insurance coverage of the room rent payable at the hospital. Maternity insurance does not kick in only after a baby is born. More and more insurance providers are not offering insurance coverage for infertility-related treatment, any costs arising out of pregnancy-related complications, and medically and legally justifiable terminations of pregnancy.
  • Many insurance policies targeted toward to-be mothers also offer insurance coverage on the newborn baby's expenses for a fixed period that the insurance companies decide. Expenses toward timely vaccinations of the baby and other related medical costs are included in most maternity insurance policies. However, in the event of an ectopic pregnancy, insurance coverage is generally not provided under the maternity insurance policy, rather is part of the insurance coverage offered under a health insurance policy that covers hospitalization charges and surgery costs.

Mode Of Payment Under Maternity Health Insurance

In terms of the mode of payout, there are typically 2 options available under maternity insurance policies,

  • The first one is the cashless claim facility. It is regarded as the best option since it eliminates the hassle of handling tedious paperwork and making the payment upfront, and then going for a reimbursement. This mode of payment can be availed at partner hospitals of the insurance provider. While opting for the cashless claim facility, the medical expenses for pregnancy and any related treatment covered under the maternity insurance policy will be paid to the healthcare institution directly by the insurer.
  • The second option is filing a reimbursement claim for the expenses incurred during the pregnancy and delivery you wish to be compensated for after paying them from your pocket. Reimbursement claims are opted for if the hospital is not a network partner of the insurance company, and therefore, cashless claims are not provided for by them.

Who Can Buy Maternity Insurance?

Young women or couples who wish to start a family after a year or two are the primary customers of such maternity insurance policies. Additionally, parents who already have a child and wish to be prepared for a second one can also subscribe to a comprehensive maternity insurance plan. Last but not least, any woman or couple who are not particularly planning for children or a family in the foreseeable future but are simply taking steps to secure their financial status can also benefit from a maternity insurance policy.

One can only secure the benefits covered under the maternity insurance policy after the minimum waiting period that the insurance provider decides. Therefore, if the minimum waiting period is that of 1 year since the purchase of the policy, then any pregnancy-related costs incurred within 1 year of purchasing the policy will not be covered by the maternity insurance policy. Moreover, if you have already made use of the same maternity insurance policy for two children of yours, the third birth will not be covered under most insurance policies.


Maternity insurance policies are extremely necessary for today's time, specifically for young couples who wish to secure their financial situation in the long term without jeopardizing their family's future. There are various maternity insurance plans for you to choose from and a vast range of plans and benefits that can be tailored to meet your specific needs. Therefore, investing in maternity insurance is likely to be one of your best decisions, especially if you plan on having your children (or child) in the future.

Also Read: 

Which Is The Best Health Insurance Policy

Is Health Insurance Taxable?


This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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