What is Health Insurance with Maternity Cover?

bySurobhi BoseLast Updated: August 17, 2022
What is Health Insurance with Maternity Cover

Pregnancy or maternity is one of the most important phases of life. Nurturing a child is an expensive affair and requires good financial backup to meet the needs of the growing baby. Thus, one needs to be prepared in advance to embrace parenthood. Health insurance with maternity cover helps to take care of maternity expenses, which include delivery costs, hospital stay, medical tests and medicines.

The health insurance plan with maternity cover helps to deal with the rising cost of health care so that one can enjoy the happiest moment of life without any stress. Read further to know in detail about health insurance policies with maternity cover.

What is Maternity Insurance?

Maternity insurance offers coverage for all pregnancy or delivery-related expenses up to a certain limit during a policy tenure. Some insurers offer pregnancy cover with newborn baby expenses and pre and post-natal expenses in a maternity insurance policy.

Moreover, some organizations also offer their women employees the benefits of maternity insurance along with the group health insurance policy. Also, the majority of the group’s health insurance policies offer maternity cover as a rider benefit with a sub-limit not exceeding Rs.50,000. Some of the maternity insurance plans provide coverage for pre and post-hospitalization wherein the policy covers the pre-hospitalization costs up to 30 days before the date of admission. Expenses such as room charges, nursing, doctor consultation, anesthetist consultant and surgeon fees are also covered.

It is imperative to have a proper understanding of the inclusion and exclusion of maternity insurance to make the right financial decision and ensure the maximum utilization of the insurance policy.

What is Covered in Health Insurance with Maternity Cover?

What is Health Insurance with Maternity Cover

Let’s take a look at the inclusions of maternity health insurance plans:

Maternity related hospitalization

The pre and post-hospitalization expenses will be covered for up to 30 days before delivery and 60 days after delivery.

Hospitalization coverage

The health insurance with maternity coverage takes care of the hospitalization expenses, which include nurse, room rent, anesthetist consultation, surgeon, emergency ambulance charges and medical practitioner.

Delivery including pre and post-natal expenses

This includes cesarean and regular delivery expenses along with any post-delivery complications for the mother.

Newborn Baby Coverage

Health insurance plans with maternity coverage also include insurance for infant and neonatal care from day 1 to up to 90 days. The maternity health insurance plan covers all needs of the newborn baby. However, it is important to inquire about the insurer’s stance on premature labor and complicated deliveries.

What is Not Covered in Health Insurance With Maternity Cover?

Let’s take a look at the exclusions of maternity insurance:

Pre-existing diseases affecting pregnancy

If a person has any pre-existing diseases that may affect the pregnancy like high blood pressure, epilepsy, etc. then they will not be covered under maternity health insurance cover.

Infertility treatment expenses

Infertility treatment or IVF are not covered in a maternity insurance plan.

Congenital diseases

These are genetic medical conditions that may occur in children before or at birth, like down syndrome, heart disease, or spina bifida are not covered by the maternity insurance policy.

Medicine cost apart from the one prescribed by the doctor

Medicine prescribed by doctors is generally covered under the policy. However, any other health supplements or vitamins are not covered under maternity insurance.

How to File a Claim?

Cashless Claim

The policyholder can opt for the cashless claim at any of the network hospitals of the insurance company. In the cashless claim, all the treatment and hospitalization cost is covered by the insurance company.

Reimbursement claim

The policyholder can opt for a reimbursement claim at any hospital of their choice. In a reimbursement claim, the claim amount is initially paid by the insured to the hospital. The policyholder can later submit an application to the insurer along with the details of hospital bills and treatment costs to avail of the reimbursement amount.

Why is it Important to Have Maternity Benefit?

Here is why it is important to have health insurance with maternity cover:

Financial Security

Health insurance with maternity cover helps an individual to be financially secured during one of the most important moments of life. The plan ensured that all the financial requirements are taken care of so that one can enjoy parenthood and have a stress-free delivery.

Peace of Mind

With a maternity insurance plan, one can have peace of mind that all the pre and post-natal treatments are taken care of.

Relaxing Onset to Parenthood

A maternity insurance plan not only provides coverage for the expenses during delivery but also covers the newborn baby up to its first 90 days (includes any medical complication and required vaccination). With a health insurance plan with maternity cover, an individual can relax and enjoy the beginning of a new journey.

Wrapping it Up!

As it is rightly said by a well-known American author, Rick Warren- “The Wise Look Ahead and Make Plan”, it makes sense to get familiar with the concept of maternity insurance in advance and buy it before the onset of parenthood. With maternity insurance one can enjoy this important moment of life without worrying about financial planning.

Can I get health insurance if I am pregnant?
Yes, one can avail health insurance when they are pregnant. However, it is recommended to go through the policy inclusions and exclusions while purchasing the policy.
Is pregnancy considered a pre-existing condition for health insurance?
Most of the insurance providers do not provide any maternity insurance for the insurance buyer who is already pregnant. This is because they consider the pregnancy as a pre-existing condition.
What is covered under maternity insurance?
All the expenses, up to a specific predefined limit for the delivery of the baby are covered under the maternity insurance policy. The coverage is provided for the normal as well as C-section deliveries. Moreover, some policies also include the cost of termination due to complications.

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