Group Insurance Cover For Maternity. Is That Enough?

In life, you can have carefully laid financial plans for all aspects. However, there is one exception. There is no way that you can plan for medical expenses and medical emergencies. Pregnancy is a fantastic stage in your life that you and your spouse or partner should enjoy and create memories to cherish forever. However, along with the joy comes financial anxieties, as pregnancy and maternity are expensive affairs. Investing in a mediclaim policy with maternity cover is a smart move to ease your concerns significantly.

At this juncture, you may ask yourself whether the pregnancy is covered in mediclaim.  To answer your question directly, yes, you may avail yourself of a mediclaim policy for pregnancy. These covers may be a part of your policy or you may avail yourself of a product specifically geared to be a cashless mediclaim policy for pregnancy. More on this later.

Maternity Cover in a Group Insurance Policy

Before we get into the specifics of a group mediclaim policy with maternity cover, let us first briefly understand the concept of group insurance. Group insurance is a type of insurance policy that covers a group of people with something in common under the same plan. In India, most employers provide their employees with group health insurance. Such insurance covers the employee and the employee’s dependents, such as their spouse, children, and parents.

Maternity changes the life journey of women and their families in many ways. Pregnancy and maternity expenses are ever on the rise.  In 2022 – 23, the medical trend rate in India—medical inflation—was 14 %, the highest in Asia and higher than the global average of 10.7 % for the same period.

To safeguard their employees financially and help them have their babies delivered in quality healthcare facilities, the group health insurance plan provided by the employer includes mediclaim with pregnancy cover and mediclaim with maternity cover.

An employer-provided group mediclaim policy with pregnancy cover is an added perquisite for the employee as it is usually provided free of cost and is calculated along with the employee's CTC.

Features and Benefits of Group Mediclaim Policy for Maternity

Given below are some of the features and benefits of a group mediclaim policy for maternity:

1. There is no waiting period for maternity benefits in this policy. You and your spouse are covered from Day 1 after joining the organisation and issuance of the policy.

2. Standard delivery and Caesarean – Section deliveries are both covered.

3. Hospitalisation expenses such as doctor’s and surgeon’s fees, expenses incurred in the Operation Theatre for surgery, room rent, and the cost of medicines are covered.

4. The cover usually includes 60 days of pre-hospitalisation and 90 days of post-hospitalisation expenses.

5. Your newborn baby is covered from Day 1 for a period of 90 days.

6. After the delivery of your baby, all vaccination expenses during hospitalisation are covered.

7. Typically an employer-provided mediclaim policy for delivery is cashless in nature.

8. Such mediclaim with pregnancy cover also covers legal, medical termination of pregnancy should the medical need unfortunately arise.

Going by the benefits above, you may feel that the employer-provided group mediclaim policy for pregnancy is your best bet. However, you will soon know that despite the seemingly lucrative features, your group mediclaim for maternity is usually not enough and often falls short of covering your pregnancy and maternity-related expenses.

Why is Your Employer-Provided Group Mediclaim for Maternity Not Enough?

While the benefits provided by your group health insurance cover may seem very attractive at first glance, they are not a complete solution for pregnancy—and maternity-related expenses.

Group insurance partially covers maternity costs. However, such policies have sub-limits built into them, which makes  the coverage provided inadequate.

Most companies provide their employees with group health insurance policies with a sub-limit for pregnancy and maternity expenses. In most cases, this sub-limit is only Rs 50,000. This sub-limit includes hospitalisation expenses, doctor’s and surgeon’s fees, room rent and expenses of your newborn baby.

The cost of a C-Sec delivery alone in the metro cities ranges from Rs 70,000 to Rs 2,00,000, and the cover provided needs to be higher. You have to shell out quite a substantial amount of money from your pocket.

Few new-age companies and some new start-ups provide their employees with a group health insurance policy with higher sub-limits for pregnancy and maternity, from Rs. 1,00,000 to Rs. 1,25,000. This, too, may not be adequate, especially if you have complications in your delivery. The number of such companies is also very few and far between, so the enhanced cover for maternity provided by their group health insurance policy is not considered a mainstream benefit in society.

Why Should Young Couples Purchase Personal Maternity Cover?

As you have already seen, the maternity coverage offered by your employer-provided group health insurance policy is insufficient and often becomes inadequate. This leads us back to the initial nervousness and financial anxiety, which may spoil your memorable pregnancy and maternity experience. Rather than spending sleepless nights because of such financial worries, you should be staying up at night tending to your bundle of joy after your delivery.

One way to hedge your financial burden is buying your maternity health insurance, a comprehensive health insurance policy that covers the following expenses relating to your pregnancy:

1. Doctor’s and surgeon’s fees
2. Cost of medical tests
3. Hospitalisation expenses
4. Cost of delivery – both normal delivery as well as Caesarean Section (C-Sec)
5. Pre and Post Natal expenses
6. Expenses of your newborn baby
7. Expenses incurred in case of complications in pregnancy
8. Cost of vaccines for your newborn baby
9. Stem cell preservation (at least assistance)
10. Expenses related to legal, medical termination of pregnancy if unfortunately medically required

As you can see, your personal maternity health insurance policy is a great support in helping you access quality healthcare facilities as it ensures that the financial burden is taken over by the health insurance company.

Having learnt this, it is natural for you to want to know about the best mediclaim policy for pregnancy. Those staunch believers in the PSU Government health insurance companies may even ask about the New India Assurance Mediclaim Policy for Pregnancy. This policy is more of a standard comprehensive health insurance policy covering maternity expenses.

In India, there are no exclusive maternity health insurance policies available. Care Joy by Care Health Insurance is a product offering maternity health insurance specially designed for young couples who are planning to start a family. The policy focuses on maternity-related hospitalisation but also covers other hospitalisations while it is in force.

Care Joy comes in two variants – Joy Today and Joy Tomorrow. It has a maternity waiting period starting from nine months and provides cover for your newborn baby from the first day to the age of ninety days. This policy has an entry age starting at eighteen years for adults, and maternity cover is available for up to forty-five years of age.

Benefits of Care Joy Maternity Plan

Pre-natal customised diagnostics package from SRL for all three trimesters at a discount of 50%

1. A flat discount of Rs 10,000 on the Cord Cell Bank Services offered by CryoViva
2. Discount of up to 25% per cent at SRL for other diagnostics and consultations
3. These value-added services have no waiting period and may be availed of by you from the day after which you receive the policy kit.

Let us look at the maternity-related benefits of both variants of Care Joy:

Conclusion

As you have already understood, it is advisable to purchase a personal health insurance policy with maternity benefits to supplement your group insurance coverage and enjoy your pregnancy and motherhood without financial worries.

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.