Health Insurance for Maternity: A Quick Guide for Pre and Post-Natal Care

• Written by Jagriti Chakraborty

  Reviewed by Akhil Pillai

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Bringing a child into the family is a proud moment, but the financial demands can be overwhelming. 

The arrival of a little one is a true miracle that touches the heart deeply. It’s the beginning of a new story with a future filled with unconditional love. However, amidst the bliss, excitement, and anticipation of this journey lies a real-world challenge, i.e. the pre- and postnatal expenses that begin the moment pregnancy is confirmed and extend well into postpartum recovery. What starts as a few medical visits quickly escalates to diagnostic scans, major hospital costs, and baby essentials; expenses that can add up in no time. With rising costs, having a reliable health insurance policy is crucial for the family. 

The value of the right coverage can make a world of difference, as it allows families to enjoy life’s special moments instead of financial worries. However, reviewing your health insurance policy to see if it covers pre and postnatal needs is critical. The absence of maternity benefits can lead families to face significant out-of-pocket expenses. Therefore, examining your policy today is essential to ensure the best possible start to your maternity journey. 

Understanding Maternity Coverage and Its Advantages 

If you’re unfamiliar with maternity insurance, here’s a quick overview. Maternity coverage is a type of health insurance policy that covers expenses related to pregnancy, childbirth, and postnatal care. It is designed to help expectant parents manage the high costs associated with prenatal to postnatal care. 

Your Financial Safety Net During Pregnancy 

Maternity coverage offers a financial cushion to ensure that the mother can focus on her health and the child’s development, free from the burden of medical expenses or compromising the standard of medical services. 

Coverage for Pregnancy-related Complications 

While every parent hopes for a trouble-free pregnancy, unexpected complications can still arise. Your maternity coverage ensures that costs are managed, allowing you to concentrate on what truly matters, i.e. your well-being and peace of mind. 

Cost Coverage for Prenatal to Postnatal Care  

From prenatal care to delivery, the journey of motherhood often comes with innumerable expenses. A dedicated maternity insurance plan eases these costs, allowing you to embrace the arrival of your little one truly. 

Tax Benefits 

A maternity insurance policy is a win-win that offers health protection and financial advantage. Premiums paid towards the maternity insurance plan qualify under Section 80D of the Income Tax Act,1961. 

Inclusions in Maternity Health Insurance Policy

Standard inclusions in most maternity insurance plans are: 

Pre- and postnatal Expenses 

Your maternity insurance policy offers well-rounded coverage for medical expenses before and after childbirth, including doctor’s consultation, medical examination, and prescribed medication for you and your child. 

Delivery Charges 

Maternity insurance covers all delivery-related expenses, including the surgeon and medical staff fees, whether a natural delivery or a cesarean section. 

Hospitalisation Expenses

Maternity insurance comprehensively covers your hospital stay, including accommodation and nursing support. 

Coverage for the New Baby 

Your maternity health insurance policy extends coverage to your newborn for the first year, covering vaccination charges, prescribed treatments, check-ups, and ventilator support if required. 

Pre-hospitalisation and Post-hospitalisation 

Your maternity health plan provides coverage for pre-hospitalisation and post-hospitalisation costs. However, the duration of this coverage varies based on your plan’s defined limits and conditions. 

Exclusions in Maternity Health Insurance Policy

Although Maternity health insurance offers valuable support throughout pregnancy, it’s important to note that coverage to gain maternity benefits is often less than that provided by other health insurance policies. Most policies come with a lower sum insured, exclusively for maternity and childbirth costs. Additionally, this maternity coverage is subject to various exclusions and conditions, which are as follows: 

Waiting Periods 

Maternity insurance generally includes a fixed waiting period of 2 to 6 years. Claims made for pregnancy-related expenses within the policy’s waiting period are not eligible for coverage. 

Pre-existing Diseases and Conditions

Maternity insurance policies generally do not cover pre-existing conditions. If you buy the policy after becoming pregnant, the pregnancy itself will be classified as a pre-existing condition, and any related claim will not be approved. 

Regular Check-up

Most maternity insurance policies do not include coverage for routine doctor visits.

Consultation and Diagnostic Tests 

Maternity insurance typically excludes routine consultation fees and diagnostic tests during pregnancy, unless they are directly associated with your delivery and hospitalisation. 

Supplements 

Expenses related to dietary supplements, including tonics and prenatal vitamins, are typically not covered under maternity insurance policies. 

Complications Arising From Unrecognised Procedures 

Maternity insurance excludes coverage for complications resulting from procedures or treatments not yet medically approved. If, for example, complications arise due to prenatal gender testing, which is strictly prohibited in India, the claim will be rejected. 

The Actual Price of Skipping Maternity Coverage

After reviewing the inclusions and exclusions of the maternity policy, it’s time to understand the expenses you might have to bear in the absence of trustworthy maternity coverage.

Things to Consider Before Selecting the Right Maternity Health Insurance

Pregnancy is undoubtedly a beautiful journey, but it demands consistent medical intervention and financial preparedness throughout. Therefore, choosing the right maternity insurance plan requires careful evaluation. Overlooking any key detail can lead to unnecessary financial stress during a vital chapter of life's journey. 

Coverage

A good maternity insurance plan should cover everything from prenatal to postnatal expenses and delivery (normal or cesarean) and extend coverage to newborn-related expenses. 

Waiting Period 

Since maternity insurance typically has a waiting period of 9 months to 2 years, choosing a policy with minimal delay is critical if you’re considering starting a family soon. 

Premium vs Cost 

Choosing the right maternity plans means striking the right balance between comprehensive coverage and affordability. Therefore, it is critical to review the premium carefully to ensure you’re not sacrificing coverage for cost. 

Inclusions and Exclusions 

Understanding the inclusions and exclusions of your maternity insurance plan is essential to avoid confusion at a pivotal stage in life. Therefore, it is vital to meticulously read the policy details before deciding. 

Network Hospitals 

A maternity insurance plan with a broad hospital network and cashless treatment options is ideal. This eases the admission process and helps minimise out-of-pocket expenses. 

Claim Process and Settlement 

Reviewing the insurer's claim process and settlement track record is essential before finalising the right maternity policy. You can also look for insurers with transparent procedures and a high claim settlement ratio, most importantly for hassle-free cashless treatments at empanelled hospitals. 

Say Yes to Stress-Free Delivery with Care Health Insurance 

A well-chosen plan not only eases the financial burden but also supports the overall well-being of both the mother and the newborn. To provide you with a stress-free maternity journey, Care Health Insurance offers maternity insurance, Care Joy, tailored to meet your unique needs. Considering the distinct medical needs, this plan covers every crucial expense from prenatal to postnatal care. With that in mind, Care Joy is not just a policy; it's your partner throughout this remarkable yet testing chapter of becoming a mother. So stay protected today for a happy parenting tomorrow. 

Disclaimer: 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.