Top 5 Factors to Consider When you Buy Maternity Insurance


When Should you Buy Maternity Insurance?

Expecting a baby is a joyful occasion, not just for the parents-to-be but family and friends too. Every visit to the doctor adds to the excitement; hearing the baby’s rapid heartbeat and seeing indistinct images in sonography all build up thrilling anticipation of the great day when the baby will actually be born.

The family and well-wishers hope and pray that all will go as perfectly as possible; and rightly so, since the birth of every little baby is, to an extent, still a magical work of providence. But the simple truth is that the bigger the budget for the delivery and pre and post-natal care, the better the facilities available and the more memorable the experience is likely to be. And that’s where maternity insurance comes in.

Health Insurance with Maternity Cover

A majority of health insurance policies do not cover maternity expenses at all, despite the fact that the insured is bound to be hospitalized for a period of at least 24 hours. And those policies that do offer maternity benefits are far from practical and comprehensive. Although they cover delivery expenses, both normal and Caesarean, they come with some limiting conditions. For example, you cannot avail of maternity benefits as soon as you purchase the policy; there is a waiting period that could range between 2 to 4 years, depending upon the insurer and plan. Further, these products are costly and have sub-limits that range from an inadequate Rs 15,000 to a maximum of Rs 50,000.

There are group health insurance plans that allow you to claim maternity benefits. But here again, the cover sub-limits are likely to be inadequate.

Maternity Policies with Health Insurance benefits

Today, the insurance industry offers a product that focuses more on meeting your maternity-related financial needs, although it is basically a health insurance policy too. Effectively, these policies cover a long list of ailments and pre-existing diseases but offer great maternity and newborn benefits too. Even the waiting period for maternity claims on such policies is relatively low; some insurers restrict it to just 9 months!

These products typically take care of not just the delivery expenses but the pre-natal and post-natal expenses incurred with respect to the hospitalization as well, such as room charges, nursing expenses, and the doctor’s fee. Beyond that, if the delivery gets complicated, a well-selected maternity policy will even cover expenses incurred on ambulance services in an emergency situation, ICU charges, the surgeon’s fee, anesthesia, blood, oxygen, operation theatre charges, etc.

As a caring gesture, you will find some maternity policies cover the infant in specified events, within the same policy until he/she reaches three months of age. In fact, even beyond the initial 3 months, such policies offer the option to continue having the baby covered under your existing policy. Just like other health insurance policies, maternity insurance comes with tax breaks, ‘no claim’ bonuses and both the cashless and reimbursement claim options.

Memorable Milestones

Last, but not least, having a maternity policy when you are planning to start a family could help you immensely in your financial planning exercise. After all, having a baby is a goal and a milestone and accordingly, it deserves a carefully crafted financial plan too.

What Is Covered In Maternity Insurance? What Are The Expenses Which Are Excluded?

The scope of coverage is subjective to the plan chosen and the health insurer selected. It varies but some of the key benefits covered in a maternity insurance plan include coverage for pre-natal & post-natal expenses. Not just this - expenses incurred at the time of hospitalization are also included. Many insurance policies also provide cover to the newborn baby for a period after the child is born.

On the flip side, there are many exclusions that are common. One needs to understand these carefully before making a choice. For example, if one pregnant at the time of policy purchase then the same will be considered as a pre-existing ailment and will be covered only after a certain specified wait-period. This wait-period is different for insurers and it is advised to purchase a maternity policy in advance.

There may also be caps on the amount which you can claim as expenses of the pregnancy, this amount varies according to the premium, and the policy you choose to take. The expense for normal birth and a Caesarean also varies in most cases. The age for the mother in question may also be capped, although it will be at an older age like 45. If the pregnancy is terminated after 12 weeks of conception, these may also be excluded in the policy. Another important thing to mention is that ectopic pregnancies will also not be covered.

You need to check for these exclusions, and if there are any additional exclusions which are mentioned here. This plays a huge part in choosing the right policy for you.

How Is the Premium Calculated for Maternity Insurance?

The premium for the maternity insurance policy varies according to a lot of factors. Most of the maternity insurance policies are typically add-ons to existing health insurance policies – this can have a large impact on the premium you are charged.

The age of the mother is another crucial factor as the premium increases with age. In addition, the current health status of the insured is also factored in. Insurance company's basis one’s current health status might apply loading wherein one has to pay slightly more for enrollment. The waiting period on the insurance policy you choose is yet another significant factor. The waiting period for most of the maternity insurance policies ranges from 3 to 4 years, according to the organization you choose.

Some policies have a waiting period as long as 6 years, too. These are bound to have a lower premium, because many couples may end up having a child before the waiting term is over. However, most of the expensive maternity insurance policies have waiting periods of less than 2 years, with some even having waiting periods as less as 9 months. These would charge a higher premium from the customer, owing to the increased flexibility they are offering the customer in regards to their decision to have a baby.

These are a few factors that have an impact on your premium when you opt for a maternity insurance plan.

Factors to Think of While Selecting Maternity Insurance Policy?

There are many factors which you will need to consider when you decide to have a child. Some of these are mentioned here.

  • You will need to check if the health insurance plan you have now covers maternity and child insurance too. This is the case in many instances, and spending money on an additional plan, in that case, maybe foolhardy for the parents. You will need to check with the company, just to be sure - after all, most people are not bothered about this when they sign up for the insurance policy. It may be the other way too – you may think that pregnancy-related expenses are covered in insurance, but that may not always be the case. In any case, you need to check if your existing health insurance plan has maternity benefits in them.
  • Check up on what plans the maternity insurance policy covers, too. The costs of being pregnant are higher than you think - it starts pretty early into the pregnancy, too. You will have to make a lot of visits to the doctor, pregnancy-related purchases cost a fair amount and medical examinations are not cheap either. Medical costs are soaring in general, and these can be a real financial burden for many people. Therefore, definitely remember to check what the policy covers before you opt to get a maternity insurance policy.
  • In many cases, the cashless health insurance policy you opt for may limit the amount you can claim as your maternity expenses. This amount may be Rs. 25000, and can vary from company to company. The cost of normal and Caesarean deliveries are different, too. So ensure that you understand all the sub-limits associated with it before you opt to get a maternity insurance policy.
  • The waiting period is perhaps the most important decision to make before you opt for any policy - it is a commitment you have to try to adhere to. The waiting policies range from as little as 9 months to as much as 6 years, and many companies reject your claim if you get pregnant before this period. Depending on how long you think you will take before you decide to have a child, you must choose the maternity insurance policy.
  • Maternity plans generally have a high premium rate associated with it. This is because this is a certain condition, and the companies will have to end up paying the money at some point or the other. Therefore, high premiums are the norm. However, if you do some proper research with a clear idea of what you want in mind, you might be able to find a company that is willing to give you the insurance policy at a lower premium. This can end up saving you a lot of money over time, so you must make a conscious decision regarding this.

It is always worth taking a maternity insurance policy because it is a sure-shot condition in most cases. However, ensure that you have done proper research before you settle on a policy.

Tips for Buying a Maternity Insurance Policy

  • Ensure that you do not focus solely on the maternity insurance policy when you are buying health insurance - consider other factors too.
  • In many cases, employers offer plans which cover maternity expenses. In that case, the better thing to do would be to use that rather than claiming from your own health policy. This would ensure that you are eligible for the no-claim bonus or discount in the next year.
  • In case your costs exceed those covered by your employer, you could always choose to touch your own claim to get the cost you incurred.
  • If you want some flexibility, a great idea is to build your own maternity fund with time. You can do this by investing smartly in other avenues, like FDs or liquid mutual funds where funds can be withdrawn quickly.
  • If you are already pregnant, getting a maternity policy would be redundant. You should time the purchase extremely well, to make it the most effective.


What is Covered in Maternity Insurance?

Most maternity insurance plans cover the costs associated with labor and hospitalization expenses in those days. Depending on the plan you choose to take, you may also get the costs you incurred for your prenatal and postnatal care of the baby. Some insurance policies also have a cover for the newborn baby, which can be extremely useful. Any procedure associated with the pregnancy is also covered by the policy in many cases. However, medicines and miscellaneous expenses may not be covered - so check before you buy.

Is there a Waiting Period for Maternity Coverage?

Depending upon the plan you choose to get, there can be varying waiting periods. On average, the waiting periods range from 3-4 years for the policy to kick in. It may range up to 6 years in some cases, or even be as less as 9 months depending on the plan.

Is Miscarriage Covered under Medical Coverage?

In most cases, miscarriages are covered by the insurance policy you take. Forced terminations of the pregnancy in the first twelve weeks are the only related issue which is not covered by the companies giving insurance policies.

Is Pregnancy covered under mediclaim?

Mediclaim health insurance policy usually covers pregnancy in their policy, in order to help parents get the costs they incurred during pregnancy back from the insurer. They are quite comprehensive because they cover the charges incurred throughout delivery and post-natal delivery care. However, it should be noted that generalized mediclaim policies do not cover maternity expenses.

Is maternity insurance a default part of health insurance policy?

In most cases, it is not - it may be an add-on offered to you, or you may even have to opt for additional medical insurance in order to cover your pregnancy-related expenses. You have to check any health insurance policy before opting for it, to be sure that maternity is covered.