Facts about Maternity Health Insurance in India You Cannot Ignore

• Written by Jagriti Chakraborty

  Reviewed by Akhil Pillai

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(A brief conversation between two friends)

Anita: Hey, did you hear how much delivery costs have increased lately? My cousin recently had her baby, and the hospital bill was unbelievably high! Getting treatment at a private healthcare facility is now almost a dream for many.

Jaya: Yeah, I’ve noticed that, too. Medical expenses during pregnancy are gradually going up, especially in private hospitals.

Anita: It’s terrifying. I’m planning to start a family soon, but these expenses are making me anxious.

Jaya: In that case, you should definitely look into a maternity health insurance policy. It’s becoming super important nowadays in India with all these rising medical expenses.

Anita: A maternity health insurance policy in India? Does that even exist?

Jaya: Yes. It’s a special insurance policy that covers all maternity-related medical expenses, from prenatal to postnatal costs.

Anita: That sounds helpful! Can you give me further insights into maternity insurance policies?

Jaya: Definitely. I’d love to share more details about maternity insurance policies.

A maternity health insurance policy is designed to provide financial protection and peace of mind during the crucial phase of carrying and giving birth to a baby. Given the increasing costs of medical care and greater demand for top-notch medical treatment, understanding the essential details empowers expectant parents to make informed choices to protect their health and budget wisely. Despite the clear benefits of this policy, awareness about maternity insurance in India remains limited among many expecting parents.

Let’s become more familiar with maternity insurance policies, their benefits, and other essential insights that highlight why this coverage is vital, considering the escalating costs of medical treatments.

What is a Maternity Insurance Plan in India?

Maternity Insurance Policy is a type of health insurance that provides coverage for pregnancy and childbirth. A typical maternity insurance plan in India includes prenatal care, delivery expenses, postnatal care, and newborn baby care.

Prenatal Care

Prenatal care includes regular monitoring and wellness support for the expecting mother and her baby before birth.

Delivery Expenses

Maternity health insurance covers delivery expenses for normal and caesarean births. It also pays for hospitalisation, labour room charges, doctors’ and anaesthetists' fees, etc.

Postnatal Care

Also called postpartum care, postnatal care refers to the medical attention and emotional support provided to mothers and newborns after delivery. It is considered the most critical period, during which well-being is needed so mothers can heal and babies can thrive physically and emotionally.

Newborn Baby Care

Newborn baby care refers to the essential practices that ensure the baby’s safety, health, and well-being and support their growth and development in the first few weeks or months after birth. These include feeding, hygiene, regular checkups, and vaccinations.

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

Key Reasons to Invest in Maternity Health Insurance

Welcoming a child means preparing both emotionally and financially. A maternity health plan supports you through this special journey by offering financial protection and access to quality medical care. Discover how a maternity insurance plan can make all the difference during your maternity journey.

Strong Financial Backup During Maternity

Maternity coverage offers a financial cushion to manage the unpredictable costs of pregnancy. These expenses include prenatal check-ups, delivery charges, diagnostic tests, hospital stays, and postnatal care. Having reliable maternity health insurance ensures you don’t have to compromise on quality healthcare due to budget concerns.

Insurance Support for Pregnancy Complications

Pregnancy often doesn't go as planned. Complications such as gestational diabetes, premature labour, preeclampsia, or emergency caesarean delivery might arise unexpectedly. Here, the maternity insurance policy provides a financial shield to cover specialist consultation, advanced medical treatment, extended hospital stays, etc.

Financial Support for Prenatal to Postnatal Care

The Maternity Health Insurance policy ensures end-to-end maternity expense protection from the first prenatal visit to postnatal recovery. With rising medical expenses in India, such protection ensures that the expectant family receives uninterrupted access to premium maternity treatment with utmost peace of mind.

Tax Benefits through a Maternity Insurance Plan in India

Choosing health insurance is a wise decision that guarantees quality medical care and offers the added perks of tax benefits. Premiums paid towards the maternity insurance plan qualify under Section 80D of the Income Tax Act,1961.

A Clear Look at Inclusions and Exclusions of Maternity Health Insurance

Although maternity health insurance safeguards your finances during the crucial period of motherhood, it may also come with notable exclusions. The following are the inclusions and exclusions in typical maternity health insurance in India, which can help you make informed decisions.

Inclusion Details of Maternity Insurance

Find the inclusions of a standard maternity health insurance policy, subject to a specified limit.

Inpatient Care

The maternity insurance plan covers a wide range of expenses during any hospital stay lasting 24 hours or more, including room and ICU charges, surgeon and doctor fees, anaesthesia, blood, oxygen, and operation theatre costs.

Day Care

Medical procedures completed within 24 hours are also eligible for coverage under daycare benefits.

Pre-Hospitalisation

Specific pre-hospitalisation procedures, such as diagnostic tests and medical care, can be costly. Maternity Health Insurance covers the medical expenses you incur before hospital admission.

Ambulance Cover

The maternity insurance plan ensures immediate care in medical emergencies. That’s why the policy might reimburse the cost of ambulance services provided by the hospital or any authorised service provider during a medical emergency.

Post-Hospitalisation

After discharge, maternity insurance covers medical expenses such as checkups, medication, and additional tests if required.

Newborn Cover

The policy extends coverage to newborns for the first year, covering vaccination charges, prescribed medications, check-ups, and ventilator support if required.

Exclusions in Maternity Insurance Policy

Exclusions are certain medical circumstances or expenses that fall outside the scope of the maternity insurance policy. Knowing these exclusions in advance can help you avoid unexpected out-of-pocket costs and select wisely when choosing a trustworthy maternity insurance policy.

Waiting Period

Claims for maternity expenses made during the waiting period of 2 to 6 years are not eligible for reimbursement.

Pre-Existing Diseases and Conditions

Maternity insurance doesn’t usually cover pre-existing conditions. Therefore, if the policy is purchased after pregnancy begins, it won’t cover the maternity expenses as the pregnancy itself will be classified as a pre-existing condition.

Consultation and Diagnostic Test

Regular consultations and pregnancy-related tests are usually excluded unless linked to delivery or hospitalisation.

Supplements

A standard maternity insurance policy excludes expenses related to dietary supplements, including tonics, prenatal vitamins, etc.

Complications Stemming from Unauthorised Treatments

Maternity insurance does not provide coverage for any complications resulting from treatments that are not medically approved. For instance, complications that emerged due to prenatal gender testing, which is prohibited in India, will be strictly excluded from any coverage.

Why Maternity Health Insurance in India Remains Overlooked?

Similar to Anita, many individuals are still unaware of the concept of Maternity Health Insurance. Even if people know it exists, several ambiguities make it an underutilised solution among expecting couples, leaving expecting parents financially exposed at a critical stage of their journey. Other factors contributing to this invaluable tool being undervalued include:

Waiting Period

The long waiting period for maternity health insurance often deters people, as it means they cannot make a claim immediately after purchasing the policy.. This presents a significant barrier for those already pregnant or planning to start a family soon.

Cost

The perceived high cost is anothe deterrent. Premiums for maternity insurance policies can seem expensive, especially when weighed against the long waiting period, leading many to view it as a poor investment.

Focus on Other Needs

Many individuals prioritise other health insurance needs, such as life or general health insurance, making them less keen on specific coverage for childbirth.

Fear of Financial Burden

Some people find the idea of high medical costs associated with maternity to be intimidating. However, they still underestimate the true potential of a maternity insurance policy that can make expenses manageable.

Misconception

A common misconception is that childbirth can be easily managed, so they tend to drain their lifelong savings or family support.

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 exclusions and conditions that push couples to consider more flexible financial tools that offer broader health benefits.

Covered vs Uncovered: The Role of Maternity Insurance Policy

Given the escalating medical costs, a Maternity Insurance Policy is nothing short of a blessing. In this comparison, we explore how having or not having maternity insurance can significantly impact the overall maternity experience.

Essential Considerations Before Choosing a Maternity Health Insurance Policy

Maternity Health Insurance Policy is much more than just a safety net. It is undoubtedly a wise investment that requires peace of mind. However, you must know that not all plans are created equal. Here’s what you need to know before purchasing a maternity health insurance policy to avoid common pitfalls while getting comprehensive coverage.

Extent and Depth of Maternity Coverage

Before buying maternity health insurance, you must understand that maternity-related expenses are not restricted to delivery. The costs tend to start much before childbirth and continue well after. Knowing your coverage and what’s included in the policy can help you avoid out-of-pocket expenses.

Waiting Period

Most maternity insurance policies have a waiting period of 9 months to 2 years. Knowing the waiting period can help you to avail maternity benefits and avoid claim rejections. Also, not all policies have the same waiting period. Awareness of the waiting period can also help you compare better and choose a plan that fits your financial needs.

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 get a realistic idea of what you’ll spend to protect yourself from unexpected financial burden at a defining moment in your journey.

Familiarity With Exclusion

Understanding exclusion is crucial, as most assume all maternity-related costs are covered. But standard maternity health insurance excludes pre-existing pregnancy, IVF treatments, or congenital diseases, which can lead to claim denials. Therefore, awareness about exclusions empowers you to make informed decisions and protect yourself during pregnancy.

Network Hospitals

A maternity insurance plan with a broad hospital network and cashless treatment options is ideal. This eases the hassle-free claims process, offers better delivery planning, provides access to quality healthcare, and is geographically convenient, allowing you to focus on health instead of bills and unnecessary paperwork.

Celebrate New Life with Confidence with Care Health Insurance

The worth of a remarkable maternity insurance plan is evident in its support of the complete well-being of both mother and child. It provides a sense of confidence and security during a transformative phase of life. So, to ensure your seamless journey to motherhood, Care Health Insurance offers a dedicated maternity Plan, Care Joy, which is thoughtfully curated to meet your unique needs.

Recognising the specific medical demands of pregnancy, the plan covers essential prenatal to postnatal expenses. Undoubtedly, Care Joy is your trusted companion throughout your rewarding yet demanding maternity journey.

So, take the proper steps to ensure a fulfilling start to your parenting chapter. Have a happy parenting!

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.