Maternity Health Insurance Plan

What is Covered under a Maternity Insurance Policy?

Health insurance with maternity coverage makes your life easier by offering the following coverage during childbirth:

• Pregnancy Cover- Expenses incurred pre- and postnatal can increase the couple's financial stress. The maternity insurance policy covers pre- and post-natal expenses and helps the mother and her child recover faster.
• Newborn Baby Cover- Health Insurance with Pregnancy Cover plan also has a newborn baby cover. It means that we cover your newborn's expenses from the day of delivery to 90 days to ensure good health.
• Congenital Diseases Cover- The health insurance with maternity coverage will pay the amount as a lump sum if the newborn child is diagnosed with Down's Syndrome or Cerebral Palsy.

What’s Not Covered under Maternity Insurance Plans?

Standard insurance that covers pregnancy excludes the following conditions:

• Pre-existing illness up to 36 months.
• Any illness contracted within the initial 30 days of the policy, except for those claims arising out of accidents.
• Self-inflicted injuries.
• Claim arising out of the consumption of alcohol, drugs or abuse of tobacco.
• External congenital disease.
• Non-allopathic treatment.

*For a complete list of exclusions, kindly refer to the policy document.

When to Buy a Maternity Insurance Policy

Buying a maternity health insurance policy is an integral part of family planning. However, these policies usually involve a waiting period, so it is recommended that you invest in them in advance. Here is when you must buy a maternity insurance policy:

• Once you begin planning for a baby, purchase a policy to fulfil the waiting period requirements.
• Before pregnancy, you must buy maternity health insurance, as most insurers don't cover existing pregnancies.
• Choose maternity coverage separately if your employer provides group health insurance with maternity advantages.
• Opt for policies combining maternity and general health insurance for improved benefits.

Eligibility Criteria for Care Maternity Health Insurance

When you’re considering health insurance with maternity benefits, it’s important to understand the eligibility guidelines. Here are the following criteria:

How to Buy Health Insurance for Maternity Online?

It is important to follow the steps below when claiming pregnancy insurance:

• Visit the official website of the insurer.
• Go to 'Get a Free Quote'.
• Select the plan suggested in the options.
• Enter the required details, including total members, age of the eldest member, contact number and tenure.
• Select the Sum Insured.
• Get the premium details and pay it through the insurer’s secure payment gateway. You will receive the policy documents at your registered email ID, including the policy number and e-card.

Things to Consider Before Selecting Maternity Health Insurance

With multiple options available in the market, at times choosing the right maternity insurance plans can be challenging. Thus, to enable you to decide on the right maternity insurance coverage, here are some points you should consider.

• Choose the best maternity cover insurance plan that gives you financial protection against various medical expenses, not only hospitalisation expenses.
• Savings are crucial for every family. Thus, look for premium discounts you can avail of, such as a discount on multi-year health insurance with maternity cover.
• Go through the list of cashless network hospitals so that you know you have easy access to cashless hospitalisation in times of need.
• Read the pregnancy insurance plan document carefully to understand the policy inclusions, exclusions, sub-limits, and waiting period.
• You can get maternity cover health insurance at an affordable premium by carefully comparing and selecting the right policy with maximum coverage and benefits.
• Newborn baby cover, daycare procedures, and new-age treatments are a few must-have benefits you should look for in a maternity cover insurance plan.
• Find out the procedure to file a claim under an insurance policy for pregnancy, so you need not face any hassles or delays.

How to Claim Maternity Cover Health Insurance?

Everyone expects a smooth claim experience whenever a claim arises. That’s why it is important to follow the steps mentioned below while claiming maternity health insurance:

Cashless Claim

Intimation: Inform your insurer within 24 hours of hospitalisation in case of cashless hospitalisation and 48 hours in case of planned hospitalisation.

• Pre-authorisation Request: Fill out the cashless form to seek the insurer’s approval at the TPA.
• Approval/Rejection: The status of the pre-authorisation request will be shared.
• Claim Settlement: The claim will be settled directly with the hospital authority.

Reimbursement Claim

• Claim Registration: Pay the initial medical bills and register a claim under the reimbursement category.
• Document Submission: Submit the duly filled claim form along with the required documents.
• Approval/Rejection: The status of the claim request will be shared. In case of rejection or discrepancy, the insurer will update the cause of rejection.

What are the Documents Required to Claim Maternity Insurance Mediclaim?

The documents below are needed to register a claim for maternity cover health insurance.

How is the Cost of Maternity Insurance Calculated?

When you choose maternity health, the premium is usually more than a standard health insurance plan. The reason is simple: maternity costs are predictable. Unlike other health issues that might not happen, pregnancy involves definite expenses. Insurers keep these points in mind when figuring out the price. Here are the major things that affect the pregnancy insurance cost:

• Age of the Insured: Younger couples pay lower premiums compared to those purchasing maternity health insurance at a later age (closer to 35-40 years).
• Sum Insured & Coverage Type: A higher sum insured or a comprehensive health insurance with maternity benefits covering pre- and post-hospitalisation, delivery, newborn, and vaccination will lead to higher premiums.
• City & Hospital Network: Premiums may vary based on the city of residence, as treatment costs are higher in metro cities compared to smaller towns.
• Policy Tenure: Opting for a multi-year policy, such as 3 years, often reduces the overall cost per year compared to annual renewals.
• Waiting Period: Plans with a shorter waiting period, like Joy Today with 9 months, generally cost more than those with a longer waiting period, such as Joy Tomorrow with 24 months.
• Add-ons & Extra Benefits: Some polices allow add-ons like newborn vaccination cover, OPD care, or enhanced maternity benefits, which increase the premium amount.