How to make the most of your Maternity Cover

How to make the most of your Maternity Cover

Becoming a mother brings a lot of changes to the physical and mental health of a woman. As much as pregnancy is the most precious experience of life, it brings with it a load of financial responsibilities and stress.

Maternity expenses seem a lot if you are living in India or anywhere in the world. A huge amount of medical costs is involved which makes it harder for a couple to decide when they should start a family. Be it a normal delivery or C-section, the expenses are escalating.

The first step of family planning involves proper financial planning to pay the medical costs before, during and after pregnancy. If you have a general health insurance policy and you think it will support you throughout your pregnancy journey, you are wrong here. Today, many health insurance companies can provide you with a maternity cover along with your existing policy to provide you financial safety.

Maternity, Pregnancy, Pregnant, Health Insurance

What is a maternity cover?

A maternity add-on benefit covers all maternity or childbirth-related expenses during pregnancy. It can be bought as an add-on cover to the existing health policy or as an independent insurance cover.

It will cover pre-and post-natal expenses

Maternity add-on cover is beneficial for couples as it will cover mostly all expenses related to childbirth. Delivery and labor expenses are covered including normal deliveries and C-sections. Pre- and post-natal expenses along with pre-and post-hospitalization expenses are also covered under the policy.

  • Pre-natal expenses (before-birth)

1. Ultrasound and scans

2. Doctor’s consultations

3. Medical check-ups

  • Post-natal expenses (after-birth)

1. New-born baby vaccinations

2. Hospitalization costs for mothers post-delivery

3. Complications arising in the baby or the mother

Many health insurance policies also provide coverage for newborn babies for a limited time period. Vaccinations and any critical illnesses will be covered by the benefit, depending upon the terms & conditions of your health insurance policy.

The hospitalization expenses including room rent, emergency ambulance, consultation fees, medicines, etc., are also included in the maternity cover.

Some maternity plans do not cover everything

Although the coverage must include everything from ultrasound, scans to regular check-ups, many insurance companies only provide coverage for pre-and post-natal expenses. Therefore, you must research well before buying the policy and see the exclusion list under your cover.

Coverage of infertility treatment varies from company to company.  In many cases, the pre-and post-natal expenses are not covered, unless it leads to hospitalization. Also, expenses for ectopic pregnancy are not covered under maternity insurance. In such cases, your general health insurance policy can cover hospitalization expenses.

If you are already pregnant while buying the policy, the insurance company may not cover it as it will be considered as a pre-existing condition.

Importance of having a maternity cover

A maternity cover has several advantages due to which it is considered important to apply for it. The reasons are as follows:

  1. You will be ready for any childbirth complications arising in the future. For example, if a woman is facing any complications, the expenses for the treatment will be covered by your policy.
  2. Many companies also cover infertility treatment, in case you are not able to start a family due to any complications.
  3. Your newborn baby will not have to face any problems as all the vaccination charges will be covered by your policy for a specific amount of time from Day 1.
  4. Getting treatment in a private hospital is a convenient journey, but at the same time, the expenses become hard to pay! With a maternity add-on benefit, you don’t have to worry anymore and get treatment in the best hospitals in the city.
  5. Maternity insurance plans also include cashless services in the network hospitals. Make sure that you opt to get treatment within the network hospitals mentioned in your cover to experience cashless hospitalization!

When should you buy a maternity cover?

The best time to buy a maternity cover is when you are newly married. This gives you time to begin your family planning. As the waiting period for maternity plan ranges from 2-3 years or as per the policy T&C, you must be ready with your maternity benefit at the right time.

If you already have a child and want to begin planning a second one, you can apply for the maternity add-on cover keeping in mind the waiting period.

Many health insurance policies have a certain age limit before which you are eligible to buy the add-on benefit. In many cases, the maximum age limit is <40-45 years.

Some of the maternity insurance plans are:

  • Bajaj Allianz Health Guard Family Floater Health Insurance Plan

Bajaj Allianz Health Guard Gold Plan covers maternity benefits including C-sections and normal deliveries. The policy will cover pre-and post-natal hospitalization expenses for each delivery or termination with a 72-month waiting period. The packages for the same are as follows:

1. Sum insured: Rs 3 Lakhs-7.5 Lakhs (covers normal deliveries up to Rs 15,000 & C-sections up to Rs 25,000)

2. Sum insured: Rs 10 Lakhs to 50 Lakhs (covers normal deliveries up to Rs 25,000 & C-sections up to Rs 35,000)

The plan also covers new born baby cover with mandatory vaccinations till 90 days from birth.

  • Max Bupa- Heartbeat Family Floater

Max Bupa- Heartbeat Family Floater covers maternity benefits up to Rs 1,00,000 with no additional premium for new born baby expenses from date of birth to policy year end. The plans under the policy are:

1. Individual & Family Floater Gold (covers up to Rs 1,00,000 maternity expenses)

2. Individual & Family Floater Platinum (covers up to Rs 2,00,000 maternity expenses)

3. Family First Silver (covers up to Rs 35,000 maternity expenses)

4. Family First Gold (covers up to Rs 50,000 maternity expenses)

5. Family First Platinum (covers up to Rs 1,00,000 maternity expenses)

  • HDFC Ergo- Health Suraksha Gold

HDFC Ergo provides Health Suraksha Gold & Medisure Classic insurance plans which cover maternity expenses. Under these plans, there is no capping on room rent, medicine cost, doctor’s consultations and investigations. The plans have lifelong renewability with 6000+ network hospitals providing cashless services. The new born baby cover also comes along the maternity benefits. The waiting period under Health Suraksha Gold plan is 4 years. The package includes:

1. Coverage for normal deliveries (up to Rs 15,000)

2. Coverage for c-section (up to Rs 25,000)

3. Pre and post-natal limit up to Rs 1,500

4. New born baby limit (up to Rs 2,000)

  • SBI Arogya Premier

SBI Arogya Premier plan covers maternity expenses incurred during hospitalization after 9 months of waiting period from the date of policy purchase. Sum insured under the plan ranges from Rs 10 Lakh to Rs 30 Lakh.

  • Star Health-Wedding Gift

Star Health Wedding Gift covers pre-and pot-natal expenses along with new born baby add-on cover. The plan is limited to 2 deliveries and has a waiting period of 36 months. The policy provides sum insured of Rs 3 Lakh & Rs 5 Lakh. Also, the plan will provide claim for health check-ups of fetus up to Rs 1,000 per test.

When can your maternity claim be rejected?

There are several scenarios where claim for maternity cover can be rejected. These are:

  1. Women who conceive after the normal child-bearing age as complications may arise
  2. Waiting period is not over for maternity benefits
  3. Incomplete/missing documents
  4. Maternity sum insured is exhausted, in case of second child

Though you will have to pay a higher premium, it will be worth

Maternity covers generally cost more than normal health insurance plans. With the medical costs rising every day, you must plan to buy the cover as soon as possible to avoid paying higher premiums for your policy.

How can ClaimTherapist help you?

We can guide you throughout your medical journey by decoding the terms & conditions of your policy. We have handled around 8000+ maternity cases with the support of our expert team. Our exclusive tie-ups with hospitals ensure faster process and hassle-free treatment resulting in convenient services for our customers . Many maternity covers can be hard to understand in case of which, we are here to assist you through your claim processing.

Motherhood, Mom, ClaimTherapist, Mediclaim