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Which is the best maternity insurance cover plan
Which is the best maternity insurance cover plan
Feb 26, 2016 | 6057 VIEWS
Maternity can be financially challenging for a middle-income family in urban areas as both husband and wife work to meet expenses. Owing to high healthcare costs in India, it is every bit advisable for a married couple to have a mediclaim policy with an add-on maternity insurance cover . It’s not that simple though, insurance is based on the premise of covering an unanticipated risk, however, pregnancy is planned and not a risk, hence is not covered as a risk per se by insurance companies. 

Which plans solely cover maternity? 

There are no plans that solely cater to maternity expenses however some health plans offer add-on riders to cover maternity costs.  Also, general insurance companies cover maternity in corporate group insurance policies mostly as an add-on cover with sub-limit not exceeding Rs 50,000. It is advisable to check with the human resource department of your company, if maternity is covered under the group insurance plan of your employer. It is usually the best form of maternity cover that one can ask for. 

Some health plans from companies such as Cigna TTK, Religare, Apollo Munich, ICICI Lombard, Cholamandalam General Insurance, United India Insurance, and Star Health do cover maternity expenses. 

Points to consider before buying health insurance with maternity cover:
  • Waiting period: Generally, there is a waiting period of 2-6 years before you can claim maternity expenses in such health plans. This can be counter-productive for those who plan to start a family in the near future. Apollo Munich’s Exclusive Family Health and Cigna TTK’s ProHealth Insurance Plus Plan have waiting periods of upto 4 years but it can be brought down to 2 years in case of ProHealth Insurance Plus by paying an additional premium. However, Religare Joy has an industry low waiting period of just 9 months in a policy term of 3 years but premium is higher as compared to other plans. For a three year policy, a family of two, aged between 18-45 years for 3 lakhs works out to Rs. 55,445 in Religare joy. It’s probably best to buy a maternity add-on on your health insurance at the start of your marriage, in order to factor-in the initial waiting period. 
  • What is covered? Maternity cover should provide for delivery expenses (including Caesarean) and complications arising thereof, pre-natal & post-natal expenses along with post-birth care and vaccination. It is however very difficult to find all of this covered under a single policy plan. Health plans that cover maternity expenses will typically either cover delivery charges along with pre-natal & post-natal expenses or maternity-related OPD care (outpatient department) expenses such as cost of medicines, drugs, ambulance charges and hospital stay. But plans such as Religare Joy are very comprehensive in nature covering more or less all of the aspects of maternity cover.  
  • Sum Assured: Apollo Munich’s Exclusive Family Health and Cigna TTK’s Plus provide cover maternity expenses upto Rs 15,000 for normal delivery and Rs 25000 for Caesarean delivery for a sum assured of Rs 3-5 lakh in the base plan. Most health plans that have maternity cover as add-on limit the cover amount till Rs 50,000. This amount might be insufficient in metros where this cost could easily touch Ra 1 lakh or above.  
  • New Born Baby Cover: Check if the rider covers day one new born baby cover which means covering costs for treatment of ill-health of new born baby from day one, associated pregnancy complications, pre and post natal expenses    
  • Common exclusions: Many policies do not cover post-pregnancy expenses such as medical check-ups or the cost of medication.        
It’s probably good if you have a family floater health plan already covering maternity expenses. This way a single plan will not only cover health care expenses for a family but also maternity expenses at an additional premium payment. Group corporate health insurance policy is probably the best way to get be protected against maternity expenses without feeling the pinch on your pocket. 

Here is an analysis of some health plans that cover maternity expenses: 

 
Health Plans with which cover Maternity expenses
  Religare Joy Cigna TTK’s ProHealth Insurance Plus Plan Apollo Munich’s Easy Health Insurance Exclusive (Family) Health
Entry Age - Minimum Adult: 18 years
Child: 1 Day
New Born: 1 Day
Child: 91 days
Adult: 18 years
5 years
Entry Age - Maximum Adult: 65 years
Child: 24 years
New Born: 90 Days
No maximum age 65 years
Maternity Expenses For SI: Rs. 3L
Rs. 35,000 (Including pre-natal & post-natal expenses)
For SI: Rs. 5L
Rs. 50,000
Covered upto Rs. 15,000 for normal delivery and
Rs 25,000 for C- Section per event
For SI: Rs. 3-5L
Normal Delivery Rs.15,000
*Caesarean Delivery Rs.25,000*
(*Incld Pre/Post Natal limit Rs.1,500)
[Waiting Period 4 years]
 
For SI: 7.50,10L
Normal Delivery Rs. 25,000*
Caesarean Delivery Rs.40,000*
(*Including Pre/Post Natal limit Rs. 2,500 [Waiting Period 4 years]

For SI Rs. 15, 25 & 50L
Normal Delivery Rs.30,000*
Caesarean Delivery Rs.50,000*
(*Including Pre/Post Natal limit of Rs.5,000 [Waiting Period 3 Years]
Hospitalisation Expenses For SI: Rs. 3L 
Pre-hospitalisation for 30 days
Post-hospitalisation  60 days

For SI: Rs. 3L
Pre-hospitalisation for 30 days
Post-hospitalisation 60 days
Yes (but not for maternity) Yes (but not for maternity)
Waiting period 9* & 24 months 48 months (can be reduced to 24 months with addl premium) 36, 48 months(can be reduced to 24 months with addl premium)
New born baby cover For SI: Rs. 3L
Upto Rs. 30,000
(From 1-90 Days of baby’s age)

For SI: Rs. 5L
Rs. 50,000
(From 1-90 Days of baby’s age)
Optional Coverage (1-90days) by paying addnl premium Optional Coverage (1-90 days) by paying addnl premium
For SI: Rs. 3-5L, Limit: Rs.2,000
For SI: 7.50,10L, Limit: Rs.3,500
For SI: 15,25, 50L, Limit: Rs.5,000
Vaccination Expenses As per national immunization programme over and above Maternity Expenses 1st year vaccination expenses -
Policy Period 3 years 1, 2 years 1.2 years 
Pre-Natal & Post Natal Expenses Yes No Yes
Lawful medical Termination Expenses  Yes Yes Yes
 
 

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