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 medical 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 that cover maternity incorporate group insurance policies mostly as an add-on cover with a 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 ManipalCigna, Care, HDFC Ergo, ICICI Lombard, Cholamandalam General Insurance, United India Insurance, and Star Health do cover maternity expenses.
Points to consider before buying health insurance with maternity coverage:
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. HDFC Ergo’s Exclusive Family Health and ManipalCigna’s ProHealth Insurance Plus Plan have waiting periods of up to 4 years but it can be brought down to 2 years in the case of ProHealth Insurance Plus by paying an additional premium. However, Care Joy has an industry-low waiting period of just 9 months in a policy term of 3 years but the 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 Care 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 the cost of medicines, drugs, ambulance charges and hospital stay. But plans such as Care Joy are very comprehensive in nature covering more or less all of the aspects of maternity coverage.
Sum Assured
HDFC Ergo’s Exclusive Family Health and ManipalCigna’s Pro Health Plus provide cover maternity expenses up to 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 an add-on limit the cover amount to 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 newborn baby cover which means covering costs for treatment of ill-health of a newborn baby from day one, associated pregnancy complications, pre and postnatal 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. A group corporate health insurance policy is probably the best way to get protected against maternity expenses without feeling the pinch in your pocket.
Here is an analysis of some health plans that cover maternity expenses:
Health Plans which cover Maternity expenses
Care Joy | ManipalCigna ProHealth Plus Insurance Plan | HDFC Ergo’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 up to 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) |
Newborn baby cover | For SI: Rs. 3L Up to 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 the 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 |