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Health Insurance with Maternity Benefits

Health Insurance with Maternity Benefits

Health insurance with maternity benefit means that the policy is providing the coverage for the maternity expenses of the insured person, before coming into effect the person come with a waiting period before approving.

What is Maternity Health Insurance?

Maternity insurance means the policy will cover pregnancy-related expenses. According to the report, the average woman who experiences motherhood in the age of 32-3, there is saying that having the first child in early 30s is more likely too complicated pregnancies.

Noteworthy, the proportion of caesareans to normal deliveries is 65:35 in metropolitan cities, so therefore, many women opt for health insurance which includes maternity expenses, or especially buy the policy for maternity. But maternity plans come with a long waiting period as well as high premiums.

Benefits of Maternity Health Insurance

Maternity coverage or inclusion-

  • Delivery expenses
  • Ambulance charge
  • Pre and post expenses (Depend upon the type of cesarean or normal delivery)
  • Baby cover (if an infant is diagnosed with any congenital disorder)
  • Vaccination of the infant
  • Emergencies

Waiting Period in Health Insurance with Maternity Benefits

Most maternity policies have a waiting period of 3-6 years in between the policyholder can claim benefit but after the specific period post commencement of insurance policy. It varies on the benefits provided in the health insurance but some of the general expenses which are covered by every policy are as follow-

  • Pre hospitalization expenses for 30 days
  • Post hospitalization expenses for 60 days
  • Hospitalization expenditure with a cap.

Premium Maternity Policy

Generally, health insurance with maternity benefits is expensive because it has a high risk which owes a 100 percent claim ratio, as compared to other policies. The premium of maternity policy depends on various factors like- age profile, risk factor, type of industry, number of employees, company location.

What is the Right Time to get Health Insurance with Maternity Benefits?

Pregnancy means a woman carries a baby for nine months, and if there is no proper planning it may result in burning a hole in your pocket which may over-ride the happiness of having a child. Pregnancy period means rising in the expenditure, childbirth-related expenditure, etc. so, one must plan for the maternity policies, because the first fact is it takes a long waiting period and most insurance companies do not offer insurance policies while the woman is pregnant we can say it is a pre-existing condition, those who want maternity policies should apply in advance before conceiving, an important note is the duration of the waiting period is for 3-4 years, so it’s a crucial aspect of a planned pregnancy.

Exclusion in Maternity Policies

  • IVF or Infertility related expenses
  • Acquired immune deficiency syndrome aka (AIDS) expenses
  • Pre-existing ailment or diagnosed with injured which recently came into existence 48 months
  • Termination of pregnancies within 12 weeks
  • Congenital diseases
  • Medical cost
  • Non-allopathic treatment cost
  • Consultation fees
  • Regular check-ups
  • Dental treatment
  • Drug use or alcohol-related expenses

Claim Maternity Health Insurance

The claiming process may differ from company to company, but in general, it goes like mentioned below-

  • The intimation, planned hospitalization within 48 hours, and emergency hospitalization within 24 hours.

Cashless pre-authorization entail

  • Fill in the form of pre-authorization available at the TPA Desk.
  • Upon receiving the form, the insurance team will send the approval letter to the hospital.
  • Then file a reimbursement claim.

Reimbursement process

  • Fill and submit the form of claim besides the required document to the insurance company.
  • Upon receiving the form, insurance claim management sends approval.

Some famous maturity plans with company name

  1. HDFC Ergo- Health Suraksha Gold
  2. Star Health – Weeding Gift
  3. Apollo Munich – Easy Health Young Family
  4. Care – Joy Tomorrow
  5. Max Bupa – Heartbeat Family Floater

Note: – premium may differ based on the factor like age, prevailing taxes/GST, and location.

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Written by Saakshi Gupta

Saakshi Gupta is a BBA LLB student at the Fairfield Institute of Management and Technology (GGSIPU), New Delhi. Her passion for law and business brought her to pursue law. She has a keen interest in business law, environmental law and also wants to explore more in the field of law. Apart from legal academia, she is a volunteer at a govt. program (National Service Scheme).

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