Maternity Insurance Plans: The Coverage and Waiting Period

Pregnancy – how thoroughly have you thought it through ? Have you set aside money for the birth of your child? Or more importantly, have you invested in maternity insurance plans?

To ensure that you’re financially secure at the time of pregnancy, you must have some answers pertaining to the coverage and waiting period.

Which Plan Do You Choose and What Is The Waiting Period?

Different insurers, different benefits — that’s how it is. Your choice depends on the benefits you wish to avail. For instance, some insurers offer coverage for deliveries only while others go way beyond.

But what’s more important is that insurers consider maternity as pre-existing. In other words, you can’t reap the benefits if you’re already pregnant as there’s a waiting period which is usually between 9 months to 6 years. And that’s why you should opt for a plan well in advance.

Another important highlight of maternity benefits is the number of deliveries. Most insurers offer maternity benefits for up to two deliveries. But bear in mind: a gap — generally 2 years or as specified in the policy document — between both deliveries maybe deemed acceptable in order to be considered for maternity benefits.  

What is Covered Under Maternity Insurance Plans?

Maternity expense is defined according to IRDA’s circular on Standardised definitions issued in 2013. As a result, all insurers have to abide by IRDA’s norm. Basically, it includes any form of hospitalisation expenses that can be traced to childbirth.

So, what are these expenses that are covered under maternity insurance plans? Let’s take a look.

  • Pre- and Post-natal expenses: These include expenses incurred Pre-natal ( before birth) and post-natal (after birth) for treatment related to pre-pregnancy, labour, pregnancy, and delivery for both the mother and the child.
  • Maternity Expenses: This includes coverage for delivery charges — caesarean or normal — for a maximum up to 2 deliveries. Although the coverage for expenses varies amongst insurers, the cost is usually set at:
    • INR 15,000 – 50,000 for normal delivery
    • INR 35,000 – 50,000 for caesarean section
  • Newborn Baby Cover (Day 1- 90): This includes coverage for costs related to an infant’s support system, birth defect-related issues, and special medical procedures.
  • Vaccination Cover: Few insurers cover the costs of vaccinations which are mandated by the Government of India
  • Pre-and Post-hospitalisation expenses: In general, insurers also provide coverage for pre-and post-hospitalisation expenses incurred during maternity. The time-frame is usually set at 30 days for pre-hospitalisation and 60 days for post-hospitalisation.

 

What is Not Covered Under a Maternity Plan?

The exclusions for a maternity plan are as follows:

  • Ectopic Pregnancy: A pregnancy terminated in the first trimester is not covered. Additionally, a woman aged 45 years or more cannot claim maternity benefits.    
  • Deliveries: Insurers may also not cover the entire expense incurred for deliveries (normal or caesarean). There are specific limits for both, as mentioned above.

Maternity expenses are on a steep rise which is pushing couples to opt for plans with enhanced maternity benefits. An important thing to note is that such policies have higher premiums. You should, therefore, go for a plan that is a custom fit for your needs — there are plenty of insurers already who offer lucrative maternity benefits.

They both go together! A health insurance safeguards your health and a
health check detects diseases in time to fight them. 

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