Get Expert Advice

Get Expert Advice

Homepage  > Health Insurance > Plans >

Maternity Health Insurance

Easy Navigation

Maternity Health Insurance

Welcoming a new baby to the family is not only a matter of great joy but also of great responsibility. It is best to keep yourself adequately prepared both emotionally and financially beforehand to avoid any hassle during the phase of childbirth. It is now that you feel the need and importance of maternity health plans.

As the name suggests, maternity health plans are exclusively crafted to cater to the unique financial requirements of the maternity phase of pregnancy, childbirth, and neonatal care.

What is the need for Maternity Insurance?

Beginning parenthood is one of the most significant milestones in life. This requires extreme care and protection, in every aspect including mental, physical, and financial. However, this journey might prove to be tough if you are not appropriately prepared to efficiently manage medical inflation. 

A maternity health insurance plan offers effective financial protection throughout the pregnancy course, pre- and post-hospitalisation costs, pre-and post-natal care and treatment expenses as required, delivery expenses, irrespective of the type of delivery, ambulance charges, etc. 

Therefore, to ensure complete financial protection during this exciting as well as tense phase, it is best to purchase a befitting maternity health insurance plan.

Reasons to opt for Maternity Insurance along with Indemnity Health Insurance plans

Indemnity health plans are those special plans in which you get reimbursed by your chosen insurer after the course of the hospitalisation is over. Depending on the terms and conditions of the insurance plan concerned, you are eligible to claim up to the optimum sum insured amount. You can purchase this sort of policy as an individual plan or as a part of a family floater policy.
Investing in health insurance at a young age is one of the best things that you can do for your family. Your familial responsibilities remain low at that time, so paying a health insurance premium does not seem to be quite burdensome.
However, you must note that not all indemnity health plans offer maternity coverage benefits. If you would like to ensure complete protection for your entire family, it is best to include maternity coverage benefits in your health plan. Depending on your current financial status and familial requirements, you can even opt for adding maternity coverage as a rider to your existing health policy.
This will ease the financial tensions during the tense and exciting phase of adopting parenthood by covering all the medical care and treatment costs incurred throughout the course.
You must note that standalone maternity health insurance plans are still unavailable in India. Most of the maternity coverages available now are a special add-on rider in existing indemnity policies. However, due to increasing demand and popularity, a handful of plans like Care Joy Plan have emerged that focus well on maternity requirements.

Why buy Maternity Insurance Plans?

Some of the principal reasons to purchase and maintain Maternity Insurance are:
1. Medical back-up:
Maternity policies cover delivery expenses, be it normal or Caesarean. Therefore, you need not worry about the financial resources regarding the pattern of delivery adopted as per requirement.
Apart from this, certain plans even cover pre- and post-hospitalisation expenses for 30 and 60 days respectively. Other medical charges like the surgeon’s cost, room rent, consultation fees, medical investigations, medicines, etc. are also covered.

2. Delivery in any private hospital:
Due to the rising demand for quality healthcare, the preference for private hospitals is gaining rapid popularity. The standard cost of normal delivery in a private hospital revolves approximately INR 50000 and INR 70000, while for a C-Section, it may reach INR 1 lakh.
Moreover, pregnancies are highly unpredictable and may often lead to unprecedented complications, raising the bills significantly. A Maternity health cover may largely ease the process, ensuring efficient financial backing.

3. Neo-natal coverage from day 1:
A tiny new life requires extreme medical support and care. But most standard health policies begin their coverage span for children till they are 90/91 days old. However, a maternity health cover offers this benefit from the very first day. Some of these plans also include vaccination costs from the beginning till the policy term.

4. Prepare for complications:
Any special pregnancy situation might require premature delivery, where the newborn needs incubator support. Such requirements might raise the daily hospital cost to up to INR 10000. The already stressful situation might become tenser because of the mounting hospital bills. To keep yourself prepared, you can opt for maternity plans that cover neo-natal critical ailments or suffer from any congenital health issue.

5. No financial burden for family planning:
Most couples these days take time to start a family. Keeping this in mind, the insurance providers offer maternity plans with sub-limits ranging between 1 and 4 years, depending on the type of plan you have chosen. This keeps your financial burden on the lower side during family planning.

Types of maternity plans available in India

Considering the current scenario, the importance and popularity of maternity health coverage are on the rise. But, in the Indian insurance market, maternity health insurance policy is still unavailable as a standalone plan. It is mostly available as a rider to an existing indemnity health coverage.
Depending on the terms and conditions of the health plan you have chosen, there might exist varying waiting periods to avail of the maternity coverage benefits. It differs from insurer to insurer and policy to policy. It is best to opt for coverage that offers a minimal waiting period.
A thorough research of the types of plans available in the market will reveal the true picture.
There exist differences in the coverage span of the plan too. Some plans offer critical illness care during maternity. Depending on the circumstances, it is advisable to go for the one that offers optimum coverage and protection.

Maternity insurance in-built
Maternity insurance in-built

Several insurers offer maternity coverage benefits as an inclusive part of the basic family floater policy or an individual indemnity plan. If you are not prepared beforehand, you can always buy a separate maternity coverage, which will amount to slightly more expensive than buying it as an add-on. But, you must carefully research before doing so, as not many Indian insurance companies offer it.
However, you must note that maternity coverage benefits remain limited under the scope of the particular plan that you have chosen. You can make the maximum claim up to the amount of the sum insured depending on your premium payout amount that you have decided while purchasing or renewing the plan.
In this context, you must note that most Indian insurance providers offer maternity coverage for up to two childbirths.

Maternity insurance add-on
Maternity insurance add-on

Many Indian insurance providers offer maternity coverage as a separate add-on feature along with the basic health insurance policy. This is a comparatively easier and more reasonable way to enjoy maternity coverage benefits.
This maternity add-on feature also offers financial coverage for the vaccination of the baby along with other medical treatment and care costs that may emerge during the course.
Under standard circumstances, you can enjoy pre- and post-hospitalisation costs of 30 days and 60 days respectively.

Key features of maternity insurance plans

Maternity health insurance comes with a host of exclusive unique features that need special highlighting:
1. Comprehensive coverage:
Most maternity health insurance coverage plans offer comprehensive benefits up to the limit of the entire amount sum insured for all expenses related to maternity including delivery costs, hospitalisation expenses, neonatal care, etc.

2. Waiting period:
The maternity health plans are designed such that you have to maintain a standard waiting period ranging between 9 months and 3 years, depending on the terms of the plan concerned. Because of this clause, it is better to opt for maternity coverage beforehand, so that the waiting period is over during the time of need.

3. Cashless delivery option:
You can easily enjoy a cashless delivery facility at any of your preferred network hospitals with maternity insurance coverage. As per the terms of the chosen plan, the bills get settled automatically by the insurer with the hospital authorities. You need not have to worry about finances in this respect.

4. Fast claim settlement:
The insurers tend to settle maternity claims comparatively faster. This ensures the best medical care facility and hassle-free procedures.

5. No Claim Bonus:
You can even receive a special No Claim Bonus as a yearly increment in the amount of the sum assured for each claim-free year.

Benefits of maternity health insurance plans

From the above discussion, it is clear that maternity health insurance comes with a host of handy benefits. Some of the most significant advantages of maintaining a maternity cover plan are:
1. Delivery and labour coverage:
One of the most significant aspects of maternity coverage is that it acts as a protective shield for all delivery-related expenses be it normal or C-section, which can prove to be financially pretty burdensome under normal circumstances. Apart from that it even covers medicine costs, room rent, surgeon’s fees, consultation charges, and other related expenses.

2. Neonatal care:
Maternity insurance also covers all the costs needed for newborn care. At times, due to premature delivery, the newborn needs incubator support which is quite expensive. If you possess maternity coverage, it will all be covered under the scope of the plan.

3. International maternity coverage:
 comprehensive maternity plan offers international maternity coverage benefits. This implies that even if your delivery happens outside the geographical boundaries of the country, all the associated costs will be covered.

4. Pre- and Post-hospitalisation neonatal care:
All the expenses incurred before the hospitalisation of the expecting mother and post-hospitalisation costs of both the mother and the child get covered under the scope of maternity coverage up to a stipulated time as per the terms of the plan chosen. You are allowed daily hospital allowance, along with room rent and ICU costs, if required.

5. Ambulance coverage:
Certain maternity plans even offer ambulance costs incurred related to maternity emergencies. The amount of this coverage is decided as a percentage of the total amount of sum insured or as a fixed amount, considering the terms of the plan.

6. Domiciliary hospitalisation:
Depending on the circumstances, f you are home-hospitalised for maternity contingencies, then all the costs incurred in the process, get covered under the plan.

7. Organ donation coverage:
Organ donation charges are also covered within the scope of maternity insurance.

8. Complimentary health check-ups:
Pregnancy requires frequent and regular health check-ups and close monitoring. Maternity coverage offers complimentary health check-up benefits.

9. Premium discount:
You can enjoy special discounts or rewards on premiums paid towards maternity coverage health plans.

10. Tax benefits:
As per the provisions of Section 80D of the IT Act, you can claim an optimum tax deduction of up to INR 75000 on premiums paid towards health insurance.

What is included/not included in maternity insurance plans?

Common inclusions

  1. Some of the basic inclusions of a standard maternity health insurance plan are:
  2. Ambulance charges
  3. Treatment costs related to in-patient care
  4. Medicine costs
  5. Costs incurred due to follow-up visits
  6. Expenses for prenatal care
  7. Daycare treatment costs
  8. Vaccination charges for the baby up to 1 year
  9. Room rent expenses
  10. Neonatal protection cover
  11. Delivery cost, both normal and C-Section

Common exclusions

  1. Any expenses incurred due to cosmetic surgery
  2. Any pre-existing ailment
  3. Any pregnancy-related expenses before the completion of the policy waiting period
  4. Any medical expenses incurred for treating eyesight, dental, and hearing issues
  5. Costs for vitamins and supplements
  6. Any medical costs incurred during the gestation period
  7. Infertility treatment costs
  8. IVF costs
  9. Ectopic pregnancy
  10. Miscarriage treatment costs
  11. Pregnancy of women above 45 years
  12. Costs incurred for treating any congenital issue

When to opt for maternity health insurance plans?

Most maternity plans that are currently available in India, come with a waiting period roughly between 9 months and 4 years. Moreover, insurers may deny coverage benefits if you are already pregnant. Moreover there even exists an age capping clause for availing of maternity coverage.
Like any other standard health insurance plan, you will have to pay a comparatively lesser premium amount for early purchase of maternity coverage. You can add a maternity coverage add-on after your marriage or during plan renewal.
Considering all these factors, it is better to purchase maternity cover, well before you begin planning for family expansion.

How much coverage is needed in maternity insurance plans?

Pregnancy is a highly vulnerable state of health, which may lead to unprecedented health complications at any point. This implies additional medical treatment and care, thus raising the already mounting hospital costs. Therefore, it is best to opt for a maternity plan that offers optimum coverage protection.
However, you must note that most of the Indian insurance providers offer limited maternity coverage, approximately ranging between INR 15000 and INR 50000. However, some insurers extend this limit up to INR 1 lakh.
Considering all the factors involved, you must make your choice regarding the coverage limit and then proceed accordingly. It is better to maintain a higher margin to handle any surprising contingencies.

Factors that affect the premium of maternity insurance plans

Considering the general trend, the premium value of maternity health cover is comparatively expensive, because of high-risk involvement, leading to an entire 100% claim ratio. Some of the significant factors that affect the premium value of a maternity health plan include:

  1. The age of the concerned lady plays a significant role in this context. The age of the person is directly proportional to the premium value, implying the lesser the age, the lower the premium. The risk involved in a higher-age pregnancy is much greater as the associated risks increase, thus increasing the premium value.
  2. Any health risk associated with a comparatively healthy woman is much less than that of a person suffering from multiple health issues.
  3. In the case of group health plans, the total number of employees, their designation, location, and profile of the concerned company all are important determining factors in deciding the premium value.

Waiting period for maternity insurance plans

Most maternity health plans come with a waiting period, ranging approximately between 9 months and 4 years. You cannot raise any maternity-related claim during this waiting period. The span of this waiting period varies from one insurer to another. You must seek a plan that offers a comparatively low waiting period, considering all the other factors are favourable.
Therefore, it is best to purchase the cover well beforehand right after your marriage, and then proceed accordingly. This will make you avail of the coverage benefits during need.

A step-by-step guide to buying maternity health insurance plans

Online :

  1. Visit the official website of your chosen insurer and move to the health insurance page
  2. Enter the name of the beneficiary
  3. Proceed to get the plan and click on the tab
  4. Enter all the relevant details, revealing the most suitable plan list
  5. Choose the preferred plan
  6. Move to the next page to select the amount of sum insured and view the exact premium amount
  7. Click the “Buy now” tab to purchase the desired plan
  8. Pay the premium online and the plan is yours
  9. You can download your policy document online

Offline :

  1. Locate the nearest branch of your chosen insurer
  2. Visit them and inform them regarding your plan to buy a maternity cover
  3. The representative(s) will guide you accordingly to choose the most suitable plan
  4. Once you have made your final choice, duly complete the application procedure and submit all the relevant documents
  5. Submit them all along with the premium payable amount

Documents needed to buy maternity insurance plans

Important documents that you need to submit to your insurer for purchasing maternity health insurance include:

1. Age proof: Birth Certificate; Aadhaar Card; passport, Passing certificate of 10th or 12th
2. Identity Proof: Aadhaar card; Driving License; passport
3. Address proof: Ration card; Driving license; electricity bill
4. All the relevant health check-up reports for policyholders above 45 years
5. Recent passport-size photograph.

Who can opt for maternity insurance plans?

Maternity insurance is ideal for:

  1. Newly married couples
  2. Couples willing to expand their family
  3. Couples willing for a second kid
  4. Couples who wish to have kids in the future.

How to claim maternity insurance plans?

A. Cashless claim:
You can utilise the cashless claim settlement facility at any of the network hospitals of your chosen insurance provider.
You need to duly fill in and sign the maternity insurance claim application form available at the TPA desk of the hospital.
Submit all the necessary documents along with the application form.
The concerned hospital must request clearance before claim settlement.
As soon as the application is granted by the insurer, all the bills are immediately settled directly with the hospital authorities.

B Reimbursement claim:
Due to an unprecedented situation, if you have to seek maternity treatment at any non-network hospital, you can file for a reimbursement claim settlement.
Immediately notify your insurance provider about the incident.
After discharge, complete the claim application form and submit it along with all the relevant documents.
The application will be reviewed and further documentation will be asked for if required.
Once everything is duly reviewed and approved by the insurance-providing authorities, your claim is settled by reimbursing the necessary coverage amount to your registered bank account.

List of top 10 maternity insurance plans available in India

PLAN COMPANYVARIANTCOVERAGESUM INSURED LIMIT
Aditya Birla Activ Health Platinum Enhanced Plan with maternity coverAditya Birla Health InsuranceAll the baby birth expenses, post-birth treatment costs, immunisations, pregnancy complication treatment costs, cost of abortion due to pregnancy complication, etc.INR 2 lakhs to INR 2 crores
Bajaj AAllianzHealth Guard Family Floater Health Plan with MI coverBajaj Allianz Health InsuranceAll maternity-related expenses including the medicine and treatment costs  of the newbornINR 3 lakhs to INR 50 lakhs
Barati AXA Smart Super Health Insurance with MI coverBarati AXA Health Insurance
  1. Value Plan
  2. Classic Plan
  3. Uber Plan
  1. INR 35000 and INR 25000 neonatal coverage till 90 days
  2. INR 50000
  3. INR 75000
INR 20 lakhs to INR 30 lakhs in the case of Uber plan
Care Health Joy Health Insurance Plan with maternity coverCare Health Insurance Company
  1. Joy Today (waiting period is 9 months)
  2. Joy Tomorrow(the waiting period is 2 years)
All maternity-related expenses and immunisation and treatment costs of the newborn
Chola MS Family Healthline Insurance Plan with maternity coverCholamandalam MS Health Insurance
  1. Superior
  2. Advance
  1. INR 15000 for normal delivery and INR 25000 for C-Section
  2. INR 25000 for normal delivery and INR 40000 for C-Section
Digit Health Insurance with Maternity coverGo Digit Health InsuranceDelivery costs, neonatal coverage, infertility coverage, coverage for abortion, etc. Offers 200% of the sum insured during the second childbirth
Edelweiss Health Insurance Plan with Maternity coverEdelweiss Health Insurance
  1. Gold Plan
  2. Platinum Plan
(The waiting period is 4 years)
  1. Up to INR 50000
  2. Up to INR 2 lakhs
Future Generali Health Total Mediclaim Insurance with maternity coverFuture Generali Health Insurance
  1. Superior
  2. Premier
(The waiting period is 2 years)
  1. INR 15 lakhs – INR 25 lakhs
  2. INR 50 lakhs- INR 1 Cr
Kotak Mahindra Premier Plan with Maternity coverKotak Mahindra Health InsuranceOffers coverage for missed abortion and delivery expenses of up to the first 2 children of the insured individual, born within the policy tenure; pre- and post-natal expenses, immunisation costs of the children till 2 years
Niva Bupa Heartbeat Family Floater with Maternity coverNiva Bupa Health Insurance
  1. Silver
  2. Gold
  3. Platinum
Offers several types of maternity benefits depending on the plan variant for the first 2 children, provided the insured couple maintains the plan for 2 consecutive years

Things you must know before buying a maternity insurance policy

Some important factors you need to consider before purchasing maternity health insurance cover are:

1. Sub-limit:
Similar to any normal health plan, maternity policies also offer a sub-limit clause. You must be wise enough to research well before making your final decision.

2. Premium amount:
Depending on the plan variant, the coverage span, and the total sum insured amount, the premium value is decided. You can take the help of the premium calculator to know the exact premium amount payable for the concerned plan.

3. Plan coverage:
The insurance covers you buy, must offer comprehensive coverage for all the expenses related to pregnancy and childbirth, including hospitalisation costs, consultation fees, costs of health check-ups, medications, etc.

4. Waiting period:
Most Maternity covers have waiting periods which may vary between 9 months and 6 years. Depending on your planning, and financial and familial situations, you should make your choice.

5. Network hospitals:
To avail of cashless hospitalisation facilities, you must be aware of the list of network hospitals covered by your chosen insurer. The bigger this list is the better.

6. Available discounts:
Since most maternity covers are add-ons, it is best to seek available discounts to reduce your effective premium payout amount.

7. Number of children covered:
Most insurers cover up to the first two children. However, you must be aware of the exact details of your chosen plan before proceeding.

8. Abortion and termination:
Some maternity plans offer abortion and stop costs of up to two pregnancies, provided it is undertaken due to physical complications.

Frequently Asked Questions

Except for group health plans, no insurer offers maternity coverage for already pregnant women, since it is treated as a PED.

Yes. Depending on the terms and conditions of the chosen plan, it may include maternity cover.

If the child of the insured individual is born with any ailment or deformity, it may or may not partially be covered by the insurer, depending on the terms of the plan.

Yes, it can cover your second pregnancy, provided you have completed the waiting period.

The entry age of the insured individual must be at least 18 years, while the exit age differs from insurer to insurer. However, it is mostly set at 45 years. The geographical boundaries are also considered under certain conditions.

Leading Health Insurance Companies

Manipal cigna health insurance
Aditya birla capital
STAR health insurance
NIVA HEALTH INSURANCE
care health insurance

Latest Blogs

Scroll to Top