What is Maternity Health Insurance?
Having a baby can be one of the most beautiful experiences in life. However, unless you are adequately prepared, it can also be a very anxious time. Having one extra member in the family means added expenses. So it’s important to prepare not just emotionally but also financially. This is where maternity health insurance comes to the rescue. It is designed to cover medical expenses that occur during a pregnancy. A maternity insurance policy includes pre-natal check-ups, cost of hospitalization at the time of delivery, post-natal treatment, etc., taking the financial burden off your shoulders!
What is the importance of Maternity Health Insurance?
Pregnancy brings a lot of joy and cheer. But it also carries with it a lot of extra expenses. Pregnancy and related complications are not covered by normal Health Insurance Policies. So, it is important for a couple to plan properly to meet these additional costs.
Almost all major companies in India provide health insurance with maternity coverage for their employees. However, there is a limit to this cover. Hence, it’s always wiser to take a personal Maternity Insurance Policy.
You can buy a stand-alone Maternity Insurance Policy or as an add-on to an existing Health Insurance Policy.
- Technology has enabled us to monitor a baby’s movements and heartbeats inside the womb. Deformities in the baby can also be traced before its birth. There are also tests that can monitor the mother’s health. However, all these cost a lot. A Maternity Insurance Policy can take care of all such expenses.
- Some policies of health insurance with maternity cover the expenses of the new-born baby for a few days. They also cover most of the prescribed vaccinations.
- Most policies of health insurance with maternity cover both normal and complicated deliveries. Some also offer new born baby care in hospital. These may also provide protection against congenital diseases.
- Post-delivery complications are also covered by most Maternity Health Insurance Policies.
Top maternity health insurance plans
Here is a detailed list of features and benefits of health insurance with maternity coverage plans mentioned in the table above –
HDFC Ergo Health Easy Health Premium
HDFC Ergo Health’s Easy Health plan is a very popular health insurance plan which comes in three variants of Standard, Exclusive and Premium. Premium is the most advanced variant of the plan which has the following benefits –
SBI Arogya Premier
- The plan can be taken on an individual or family floater sum insured basis
- There is a Stay Active benefit under the plan which allows premium discounts at the time of renewals if you take a specified number of steps during a policy year
- A daily cash benefit is paid if you choose shared accommodation or if you accompany a minor child
- Emergency air ambulance is allowed for higher levels of sum insured
- OPD treatments are also covered by the plan for up to 1% of the sum insured subject to specified limits
- Free health check-ups are allowed every year
- You can enhance the scope of the policy by adding the critical illness rider available with the plan
This policy also extends coverage for maternity related expenses after a short waiting period of 9 months. Other salient features of the policy are as follows –
HDFC Ergo my:Health Medisure Classic
- The sum insured is automatically restored if it is exhausted in a policy year. This restoration benefit is inbuilt under the plan and requires no additional premium
- No pre-entrance health check-ups are needed till 55 years of age
- You can enjoy an increase in the sum insured by 10% every year free of cost if no claims are made in the previous policy year. This increase is allowed on a cumulative basis up to a maximum of 50%
- Free health check-ups are allowed under the plan after every 4 policy years
- Air ambulance costs are also covered under the policy for up to INR 1 lakh
This is a comprehensive health insurance plan which allows coverage for maternity related expenses after a waiting period. The features and benefits of this health insurance with maternity plan are as follows –
Max Bupa Heartbeat Gold
- Pre and post hospitalisation expenses are covered for a period of 30 days and 60 days respectively
- Domiciliary hospitalisation expenses are also covered provided such hospitalisation exceeds 3 days
- The new born baby gets automatically covered under the policy from birth till the first 90 days. Thereafter, the baby can be covered by paying an additional premium
- Coverage for non-allopathic AYUSH treatments is available under the plan for up to INR 25,000
- The plan allows optional coverage against critical illnesses. Moreover, you can avail an optional benefit of waiver of room rent limit by paying an additional premium
- Free health check-ups are allowed after 4 claim-free policy years
- The policy pays a hospital daily cash benefit if your hospitalisation exceeds 3 days
- No claim bonus of 5% increase in the sum insured is allowed for every claim-free year on a cumulative basis. The maximum increase allowed under the plan is 50%
- A premium discount of 10% can be availed if two or more family members are covered under the plan
Max Bupa’s Heartbeat Gold is a popular health plan which offers coverage for maternity related costs. The salient features of the policy are as follows –
Star Health Wedding Gift Insurance Cover
- Coverage of up to INR 50 lakhs is available under the plan
- AYUSH treatments are covered up to the sum insured without any sub-limits
- Maternity coverage of up to INR 50,000 is allowed under the plan
- The plan covers the cost of pharmacy and diagnostic tests if such costs are incurred at a networked hospital
- Coverage for mental disorders and their treatment is provided
- 10% of the sum insured is increased up to a maximum of 100% every year if no claim is made and the plan is renewed
- Free health check-ups are allowed every year
- A range of optional coverage benefits are available under the policy
Star Health’s Weding Gift policy is a policy especially for covering maternity related costs. The salient features of the policy are as follows –
- The cost of childbirth and pre and post-natal expenses are covered under the policy
- Cost of diagnostic tests incurred for detecting any abnormality in the foetus would be covered up to INR 1000
- Coverage is available for the new born baby. Coverage is also granted for congenital disorders and defects
- No pre-acceptance health check-ups are needed to buy the policy
- There are two coverage options and post-delivery complications are covered under both the options
- A lump sum benefit is paid if the new born baby suffers from Cerebral Palsy or Downs Syndrome
Claim Process for Maternity Health Insurance
To make a claim in your plan of health insurance with maternity, you should follow the below-mentioned steps –
- Inform the insurance company immediate of your claim and get it registered
- If you are seeking cashless claims, get admitted to a networked hospital
- Obtain a pre-authorization form and fill it up for getting the approval for cashless claim settlements. The form should be submitted to the insurance company within 24 hours of emergency hospitalisation or 3-4 days before a planned hospitalisation
- Depending on the form submitted, the insurance company would approve cashless claims and you can avail treatments without paying the medical bills yourself
- After being discharged from the hospital, file your insurance claim with the company and get it settled
- In case of admission into a non-networked hospital, pay the medical bills yourself. After discharge, fill up a claim form and submit the relevant documents to get reimbursement of the medical expenses which you have incurred.
Documents required for claim settlement with Maternity health insurance
For the claim to be completely settled in your plan of health insurance for maternity, you need to submit the following documents –
- Claim form, duly filled and signed
- Policy bond
- Identity proof of the insured
- Pre-authorization form for cashless claim approval
- Doctor’s referral letter which advises on hospitalisation
- All medical bills in original
- All hospital reports in original
- All medical records and prescriptions
- Test reports of diagnostic tests undertaken
- Discharge summary issued by the hospital
- Any other document needed by the insurance company for claim settlement
- In case of reimbursement claims, you should provide your bank account details wherein the money would be reimbursed. A cancelled cheque or passbook copy of your bank account might be submitted for bank details.
Pregnancy is a very important part of life, so it is wiser to understand the financial implications of pregnancy and choose a maternity insurance policy that will take care of the major expenses. Understand all the inclusions and exclusions before making a final decision. Maternity Insurance Plans are generally quite expensive. So choose either a stand-alone health insurance with maternity cover plan or an add-on based on your financial situation and requirement. Or, just choose Turtlemint. We are always there to guide you every step of the way.