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.

What is the right time to take Maternity Health Insurance?

Most Maternity Health Insurance Policies have a waiting period of about 2-4 years. Also, most companies do not give maternity coverage to an already pregnant woman. Additionally, there is an age cap for the maternity cover. Considering all this, it’s better to buy a plan of health insurance with maternity coverage well before you plan to conceive..

Common Exclusions & Inclusions in Maternity Health Insurance

  • Delivery Procedure Expense – Normal / Caesarean Section.
  • Hospitalization, including the room rent, doctor’s fee, nurse’s charges, medicines etc.
  • Pre and post-natal charges.
  • Child Cover for certain complications.
  • Hospitalization arising out of any maternity related issue. This can be either in the pre-natal period or post the pregnancy. Usually this is for about 30 days in the pre-natal period and 60 days after the delivery.
  • Emergency ambulance charges, if incurred.
  • Vaccination costs of the baby for up to a period of 1 year.
  • Routine visit for consultation with the doctor.
  • Diagnostic Tests undertaken during pregnancy.
  • Cost of supplements and vitamins etc., unless specified in the policy.
  • Expenses that arise out of an ectopic pregnancy.
  • Artificial or in-vitro methods of fertilization
  • Any additional cost beyond the capping limit.
  • Any non-allopathic treatments undertaken.
  • Any expense that is a result of a self-inflicted injury.
  • Treatment needed due to drug or alcohol abuse.

Maternity Health Insurance Policies/Add-ons Offered by Various Companies

Plan name Coverage Maximum Maternity Benefit Approx Premium* Waiting Period
Religare Maternity Insurance – Joy Today

Up to 2 deliveries

New born cover

Rs. 35,000 – 50,000

Rs. 30,000 – 50,000

Rs. 17,000 9 months
Apollo Munich Family Easy Health Premium

Up to 2 deliveries

New born cover

Vaccinations

Rs. 30,000 for normal delivery and Rs. 50,000 for caesarean delivery, all inclusive Rs. 20,000 3 Years
SBI Arogya Premier

Up to 2 deliveries

New born cover

Rs. 15,000 for normal delivery and Rs. 25,000 for Caesarean Section, all inclusive, except vaccinations

Depending on plan

Rs. 14,500 9 months
HDFC ERGO My Health Medisure Classic

Up to 2 deliveries

Termination

Rs. 15000 for normal delivery and Rs. 25000 for Caesarean Section, all inclusive

Rs. 15000

Rs. 4,000 4 Years
Max Bupa Heartbeat Gold

Up to 2 deliveries or terminations

New born cover

Vaccinations for 1st year

Rs 40000-1 Lakh, all inclusive

Rs. 11,000 (SI 5 lakh) 2 Years
Star Health Wedding Gift Insurance Cover

Up to 2 deliveries

New born cover

Lump sum for Cerebral Palsy and Down’s Syndrome

Test for detecting congenital abnormality

Rs. 15000-20000 for normal delivery and Rs. 20000-25000 for Caesarean Section

Rs. 30000-50000

Rs. 60000-1 Lakh

Rs. 1000

Rs. 13,000 3 Years

Note: Assuming a healthy 27-year old woman and sum insured of Rs 3 lakhs, except Max Bupa. Max Bupa has a minimum SI of 5 lakhs.

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 –

  • Care Joy Today

    Care’s Joy plan is a specific maternity oriented health insurance plan which is suitable for families planning a kid soon. The plan comes in two variants of Today and Tomorrow and the salient features of Today variant are mentioned below –

    • Coverage for maternity is allowed after a very short waiting period of 9 months only
    • The policy is available on an individual sum insured basis only
    • Pre-entrance health check-ups are not needed if you are up to 45 years of age
    • Coverage for maternity expenses also includes expenses incurred on pre-natal and post-natal care
    • New born baby coverage is inbuilt under the policy wherein the new born baby is covered for up to 90 days from the date of birth free of cost
    • There is no sub-limit on room rent. You can avail a single private AC room and the costs of the room would be covered under the plan
    • The policy comes with a term of 3 years wherein you can pay the aggregate premium at once when buying the policy
  • 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 –

    • 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
  • SBI Arogya Premier

    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 –

    • 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
  • HDFC Ergo my:Health Medisure Classic

    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 –

    • 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 Heartbeat Gold

    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 –

    • 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 Wedding Gift Insurance Cover

    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.

Conclusion

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.

Why Choose Turtlemint?

Turtlemint provides a one-stop destination for all your maternity insurance needs that is quick, simple and convenient.

  • Compare all maternity health insurance policies in India with one click and find the best one.
  • Calculate the premium using our free premium calculator to understand the cost.
  • Contact our experts to resolve any queries through online chat or telephonic discussions.
  • Download all brochures and policy documents from one place.
  • Buy the best maternity insurance policy online at Turtlemint.
  • Do maternity insurance online renewal quickly.

FAQ’s

Most of the regular health insurance companies provide maternity health insurance as well. Either as a stand-alone plan or as an add-on.


There is a limit on the coverage. Refer above for details on some leading maternity health insurance plans and their coverage.


Different companies have different waiting periods. Though the average is between 3-4 years, some insurance companies have a low waiting period of 9 months.


Some regular health insurance policies include maternity cover as well.


Unless it is a group policy, no health insurance company will allow an already pregnant person to buy maternity insurance.


Some insurance companies cover the baby from birth till 90 days. After this period, the baby can be included in the family floater policy.


There are many health insurance plans which cover maternity related expenses. Under many plans maternity coverage is unbuilt under the scope of the policy while under some plans the cover is available as an optional benefit. So, if you are planning a family soon, you can invest in health insurance with maternity so that you can get coverage for the maternity expenses incurred at the time of childbirth.


There are many plans which cover maternity. Some plans include Care Joy, Star Health Family Health Optima, SBI Arogya Premier, Max Bupa Heartbeat Gold, etc.


The premium for a plan of health insurance with maternity depends on a lot of factors. These factors include the sum insured you have chosen, your age, number of insured members, your medical history and existing medical condition, the policy tenure and the pricing practice of the insurance company.


Individuals planning on having a child can purchase health insurance with maternity. The minimum entry age is 18 years and the maximum age up to which maternity coverage is allowed is usually limited to 45 years.