Becoming a mother is a magical journey. The phase of motherhood is one of the most important transition which a woman goes through. The stress level associated with today's lifestyle will bring in more possibilities of pregnancy-related complications for an expecting mother and the rate will go up as the women get older. Thanks to the sky-high prices of medical expenses, which makes things even more worse. To avoid a dreadful situation, maternity insurance plans come in as a boon for those couples who are planning for kids.
Let's first understand the meaning and features of Maternity Insurance in brief.
What is Maternity Health Insurance?
The maternity health insurance is a kind of insurance which provides coverage for maternity and other supplementary expenses. This insurance provides both pre and post-natal care, the birth of a child (either through Normal or C-Section/ Cesarean Section). The services offered under maternity health insurance are supervised by the Maternity Benefit Act.
The Maternity Benefit Act applies to women who do not work in any of the organizations which are covered by the Employees' State Insurance (ESI) but are employed in shops, factories, plantations, mines, or other organizations which employs at least 10 individuals. It also covers those women who are working in the organizations which are covered by the ESI (but whose salary surpasses the upper limit).
This insurance is specially designed for women who are expecting as it provides an additional or add-on rider which comes in as an extension to the main health insurance policy. Today some of the insurance companies prefer to offer maternity insurance benefits as a rider or as an additional service and try to reduce the burden on the premium amount which has to be borne by the policyholders.
Some of the firms in India do offer their women employees the benefit of maternity insurance in addition to the health insurance policy. Most of the corporate group policies provide maternity insurance as a rider and they put a cap on it which mainly depends on the policy provider as well as plans which are offered for employees.
Features of Maternity Insurance in India
• Hospitalization Charges - It covers all the expenses related to pregnancy, pre hospitalization charges up to 30 days before birth and post hospitalization expenses up to 60 days after the birth will be covered.
• New Born Care - Coverage is extended to the new born babies if they are diagnosed with any critical illness.
• Ambulance Services - Get ambulance charges covered in this plan during emergency.
• Save on Tax - Get a tax savings of upto Rs 60,000 under Section 80D of the Income Tax Act.
• Cashless Hospitalization facility - Expecting mothers can get a cashless payment facility which is available across India at selected list of hospitals.
• Claim - Free Bonus - Policy holders can get a 10% cumulative bonus benefit for every claim free year.
• Online Application - Anyone can apply for a maternity health insurance plan through online at any time.
• Get Comprehensive Coverage - The insurance plan covers the expenses incurred during hospital stay, medicines, delivery related expenses and so on.
• Fast Claims Settlement - Policy holders can get fast claim settlement across all the network hospitals. All one has to do is to get in touch with the single point of contact available at most of the hospitals related to insurance.
Some of the maternity insurance policies provides coverage for pre hospitalization charges up to 30 days before the date of admission and some policies even cover the surgeon's fees, anesthetic consultation charges, room charges, nursing charges, doctor consultation fee and so on. But some of the insurance companies do not cover certain charges and hence exclusions are also there.
Exclusions in Maternity Insurance in India
Some of the exclusions in maternity health insurance in India are:
- Doctor's consultation fee for a routine check up
- Medicine expenses for both mother and baby
- Follow-up diagnostic test related costs during the tenure of pregnancy (9 months)
- Aesthetic treatments
- Non allopathic treatment charges
- Pre - Existing diseases within 48 month waiting period
- Cost of dental treatment or lenses or spectacles
- Treatment costs of congenital diseases
- Expenses incurred during In-Vitro Fertilization procedure
- Expenses incurred as a result of treating HIV/AIDS
- Expenses incurred to treat drug or alcohol use
- Expenses incurred due to self inflicted injury
Waiting Period of Maternity Insurance
The group health insurance plans will provide maternity-related expenses to the policyholder and his/her family after 9 months of the waiting period. But most of the maternity based health insurance plans will cover the expenses related to maternity only after 2 to 6 years of continuous policy years.
Usually, the health insurance policies which covers maternity expenses will be more costly when compared with the other regular ones. The premium rates vary based on the age of the insured at the time of entry, the sum insured, number of employees (applicable to a group policy), location, related risk factors.
A policyholder can choose the desired insured sum amount directly at the time of purchasing the policy. One can go for an optimum sum insured amount which will fall within the insurer's pre-defined limits and your premium rates will be linked to the sum insured. If the policyholder opts for a high sum insured amount then they will have to pay a higher premium amount.
Let's take a look at 5 Best Maternity Insurance Plans in India 2020
1. Star Health Wedding Gift Insurance Plan
Provided by Star Insurance Company, this maternity insurance plan protects the insurers in adversity and supports them in moments of joy (childbirth). Any of the resident Indian couples who are aged between 18 - 40 years can go for this plan. This plan can be renewed up to the age of 45 years. The policy period is offered for 1 and 2 years respectively.
Features of Star Health Wedding Gift Maternity Insurance Plan
- Provides inpatient hospitalization expenses for a minimum of 24 hours.
- Covers cost of medicines and drugs.
- Covers fees of a medical practitioner, surgeon, consultants, anaesthetics, specialists.
- Get Newborn baby cover (includes congenital defects or disorders)
- Pre and postnatal expenses will in included.
- Expenses related to the delivery of child either through normal or Caesarean delivery for one delivery only (up to the set limits)
- Get child delivery expenses coverage of up to Rs 15,000 for normal delivery and Rs 20,000 for cesarean delivery under Option 1. Under option 2, get Rs 20,000 for normal delivery and Rs 25,000 for cesarean delivery.
2. Max Bupa Heartbeat Family Floater Plan
Provided by Max Bupa Insurance company, this maternity insurance plan comes under two variants Gold and Platinum, with coverage options of Rs 5 lakhs, Rs 7.5 lakhs, Rs 10 lakhs, Rs 15 lakhs, Rs 20 lakhs, Rs 30 lakhs and Rs 50 lakhs respectively.
Features of Max Bupa Heartbeat Family Floater Plan
- Get maternity benefits for up to 2 deliveries, after 2 - years of continuous coverage.
- Get coverage for emergency medical evacuation and hospitalization expenses abroad (outside India).
New Born Baby
- Your newborn baby will be covered as an insured person from birth and you need not have to pay any premium till the end of the existing policy year (only if maternity claim is admissible under the policy).
- Also, get cover for vaccination expenses of the newborn for the first year (applicable only if you add the baby in the policy for the next policy year).
- If in case you run out of your base sum insured and loyalty additions (either fully or partially), then you will be entitled to get an additional sum insured amount which is equal to the base sum insured for the subsequent claim in the same policy year.
- The refill benefit can be availed for both same and different illness.
3. Royal Sundaram Total Health Plus
Rolled out by Royal Sundaram Alliance Insurance Company Limited, provides health insurance cover of up to Rs 20 lakhs. Get maternity benefit of up to Rs 30,000 under the Gold Plus Plan and up to Rs 50,000 under Platinum Plus Plan. The benefit is applicable only for the delivery of the first 2 living children.
Features of Royal Sundaram Total Health Plus
- Policyholders can get 5% no claim discount on renewal for both floater and individual cover
- The insurance plan will cover hospitalization expenses, pre and post hospitalization expenses, daycare expenses, ambulance charges, master health check-up.
- Coverage is provided for people who are aged between 91 days (infants) to 65 years.
- Master health check-up expenses will be reimbursed.
4. Religare Joy Maternity Insurance Plan
Provided by Religare Health Insurance Company, comes with two variants Joy Today and Joy tomorrow. Get maternity cover of up to Rs 35,000 per claim for Rs 3 lakh insured amount and up to Rs 50,000 per claim for Rs 5 lakh insured amount.
Features of Religare Joy Maternity Insurance Plan
- This plan covers ambulance charges of up to Rs 1,000 per claim.
- Covers inpatient care expenses are it room rent, boarding and nursing expenses and so on up to the sum insured.
- Get the newborn cover of up to Rs 30000 (Rs 3 lakh insured amount) and up to Rs 50,000 (Rs 5 lakh insurance amount).
- Get a bonus of 100% sum assured if there are no claims during the tenure of the policy for 3 years.
5. HDFC Ergo Health Suraksha Insurance Gold
This insurance policy is from a joint venture formed between HDFC and ERGO International AG. It is one of the affordable policy plans which offers coverage for inpatient hospitalization expenses and even for pre and post-hospitalization expenses. The unique feature of this plan is there is no sub-limit on the hospital charges, doctor fees, room rent in hospital and for illness. Get maternity coverage along with newborn baby cover after completing a waiting period of 4 years.
Features of HDFC Ergo Health Suraksha Insurance Gold
- No limit on age for entry.
- The plan is available at more than 6000 hospitals across India and policyholders can avail cashless medical treatments.
- Get optimized medical insurance plans at an economical premium cost.
- Get smooth claim procedures with minimum documentation.
About the Author
Archana is a Content Writer at GoodReturns. She has been writing articles related to investment planning and personal finance for more than two years.