Maternity insurance is a comprehensive plan that covers medical expenses incurred during pregnancy, delivery costs, pre and postnatal care, hospitalisation charges, medical tests, medicines, and newborn baby expenses. A maternity insurance policy prepares women in advance for the changes that they will go through, and provides financial coverage and buffer, as it is an expensive affair.
In order to enjoy the benefits and joys of motherhood, it is important to be financially prepared. Inflation and rising healthcare costs puts a lot of monetary pressure, hence medical insurance is highly advised.
In addition to covering the hospitalisation and delivery charges, the newborn baby is also provided health cover for a certain period of time after birth.
Considering investing in maternity insurance? Read ahead to know everything about it.
Table of Contents
What is maternity insurance?
A type of medical insurance, this policy provides coverage for all pregnancy related expenses, including delivery costs. Some insurance companies also provide cover with pre and postnatal expenses, as well as newborn baby expenses. Some companies also offer maternity insurance either separately, or as a rider to their female employees.
In India, all maternity insurance policies come with a waiting period that ranges from 9 months to 6 years. During this period, the insured cannot claim any pregnancy related expenses. Therefore, it is advised to get maternity insurance a few years prior to starting a family.
Documents needed to apply for maternity insurance
While the specific list of documents varies from one company to another, some common documents that are required are:
- Any document that shows proof of address like driving licence, electricity bill, or ration card
- Any proof of identity like driving licence, electricity bill, or ration card
- Any document that shows proof of age like birth certificate, Aadhar Card, passport, or driving licence
- For policyholders who are over 45 years, medical examination reports
- Passport size photographs
Inclusions and exclusions
Generally speaking, all maternity insurance policies include these covers:
- Hospitalisation expenses including drug and medical charges, room rent charges, and specialist fees
- Pre and post hospitalisation expenses
- Delivery expenses
- Coverage for newborn babies for a period after their birth
- Ambulance charges
- Pre and postnatal expenses
- Some medical insurance plans also provides additional coverage for daycare procedures and other treatments
Some exclusions to the policy are:
- Pre-existing diseases are covered after the 48 month waiting period
- Illnesses and diseases contracted within the first 30 days are not covered
- Costs relating to non-allopathic treatments
- Hospitalisation expenses incurred due to a self-inflicted injury
- Hospitalisation expenses incurred due to alcohol or drug abuse
- Treatment of congenital diseases
- Cost of dental or ophthalmology treatments
- Expenses arising due to AIDS/HIV treatment
- Aesthetic or cosmetic treatments
- In-vitro fertilisation or infertility treatment costs
- Surrogacy expenses
- Ectopic pregnancy
Claim procedure
The claim process differs from insurer to insurer, but the general claim process remains the same. Follow these steps to make claims on the maternity insurance policy:
- Claim intimation: Before raising a claim, intimation of the same has to be made to the insurer. In case of planned delivery and hospitalisation, the insurer must be intimated at least 48 hours before. In case of emergency hospitalisation, the insurer has to be intimated within 24 hours of hospitalisation. The claim intimation can be done through the helpline number or email ID.
- Cashless claim: If you are seeking cashless claims against the maternity insurance at a network hospital, follow these steps to request for pre-authorisation.
- Fill up the pre-authorisation request form that is available at the hospital desk. The same will be sent to the insurer.
- Once the insurance firm receives this form, the claim management team will either approve, reject, or raise a query to the hospital.
- On approval of the pre-authorisation, cashless treatment can be availed.
- Reimbursement claim: If you have undergone treatment at a non-network hospital, you must pay for the treatment in full, and then raise a claim. Follow these steps to do the sam.
- Fill up the original claim form, sign it, and send it along with the documents to the insurance firm.
- The insurer will go through the claim, and send an approval letter, reject the claim, or respond with a query.
- If approved, the settlement will be made within a few days.
Benefits of maternity insurance
Maternity insurance allows the family to focus on the health of the mother and the newborn baby, without worrying about the expenses and bills. Depending on the medical insurance plan that you choose, the medical treatments required for the newborn are also covered, ensuring that the child gets the best treatment available.
The medical and healthcare costs are rising, and maternity insurance makes sure that your family has access to the best healthcare without financial constraints.
Additionally, there are tax deductions on the premium payment.
FAQ:
Q: What is maternity health insurance?
A: Maternity health insurance is a type of health insurance policy that covers the medical expenses related to pregnancy and childbirth, such as hospitalization, delivery, pre and post-natal care, and newborn baby care.
Q: Why do you need maternity health insurance?
A: You need maternity health insurance because pregnancy and childbirth can be expensive and unpredictable. A maternity health insurance policy can help you cope with the rising medical costs.
Q: How can you buy maternity health insurance?
A: You can buy maternity health insurance by comparing and choosing a suitable plan from various insurance providers, such as ICICI Lombard, Policybazaar, ACKO, or ValuePenguin.
Q: What are the benefits of maternity health insurance?
A: Maternity health insurance offers various benefits, including coverage for normal and C-section delivery, pre- and post-hospitalization expenses, newborn baby expenses, vaccination charges, ambulance charges, and cashless facilities.
Q: What are the limitations of maternity health insurance?
A: Maternity health insurance has limitations, such as a waiting period, a sub-limit, a co-payment, or an exclusion. A waiting period is when you cannot claim any maternity-related expenses. A sub-limit is the maximum amount the insurer will pay for a specific expense.
Key takeaways
Invest in maternity insurance and enjoy the joys of pregnancy, without any worries. Check the waiting period and inclusions/exclusions list carefully before zeroing in on any medical insurance policy.
