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Maternity cover in Group Health Insurance Policy

A well-designed maternity coverage for the well-being of expecting mothers and the newborn.

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UID: 5701 | *T&Cs apply

UID: 5701 | *T&Cs apply

Maternity cover in Group Health Insurance

The maternity coverage in a Group Health Insurance Policy helps you claim the expenses related to childbirth. Infact, this coverage will allow you to claim for additional costs like pre and post-natal expenses as well. Maternity Health Insurance provides a strong backup for those who are planning to start or extend their family, by reducing their financial burden.

Maternity Cover in Group Mediclaim Policy
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Some couples may be quite uncertain to bring a baby into the world due to rising medical costs. Employer Health Insurance can help reduce this anxiety and offer a helping hand with the related expenses.

Maternity Cover is usually offered as additional coverage under a health insurance policy. Sometimes insurance companies may ask you to pay extra for this cover or provide it in their Group Insurance policy without additional charges.

What is Maternity Cover in Group Health Insurance Policy?
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Maternity Cover offers an array of coverages and is not limited to childbirth. Take a look at the following section to understand the meaning of maternity benefit in health insurance. The meaning of maternity benefit is you can make a claim for maternity expenses against your Group Health Insurance policy. Usually, the following two events are covered.

Maternity Health Cover under a Group plan primarily covers delivery expenses. This includes the cost of hospitalisation.

The newborn baby is covered with health insurance for up to 90 days. The child can then be added to the base plan.

What is Covered Under Maternity Benefit in Group Mediclaim Policy? (Inclusions)
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Maternity Cover in Group Mediclaim Policy is one of the many benefits offered under a group plan. It helps in reducing the financial burden on you and your spouse when you plan a baby. You can focus on taking care of the baby without thinking about covering the major part of the hospital bill when you are covered under Maternity Insurance. Here is the list of inclusions of this cover.

1. Pre and post-natal expenses - ACKO usually offers a coverage of 60 days before and 90 days after hospitalisation.

2. In-patient hospitalisation - The cost of hospitalization (such as doctor's visit charges, surgeries, etc.) and room rent is covered.

3. Lawful termination of pregnancy - The cost of lawful termination is covered under Maternity Cover In Group Health Insurance Policy.

4. Type of delivery - Both types of deliveries (normal and c-section) are covered. The cost of normal delivery is lesser.

5. Vaccination costs - The vaccinations for the baby begins soon after birth. Related costs are covered as per the WHO schedule.

Note: The waiting period is not applicable for raising a claim against Maternity Benefit in a Group Health Insurance Policy.

What is Not Covered Under Maternity Coverage of Group Mediclaim Policy? (Exclusions)
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Exclusions are a usual part of any health insurance policy. These are conditions when you cannot raise a claim against your Maternity Cover. Here is a list of exclusions for reference.

1. The cost of harvesting and/or storing stem cells

2. Ectopic pregnancy

3. Medical expenses arising out of a complication in assisted conception

4. Consultation fees

5. Birth control procedures

6. Hormone replacement therapy

7. Voluntary termination of pregnancy

8. Surrogate or vicarious pregnancy

9. Regular check-ups

10. Non-allopathic treatment costs

11. Termination of pregnancy before 12 weeks

12. Infertility treatments

What Maternity Benefits are Available in Group Health Insurance Plans?
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Apart from the coverages of Maternity Health Insurance cover, ACKO offers two major benefits. These benefits can be helpful in clearing doubts on how to go about any significant change that is created from a pregnancy.


Free online consultation
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Expectant parents often find themselves worrying about even the smallest of things. Online consultations can provide an insight into how to deal with this anxiety. ACKO can help in arranging teleconsultations with certified medical practitioners for labour preparation, antenatal support, postpartum support.


Child protect cover
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ACKO covers the cost of the insured person’s mother to stay with the patient if he/she is admitted to an ICU, a Neonatal ICU, or a Cardiac Care Unit of a Hospital. This is provided the child is less than 15 years of age. Thus, a mother can accompany a child that is in a serious condition.

Difference Between Maternity Sum Insured and Overall Sum Insured Under Group Health Insurance
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Take a look at the following table to know the difference between Maternity Sum Insured and Overall Sum Insured Under Group Health Insurance.

Parameters Maternity Sum Insured Overall Sum Insured
Meaning The amount of money that can be claimed for maternity expenses is called Maternity Sum Insured. The pre-decided amount of money that can be claimed for the cost of a covered medical treatment is called Overall Sum Insured.
Scope Limited to maternity expenses. Can be used for all types of medical treatments covered under the policy.
Amount Lower than Overall Sum Insured. Higher than Maternity Sum Insured.
Childbirth Expenses Covered Not covered
Newborn Baby Expenses Covered up to 90 days An insured child covered from 90 days up to 25 years of age i.e. dependent child.

Frequently Asked Questions
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This section covers some common queries you may have after reading the above article. Feel free to get in touch with ACKO anytime if you have specific questions related to Maternity Health Insurance cover.


Is co-pay applicable on Maternity Health Insurance?

Usually, the feature of co-pay is not applicable on Maternity Cover. Do check your ACKO policy to know more about any applicable Copay.

Does ACKO cover the Newborn Baby with insurance?

Yes, a newborn baby is covered for up to 90 days from the date of birth with insurance.

Is an Internal Congenital Disease covered under Group Health Insurance?

No, Internal Congenital Disease is not covered under Group Health Insurance.

Is pregnancy covered under Group Medical Insurance?

All the costs related may not be covered under Group Medical Insurance, however, certain prenatal expenses are covered.

Are maternity-related expenses covered with Health Insurance?

A basic Health Insurance policy may not cover maternity expenses however, one can opt for a Maternity Cover add-on to get this coverage.

Is maternity covered from day one in my Employer Health Insurance?

Yes, an insurance company especially ACKO covers maternity expenses from day one, i.e. when the policy starts.

Can both parents claim maternity expenses separately?

Both parents, i.e. husband and wife may not be allowed to claim separately for the same pregnancy.

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