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Maternity Health Insurance Coverage

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Home / Health Insurance / Maternity Health Insurance

While the anticipation of having a baby is incredibly exciting, it's crucial to ensure that each stage of this journey is properly taken care of. That's where maternity health insurance comes in acting as a superhero for mothers! Guess what? The digital age has made it incredibly convenient for you to safeguard your own and your babys well being, with a few simple clicks.

In this article we will explore all the aspects of maternity health insurance plans and provide you with everything you need to know if you are considering starting a family. Lets dive in!

What is Maternity Health Insurance?
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Maternity health insurance serves as a financial safeguard, for pregnant women and their infants. This unique form of healthcare coverage is specifically tailored to address costs associated with pregnancy, delivery and postpartum care. In other words, it acts as a safety net allowing you to fully embrace the joys of pregnancy without worrying about the burden of hospital expenses.

Key Features & Benefits of Buying Maternity Health Insurance Online
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Here are the key features and benefits of buying Maternity Health Insurance.

Why should you buy health insurance with maternity cover?
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Here's why buying health insurance with Maternity Coverage is a game-changer for you and your growing family.

When should you opt for Pregnancy Insurance?
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Here is when to consider pregnancy insurance.

  1. Early Planning for Parenthood: It's never too early to start planning for parenthood. Pregnancy Insurance is beneficial when you're in the family planning phase. By securing coverage early, you ensure that unexpected medical expenses during pregnancy are taken care of.

  2. Financial Comfort: Bringing a new life into the world is undoubtedly a joyous occasion, but it comes with its share of expenses. Pregnancy Insurance helps ease the financial burden associated with maternity care, delivery, and postnatal expenses. If you're looking for financial comfort during these crucial months, insurance is a wise choice.

  3. Coverage for Unforeseen Complications: While we all hope for a smooth pregnancy, unforeseen complications can arise. Pregnancy Insurance provides coverage for unexpected medical conditions or emergencies, ensuring you have the support you need without worrying about the associated costs.

  4. Maternity Expenses Coverage: Maternity-related expenses, including pre and postnatal care, hospitalisation, and delivery charges, can add up. Pregnancy Insurance typically covers these costs, allowing you to focus on the well-being of the mother and the new arrival without the stress of financial concerns.

  5. Workplace Coverage Gaps: Some workplaces may not provide comprehensive maternity benefits. If you find yourself in a situation where your employer's coverage is limited, Pregnancy Insurance acts as a supplementary plan to fill in the gaps, ensuring comprehensive coverage for all your needs.

Eligibility Criteria for Maternity Health Insurance Policy
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Here is a list of eligibility criteria that insurance companies generally have for Maternity Insurance.


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 Most insurance providers have a minimum and maximum age limit for policyholders. Ensure you fall within the specified age range when applying for maternity health insurance.


Pre-existing Conditions
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Disclose any pre-existing health conditions truthfully. Some policies may have waiting periods or exclusions related to pre-existing conditions, so it's important to provide accurate information.


Existing Policies
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Check if there are any restrictions regarding existing health insurance policies. Some insurers may have specific guidelines on the number or type of policies a person can hold simultaneously.


Policy Waiting Period
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Understand the waiting period associated with maternity coverage. Ensure that you plan ahead, considering the waiting period, so you can avail of maternity benefits when needed.


Renewal History
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A consistent and timely renewal history with your health insurance provider is often a positive factor. Make sure your existing policies are up to date, as it can influence the approval of a maternity health insurance policy.


Income and Financial Stability
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While not always explicitly stated, some insurers may consider the policyholder's income and financial stability. This can impact the coverage amount and premium affordability.


Medical Check-ups
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Depending on the insurer and the age of the policyholder, a medical examination may be required before issuing the policy. Ensure you complete any necessary medical check-ups promptly.


Family Medical History
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Some policies may inquire about the policyholder's family medical history. Be prepared to provide information about any hereditary conditions that may impact the eligibility or terms of the policy.



Inclusions of maternity health insurance
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Here is a list of common inclusions of Maternity Health Insurance.

  1. Prenatal and Postnatal Expenses: Your insurance buddy will take care of the medical expenses before and after the delivery. This includes doctor visits, tests, and medications to keep you and your baby healthy.

  2. Hospitalisation Costs: When the big day arrives, and you need to stay at the hospital, your maternity insurance has your back. It covers room charges, nursing expenses, and other related costs, so you can focus on the beautiful moment without worrying about the bills.

  3. Delivery Charges: Whether it's a normal delivery or a superhero-style entrance via C-section, your insurance friend helps cover the delivery expenses. No need to stress about the hospital bills – just enjoy the magical moments.

  4. Newborn Baby Coverage: Maternity insurance is not just about you; it's also about your little one! Many plans include coverage for your baby's initial medical needs, like vaccinations and health check-ups.

  5. Pre-existing Conditions: Some plans even cover pre-existing conditions related to maternity.

Exclusions of maternity health insurance
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Here is a list of common exclusions of Maternity Health Insurance.

  1. Waiting Periods: Maternity insurance usually comes with waiting periods. This means that you won't be able to make a claim immediately after purchasing the policy. Ensure you know the waiting period and plan accordingly.

  2. Pre-existing Conditions: If you're already pregnant when you buy the insurance, expenses related to the current pregnancy might not be covered. Maternity insurance typically doesn't cover pre-existing conditions, so it's best to get insured before you plan for a family.

  3. Complications from Unrecognised Procedures: Some insurance plans may not cover complications arising from procedures that aren't recognized by medical authorities. Ensure that the treatments and procedures you're considering are acknowledged by the insurance provider.

  4. Non-Medical Expenses: While maternity insurance covers medical expenses, it may not cover non-medical expenses like baby clothes, diapers, or other personal items. Make sure you are aware of what exactly is covered under your policy.

  5. Multiple Births: If you're expecting twins, triplets, or more, check the policy details. Some policies may have limitations on the number of deliveries covered in a single pregnancy.

  6. Late Enrollment: If you're already pregnant and apply for maternity insurance, there might be restrictions or exclusions. It's always better to plan ahead and get insured before you conceive.

  7. Alternative Birth Methods: Certain alternative birthing methods or delivery options may not be covered. It's crucial to discuss these specifics with your insurance provider to avoid any surprises later on.

  8. Unrecognised Providers: Maternity insurance plans often have a network of recognized healthcare providers. If you choose a healthcare facility or professional not listed in the network, your expenses may not be covered.

Documents required to raise a claim for Pregnancy Insurance
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Here is a list of documents generally required to raise a claim for pregnancy insurance.

What is the claim process to avail health insurance maternity cover?
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Here is a usual claim process for maternity health insurance.

Step 1: Coverage Check

First things first, make sure your health insurance policy includes maternity benefits. Not all policies automatically cover it, so double-check to avoid any surprises later.

Step 2: Preparing for the Stork's Arrival

Before the big day, get in touch with your insurance provider and inform them about the impending arrival of your little one. This early heads-up can help you understand the documentation and processes better.

Step 3: Documenting the Journey

When the time comes, gather all the necessary documents. This usually includes the hospital bills, doctor's reports, and any other relevant medical documents. Keep them organised because you'll need them for the claim.

Step 4: Filling in the Forms

Your insurer will provide you with claim forms. Fill them out accurately and provide all the required information. Don't worry; it's mostly basic details about the hospital stay and medical expenses related to childbirth.

Step 5: Settlement

If all goes well, and it usually does, you'll receive the reimbursement or direct settlement for the maternity expenses. It's like a little financial blessing to help you focus on the joys of parenthood without worrying about the bills.

What is the Waiting Period for Maternity Benefit?
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The waiting period for maternity benefit is essentially the time you need to wait before you can start availing the benefits provided under the Maternity Benefit Act. This act is a wonderful support system for expecting mothers, ensuring they get some financial relief during their maternity leave.

So, how does it work? Well, the waiting period usually starts from the date of joining a new job. In most cases, you need to have been employed for at least 80 days in the 12 months leading up to your due date. This is like a little countdown before you can unlock the benefits.

Once you meet this criterion, you're eligible for maternity benefits! These benefits typically include paid leave for a specified duration before and after childbirth, ensuring you have the time and support to take care of yourself and your new arrival.

How is the Cost of Health Insurance with Maternity Cover Calculated?
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Now, let's demystify how they calculate the cost of this valuable coverage.

Frequently Asked questions
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Here are a few common questions related to Maternity insurance and the benefits it provides


What benefits does maternity health insurance provide?

Maternity health insurance provides a financial backup at the time of delivery and childbirth. It also provides health insurance coverage for the newborn baby and for customary vaccinations.

What happens if a child is born with any complications?

If your child is born with complications, a good maternity insurance plan can provide financial support for medical expenses. Coverage varies, so check the policy details to understand the extent of assistance available.

What is the minimum and maximum sum insured under pregnancy insurance?

The minimum and maximum sum insured depends on the insurance provider and the specific plan. Typically, coverage starts at a reasonable amount and can go up to a substantial sum. It's wise to choose a sum assured that aligns with your anticipated medical expenses.

What should I consider before buying a maternity insurance policy?

Before purchasing maternity insurance, consider factors like waiting periods, coverage for pre-existing conditions, and the overall coverage provided. Assess if the plan suits your needs and preferences. Don't forget to inquire about any additional benefits the policy may offer.

Can husband and wife claim maternity?

Yes, some maternity insurance plans cover both spouses. Ensure to check the policy terms to confirm coverage for both husband and wife. Having comprehensive coverage for both partners ensures a more holistic approach to maternity-related expenses.

Do maternity insurance plans come with no waiting period?

Waiting periods are common in maternity insurance plans. It's crucial to review the policy terms to understand the waiting period involved. Some plans may have shorter waiting periods for specific benefits, so choose a plan that aligns with your family planning timeline.

What is the ideal time to buy maternity health insurance?

One should speak to the insurance company about the waiting period related to maternity benefits on health insurance. Ideally, maternity benefit should be bought while adding a new member (spouse) to the health insurance policy i.e. soon after the wedding.

Can I buy and claim maternity insurance while I am pregnant?

An insurance company may not allow you to buy and claim maternity insurance when you are pregnant. The insurance company will consider this pregnancy as a pre-existing condition while buying the plan and will enforce a waiting period for raising a claim.

What are the coverages of a maternity health insurance plan?

You can find the complete list of coverages of a maternity health insurance plan in this section. Please take a look.

Are there any eligibility criteria for availing the maternity benefit?

Yes, there are a few eligibility criteria when it comes to availing maternity benefits. The maternity can be claimed only by an insured person listed in the base plan. The entry age is 18 years, i.e. the policy seeker should be at least 18 years of age to avail insurance benefits for maternity. The exit age set by some insurance companies can be 45 years. The delivery of the baby needs to take place inside the geographical limits of the country.

Is a newborn baby covered under health insurance?

Yes, the newborn baby automatically gets covered under health insurance under maternity cover for the first 90 days. After which the policyholder needs to list the baby in the base plan.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet, and is subject to changes.