Planning a kid? Timing the maternity cover will stand you in good stead

• While health insurance plans vary from insurer to insurer, maternity benefits are typically not covered under a basic health insurance plan.
  
• One might have to opt for a maternity add-on cover or take a plan that has maternity benefits embedded in it.
  
• A maternity plan typically covers any expenses related to the delivery of the baby, including hospitalisation, room rent etc.
  

The arrival of a newborn is certainly one of the happiest moments of a couple’s life. However, maternity is expensive and needs to be budgeted for. Alternatively, one may opt for a maternity cover. Here, we take a look at what one needs to know about maternity insurance and things to keep in mind before getting one.

Does your health insurance cover maternity benefits?

While health insurance plans vary from insurer to insurer, maternity benefits typically are not covered under a basic health insurance plan. One might have to opt for a maternity add-on cover or take a plan that has maternity benefits embedded in it.

“If you are someone who is recently married and is planning to expand the family, it makes immense sense to opt for a maternity cover. The hospitalisation expenses in India are on the rise and medical inflation in India is pegged at around 14%,” says Vivek Chaturvedi, CMO and head of direct sales, Digit General Insurance.

Acording to Chaturvedi, the average cost of delivering a baby typically ranges between ₹75,000- ₹1 lakh. The cost could be more in private hospitals in metro cities or in case of C-section, or Caesarean birth.

For working professionals, maternity cover might be included as a part of their corporate group medical insurance. However, the coverage limit under such plans are generally low, typically in the range of ₹30,000 for normal deliveries and ₹50,000 for C-section deliveries. This limit doesn’t complement the rising medical costs associated with maternity.

“Hence it is advisable to opt for sufficient maternity health coverage, to minimise the outflow, especially during the time when there will be anyways additional expenses due to the addition of a newborn baby in the family,” says Parthanil Ghosh, President- Retail Business, HDFC ERGO General Insurance Company.

When should one opt for maternity cover?

One should opt for maternity cover or should take up a health plan with maternity cover, depending upon their life stage.

“For a young couple, who are planning to start a family, maternity cover should be definitely a part of their financial planning, as with the rising health care, which includes the rising expenses for childbirth as well, a maternity cover would provide them with the necessary financial cushion,” says Ghosh.

Policy exclusions and conditions for maternity health insurance vary from insurer to insurer. So, select a policy by comparing its features, inclusions, and exclusions online. When purchasing health insurance, it's important to consider the waiting period before coverage begins.

“Keep in mind that if you are already pregnant, you will not be covered. A good time to purchase maternity coverage is when getting married or renewing your health insurance plan.

Waiting periods can vary from insurer to insurer, ranging from 9 months to several years. Many plans now offer reduced waiting periods for maternity coverage, with some as short as 9 months,” says Siddharth Singhal, business head, health insurance, Policybazaar.com.

What is covered under maternity health insurance

The benefits offered under a maternity cover may vary from insurer to insurer. “It typically covers any expenses related to the delivery of the baby, including hospitalisation and room rent charges up to the specified sum insured. Caesarean section deliveries, commonly known as C-section deliveries are also covered under the maternity cover,” says Chaturvedi.

Any expenses arising due to pregnancy complications are also covered. The policy also covers any number of medically necessary and lawful terminations.

Hospital expenses of the baby up to 90 days are also covered and includes any post-natal care and required vaccinations during the specified period as well. The cost of vaccinations alone in the first three months may range between ₹5,000- ₹10,000. Some insurers may also cover infertility treatment under this add-on.

Exclusion and limitations of maternity coverage

If you have a pre-existing condition that could complicate your pregnancy, make sure your policy covers it or offers additional coverage. Similarly, if you are expecting twins or triplets, there may be specific conditions or limitations regarding coverage for multiple births.

“Most health insurance plans do not cover the cost of infertility treatment, but some newer plans may offer coverage for IVF treatments. The level of coverage can vary among insurers, so be sure to carefully review the inclusions and exclusions,” says Singhal.


Things to keep in mind

As we have seen, the inclusions under maternity cover vary from plan to plan, so it is important to assess your needs. It is always better to go for a comprehensive cover, which will come with extended benefits like termination costs, infertility treatment costs, etc., which are generally not a part of a simple maternity health cover.

“Since maternity plans come with a wide range of waiting periods, one must assess the same and ensure that it matches with the aspirations to start a family. For example, for a couple, who are planning to start a family soon, a maternity plan with a long waiting period will not work,” says Ghosh.

It is also important to keep in mind the coverage limit and opt for a cover with a higher limit and look at the claims settlement ratio.

A well chosen maternity insurance policy can make the joy of childbirth financial stress free. And as parents, you would have got off to a flying start.