An Insight into Maternity Health Plans in India

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Bringing a new life is not only a huge responsibility but also brings infinite joy to new parents. Simultaneously, it implicates a huge financial expenditure. Given the rising medical costs, a rising number of caesarian births and expensive medicines; the financial pressure can be greatly relieved by procuring a maternity health plan. Here, we walk you through various aspects of this health plan. Stay hooked!

Defining Maternity Insurance

Maternity insurance provides you financial coverage during and post-pregnancy. It includes pre and post hospitalization costs, ambulance charges, delivery charges, and pre and post-natal care. Thus, maternity insurance not only covers the mother but also takes care of the expenditure of the baby until a certain period. The financial coverage is for both normal and caesarian deliveries.

Status of Maternity Health Insurance

It might be noted that maternity benefits are never a part of the base health plan. They are always available as riders of any health plan. This means that it always comes at an extra cost. Few policies provide maternity benefits under the umbrella of OPD related expenses.

Most Corporate Health Policies offer maternity coverage. For individual and family floater health plans, maternity coverage typically has a high premium and long waiting period spanning from nine months to six years.

Features of a Maternity Insurance Plan

The salient features of a maternity insurance plan are as follows:

  • Waiting Period- As already discussed, there is almost always a waiting period for maternity coverage that can vary from nine months to six years. If you are already pregnant at the time of purchasing the policy; you would not be eligible for that benefit. Hence, it’s important to buy this insurance at the right time with proper planning.
  • Comprehensive Coverage – Most maternity coverage offers you a robust cover and benefits like hospitalization charges and other associated costs for normal and caesarian delivery, ambulance service, doctor’s charges, room rent, etc. It also covers pre-pregnancy medical expenses like the doctor’s fee, diagnostic fees, etc.
  • Pre and Post-Natal Care – A good maternity plan covers a mother’s expense but it also takes care of the expenses occurring for the newborn baby. Apart from general expenses over the baby for a certain time, the baby is also covered for the critical illness if diagnosed.
  • Cashless Facility – Like most leading health plans; you can also avail of the cashless benefit if you get the expecting mother admitted in the network hospitals provided by the insurance company.
  • Flexibility to Select the Sum Insured- Many insurance companies give you a limit to the sum insured for the maternity benefit. This is in compliance with the rider law where the premium amount of a rider cannot exceed 30 percent of the premium amount of the base health policy. But few insurance companies give you the flexibility to choose the sum assured and the premium amount is charged accordingly.
  • Claim-Free Bonus- Like the base plan, you have the advantage of claiming a No Claim Bonus on the premium amount of subsequent year if you did not make any claim in the previous year.
  • Tax Savings – Like your base health plan, you also get the advantage of tax benefit on the premium amount for your maternity health plan under Section 80D of the Income Tax Act, 1961.

Eligibility for The Maternity Health Insurance Plan

Different insurance companies have different criteria for offering a maternity health insurance plan. But generally, the age limit for it is capped at 32 to 33 years. It might also have the sublimit clause and various other conditions as laid by that particular insurance company. Hence, it is imperative that you must understand all the benefits and conditions well before going ahead with the maternity plan.

You must also remember that very few insurance companies would offer you a maternity health plan if you are already pregnant. This is because the network companies see pregnancy as a pre-existing condition that is not covered by any health plan. But you can procure a maternity health plan even after getting pregnant albeit under the strict conditions laid by the insurance company.

Exclusions of Maternity Health plan

Like all health plans, even maternity health plans have their own set of exclusions. Few general exclusions that are a staple of most maternity health plans are:

  • Non-allopathic treatment costs
  • Regular check-ups and consultation fees
  • Congenital disease
  • Termination of pregnancy if it happens under 12 weeks.
  • Any pre-existing illness or injury that gets diagnosed within 48 hours of the commencement of the policy.
  • Any expense for treatment of AIDS, drug and alcohol use, self-inflicted injuries, etc.
  • Any expenses incurred for dental treatment
  • In-vitro fertilization and infertility related treatment costs.

Final words

A maternity health plan can indeed emerge as a boon that can help you get through the intense financial burden of childbirth. However, it has plenty of stipulations and must be researched well before purchase. You must always ensure that it meets your requirements well.

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