Maternity Benefit in Health Insurance

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Parenthood, no doubt, is a life-changing and exciting journey for many. It brings a lot of joy and cheer. It, however, also comes with a lot of added expenses - which are generally not covered under health insurance. In order to avoid stressing about finances during such a magical journey of your life, you should consider purchasing the maternity benefit cover with your health insurance policy.

What is the maternity benefit cover? How does it work? When should you opt for it? What are the things you must be aware of before opting for the maternity benefit cover?

Let’s find out!


What Is Maternity Benefit In Health Insurance?

Maternity benefit in health insurance is an add-on cover that you can add to your existing individual or family floater policy. This add-on benefit will cover the expenses associated with pregnancy. There, however, might be some conditions for coverage of maternity costs.

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Conditions For Coverage Of Maternity Costs Under Health Insurance

Here are some conditions related to maternity benefit cover in health insurance you must be aware of -

  • Cost is covered up to a specific limit

    Most insurance companies will specify a limit up to which they will cover the expenses related to maternity. If you incur expenses beyond the limit specified by the insurance company, you’ll have to pay for the expenses out of your pocket.

    For instance, Ayushi has a health insurance policy with a sum insured of Rs. 15 Lakhs. She has opted for the maternity benefit cover - where the limit specified is Rs. 75,000. This means the insurer will only cover maternity-related expenses up to this limit, i.e., Rs. 75,000.

  • Several types of expenses are covered

    Prenatal costs incurred 30 days prior to the delivery of the baby and post-natal costs incurred 60 days after the delivery are covered under the maternity benefit.

    Some policies also cover the cost of medicines, ultrasound, medical checkups, etc. And, the cost of both normal and caesarean delivery are covered under the benefit.

  • Restriction of the number of deliveries covered

    Under some health insurance policies, there might be a restriction on the number of deliveries for which the maternity benefit can be used. Some plans, for example, only cover a maximum of two deliveries.

  • There will be a waiting period

    The maternity benefit comes with a waiting period of 9 months to 4 years. Meaning, you won’t be able to use the benefit during this period. If you file a claim related to maternity-related expenses during the waiting period, the insurance company won’t pay.

    For example, Akash and Divya are covered under a family floater cover of Rs. 10 Lakhs. They opted for the maternity benefit cover in May 2021. The benefit has a waiting period of 12 months. This means that Akash and Divya will be able to claim under the maternity benefit in June 2022 - after the waiting period of 12 months is completed.

  • Cover for the newborn baby

    The maternity benefit cover in health insurance is not only limited to the delivery of the baby. Some health insurance policies, in addition to covering the to-be mother, may also cover the newborn baby for a set period of time.

  • Vaccination and other expenses of the newborn baby

    Under some health insurance policies, the costs of vaccination of the baby, medical treatments, and so on are also covered for a specific time period.

    Some insurance companies specify a list of vaccines they will cover, whereas other insurance companies may place a cap on the amount up to which the vaccination-related costs will be covered.

Please note, the above conditions and limits may vary across insurance companies. Make sure you check the policy document before going ahead - to avoid any difficulties later on.

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Who Should Purchase Health Insurance With The Maternity Cover?

You generally get a 15-30 day grace period post the renewal due date for your Health Insurance renewal.

You're thinking of getting married and starting a family in the near future.

You just got married and intend to start a family soon.

You already have a child and are planning to have another one.

You're planning on having a child four to five years down the line.

That is all from our side today. Hope this article helped you gain enough clarity on how the maternity benefit cover in health insurance will offer financial protection against expenses related to maternity.