Things to know about Maternity Cover under your Health Insurance Policy


Today people are aware about the rising cost of health including increasing expenses of maternity and child care. In order to meet the cost of child rearing and the expenses related to pregnancy and delivery couples chalk out a financial plan. Taking up a maternity insurance is becoming an integral part of that planning. However, despite the growing popularity of maternity cover, policy holders are still not fully aware about the key features of such a policy. Therefore, if you are on a mission to expand your family, here’s all that you need to know about maternity insurance plan.

Things to know about Maternity Cover

When is the right time to take a maternity cover?

Most maternity insurance policies have a waiting period for 3-4 years. This means that you can avail the benefits under policy only after the completion of the waiting period. Therefore, the best time to buy a maternity cover is right away marriage. Couples these days anyways wait for a few years before planning to have a child, thus buying the policy as a newlywed couple makes most sense.

What are the benefits covered under maternity policy?

Maternity insurance plan is applicable to both natural delivery and birth via cesarean. The policy is designed to reduce out of pocket expenses related to pregnancy, labour and post-natal care. Benefits of the policy can be summarized as under –

  • Covers both pre and post hospitalization expenses

  • Covers pre & post-natal care cost

  • Cover to new born baby

What are the key exclusions under maternity cover?

Benefit of maternity cover does not apply in the following scenario-

  • If pregnant at the time of purchasing the policy. In such cases, the insurer will consider it as a pre-existing condition and shall not be covered by the scheme.

  • If pregnant before the completion of waiting period.

Is maternity insurance a default part of health insurance policy?

No, maternity insurance is not a default part of your main health insurance policy. It is an ad on feature that is part of some insurance policies. In wake of a time when any kind medical treatment including maternity expenses are so high, some insurers have started providing maternity cover as part of health insurance policy. Most insurance take up a health insurance policy thinking that maternity feature is part of the scheme. However, this is not the case. It is important to check with the insurer about the same prior to taking up a health policy.

Does maternity insurance cover congenital conditions?

A baby born with any kind of abnormality, diseases, deformity, illness or condition is defined as congenital diseases. Some health insurance policies do provide cover against congenital condition. However, the degree of cover varies from policy to policy. Typically, insurance policy does provide cover of a certain limit to new born babies up to a period of 90 days.

How is the premium amount determined for maternity cover?

The premium amount of health insurance policy with maternity benefits is usually high. However, for couples or families who are looking at the prospects of expanding their family in the distant future, going for a maternity cover is a wise move. Maternity and pregnancy can be a costly affair and in order to reduce out of pocket expenses, couple must feel encouraged to opt for this additional cover.

What if you have a group insurance policy with a comprehensive maternity cover?

In such a case, it is advised to go with your corporate plan. This way your main health insurance plan will remain untouched and you will get the benefit of no-claim bonus.

In which scenarios maternity claims may be denied?

Women who conceive in the later part of child-bearing age, generally after the age of 35 years, the claim registered by them are likely to be denied. Such pregnancies are high risk and lead to pregnancy related complications.