International Women’s Day: How to buy health insurance with maternity coverage

Women, in today’s world, are taking the lead in making financial decisions. And, on International Women’s Day, if you or your friends, colleagues, relatives etc are getting ready to start their family and have kids – there’s a helping hand from health insurance policies in India.

If you are searching for a health insurance policy with maternity benefits, you need to be aware of a few important things. Maternity insurance plan is like any other health insurance policy that provides coverage to expenses related to pregnancy as well. However, the terms and conditions of health insurance with maternity coverage could be slightly different than regular health covers.

Not all health insurance plans may not offer maternity cover, one needs to be careful while the selection of the right health policy. In some policies, it may be specifically excluded as well. “Not all Health Insurance plans cover maternity expenses as a part of the base plan. Many health plans offer it as an add-on benefit or in the higher variants of the plan. However, there is a usually a waiting period,” says Shanai Ghosh, CEO, Edelweiss General Insurance.

So, the first thing is to check whether the health insurance policy is offering maternity benefit or not. The most striking feature of the maternity insurance plan is the ‘Waiting Period’ in them. “The waiting period in maternity covers differs from company to company. However broadly, it is usually in the range of 36-48 months,” says Shanai.

By waiting period it means, the expenses related to maternity will not be covered during the period after one has purchased the policy. For example, someone buying maternity cover in March 2020, the pregnancy-related medical bill will be reimbursed only if the expenses have occurred after March 2023 or March 2024. There may not many health insurance with maternity coverage and no waiting period in India. Even if there are any, the premium in those policies could be very high.

Planning, therefore, needs to be well in advance to take the benefit from maternity insurance plans with no waiting period. “Health insurance policy having a maternity cover is a good option that all newly wedded couples can opt,” says Dr. Shreeraj Deshpande, Chief Operating Officer, Future Generali India Insurance.

But, what if one is covered under a group health insurance policy? “Tailor-made group health policies which an employer buys to cover his employees and their dependents may or may not have a waiting period, depending on the option availed,” says Dr. Deshpande. However, relying on group health may not be the right approach.

Having purchased health insurance with maternity coverage, one is sure to get usual coverage as provided by a regular health cover. In addition, the maternity expense will get coverage. “Although coverage differs across insurers, many insurers offer coverage to the baby from day one, hospitalization expenses for delivery, vaccinations and pre-post-natal expenses,” informs Shanai.

As far as inclusions are concerned, the policyholder should be aware of the important terms and conditions. According to Dr. Deshpande, the important things to look at are, “Covers, additional benefits, waiting periods, sub-limits, standard exclusions, exclusions on non-medical charges amongst others.”

Here’s what Shanai has to suggest on one’s health insurance portfolio- “It is advisable to have a base health plan with enough cover for hospitalisation, OPD, pre -post-hospitalisation cover including maternity. You can then add a top-up plan with the base health plan sum insured as a deductible. Some plans cover Critical Illness within the health cover. If not, it is advisable to purchase a standalone Critical Illness plan as well.”