Starting a family is one of the most exciting and joyful times in anyone's life. However, it also comes with a huge financial responsibility, especially regarding the expenses related to pregnancy and childbirth. This is precisely why having a good health insurance policy that covers maternity is essential nowadays.
What is Maternity Coverage in Health Insurance Plans?
Maternity coverage in health insurance is nothing but your insurance company covering the cost of childbirth. It’s a safety net designed to ease the financial burden associated with maternity care. This ensures you can focus on what matters most without worrying about medical expenses.
But at the same time, this doesn’t mean your insurer covers all maternity-related expenses. There are specific inclusions that the insurer covers and exclusions that the insurer will not cover. Let’s explore this in detail now.
What is Covered Under Maternity Health Insurance Plans?
Maternity involves numerous costs – when delivering a child, you have to pay for prenatal care, regular check-ups, ultrasounds, and other necessary tests to monitor the health of the mother and the baby. You should also pay for the postnatal care, which includes follow-up visits and treatments after the delivery, not to mention the actual delivery cost, which can vary significantly depending on whether it's a regular delivery or a C-section.
All of these costs associated with delivering a child are called maternity expenses, and depending on the insurer and policy, they cover some or most of these costs.
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This begs the question –
What are the Best Maternity Health Insurance Plans?
- Aditya Birla Activ Fit Preferred
Aditya Birla Activ Fit Preferred is explicitly crafted for young adults, considering the discounts offered during insurance renewals if you are healthy (as diagnosed in their Health Assessment Program). This is a decent pick with 2 variants - Plus (individual, multi-individual and family floater) and Preferred (family floater), extending exhaustive sum insured ranging from ₹1 lakh to ₹1 crore.
The policy offers maternity coverage perks, multiple premium discounts if you stay healthy during renewals, and add-ons like - Super No-Claim Bonus, OPD coverage, Reduction in maternity waiting period, Travel Protect Cover, Premiums Waiver Cover, EMI Protection Cover, and Consumables Coverage. - Tata Medicare Premier
Tata Medicare Premier is a great policy, considering it covers most bases and then goes beyond the traditional feature set to offer maternity coverage, coverage for international treatments, and even pay for outpatient consultations. All of these are subject to certain conditions of course, but if you are looking for comprehensive coverage, very few policies can beat this. The only caveat is that it is an expensive policy. - ICICI Lombard Elevate
ICICI Lombard Elevate is an excellent health insurance policy on paper – it has unlimited coverage once in the policy’s lifetime, has a wide range of add-ons, global coverage and even has maternity cover. . However, it has limitations, such as sub-limits on specific treatments, a nominal renewal bonus, and room rent restrictions on the base plan. All in all, this is a decent health insurance plan if you’re looking for coverage for your family. - Niva Bupa Aspire
Niva Bupa has a vast network of over 10k hospitals and offers add-ons such as teleconsultations, coverage of pre-existing diseases, consumables, etc. It also has a unique feature where your premiums will not increase due to age until you make a claim. However, as an insurer, we feel Niva Bupa can have better metrics than its peers. We still feel this is a decent choice if you’re looking for cashless coverage. - Star Super Star
STAR Super Star offers customisable health insurance with features like add-ons for childbirth, newborn expenses, and Assisted Reproduction Treatment (ART), as well as a premium freeze benefit that helps save money over time. It has no room rent restrictions, no copayment, and provides full coverage with no disease-specific sub-limits (except for maternity). With over 20 add-ons available, the plan is highly flexible. However, the insurer’s below-average claim settlement ratio and operational inefficiencies may affect claim processing and customer service, making it a mixed choice for those seeking a personalised plan.
Should You Buy a Maternity Health Insurance Plan?
Whether or not you should have maternity coverage by your policy is not a straightforward “Yes” or “No”. It has numerous nuances that vary from policy to policy and has various advantages and disadvantages that might affect some people more than others. Here, we have compiled a list of some advantages and disadvantages that are common across most policies:
- Pros of Maternity Health Insurance Plans
a. Covers maternity and post-maternity costs: Your insurance policy's maternity coverage ensures you are financially protected against childbirth costs. If at all you make out-of-pocket expenses, this ensures that it is the least.
b. Internal congenital disorders: Sometimes, babies may have disorders that affect them right from birth. These are called congenital disorders and are classified into internal and external congenital disorders. External disorders, such as cleft lip and club foot, are easily visible to the eye.
Internal congenital disorders are not easily visible, such as heart disorders or Down Syndrome. Earlier, insurers did not cover congenital disorders, but nowadays, if a policy covers maternity, internal congenital disorders are covered.
c. The newborn is covered right from Day 1: Many maternity policies will also cover the newborn right from day one. This ensures that vaccinations or other childcare-related expenses (within the policy’s scope) are also covered.
2. Cons of Maternity Health Insurance Plans
a. Waiting period: One significant downside of maternity policies is the waiting period. In most policies, even if you purchase a policy that covers maternity expenses, the waiting period will be activated only after you get married and add your spouse. Keeping this in mind, choose a plan with the shortest waiting period.
b. Both spouses must opt for maternity coverage: Even though the husband will never use maternity coverage, insurers mandate that both spouses purchase it. However, there are exceptions, such as Niva Bupa Aspire, where you can purchase the maternity add-on before you are married and add your spouse. But it is important to note that this is not the norm.
c. Sub-Limits: Health insurance policies that cover maternity expenses are notorious for having sub-limits on their coverage. Ensure the policy has no sub-limit or, at least, a good sub-limit covers all the anticipated costs.
d. High premiums compared to the same plan without maternity: Insurers usually charge a higher premium if a policy covers maternity. This is because they anticipate a larger payout if a couple opts for maternity coverage. Ensure that the cost differential between the policies is not very high.
Things to Remember while Purchasing the Best Maternity Health Insurance Plans
- Cost Comparison: As mentioned earlier, maternity health insurance plans often have higher premiums than standard health insurance policies.
- Newborn Coverage: Some policies cover the newborn right from Day 1, but others cover the newborn only after 90 days. You need to be aware of this waiting period because if the infant develops an unfortunate condition within 90 days, which happens to be a crucial period for newborns, the insurer will only cover it if they have coverage from Day 1.
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Conclusion
Choosing the right health insurance plan is crucial to ensure financial stability and comprehensive coverage during pregnancy and childbirth, especially for expecting couples.
However, if you have sufficient funds available and don’t mind paying the entire amount in one go during the delivery, as well as the costs following maternity, such as vaccinations, then you probably don’t need maternity cover.
