Is Pregnancy Covered in Health Insurance?

Is Pregnancy Covered in Health Insurance? Pregnancy is not always covered under a basic health insurance plan. Most standard policies exclude maternity-related expenses unless they’re explicitly mentioned. However, many insurers now offer maternity coverage as an add-on benefit or include it in comprehensive family floater plans. If you're planning to start a family, it's essential to choose a health insurance plan with maternity coverage, or add it to your existing policy, as all plans come with a waiting period.

With rising medical inflation, a standard delivery can cost anywhere between ₹25,000 and ₹1,00,000, while a  C-section may range from ₹50,000 to ₹1,25,000, and thus planning becomes essential.

Maternity coverage in health insurance eases this financial burden by covering childbirth and related costs. In this guide, we’ll break down what maternity insurance includes, the best time to buy it, and Ditto’s policy picks to help you make a wise, informed choice.

Not sure which riders you actually need? Talk to Ditto’s expert advisors today and get unbiased, personalised guidance - absolutely free.

Did You Know? The Pradhan Mantri Matru Vandana Yojana (PMMVY) provides direct cash benefits of ₹5,000 to pregnant and lactating women for their first living child to support nutrition and wage loss compensation.

What’s included and not Included in maternity insurance plans ?

Maternity insurance offers helpful coverage, but it comes with certain exclusions. To help you understand better, here's a clear comparison of what's usually included and excluded in most maternity health insurance plans:

Category	What’s Covered	What’s Not Covered / Limits
Delivery Expenses	Normal delivery costs (doctor, hospital, anesthesia) C-section surgery (OT charges, surgeon fees)	- Cosmetic procedures - Elective abortions
Hospitalization	- Room rent (usually capped) - ICU if needed - Doctor, nursing fees- Ambulance - Hospital-based procedures	- Charges beyond policy limits or exclusions
Pre-natal Care	- Gynecologist consultations - Ultrasounds, lab tests - Pregnancy supplements (if prescribed) - Covered 30–60 days before delivery	- Non-prescribed vitamins -Ayurvedic/Homeopathy treatments
Post-natal Care	- Follow-up doctor visits - Post-delivery medications - Covered for 30-60 days after delivery	- Cosmetic recovery treatments
Newborn Baby Cover	- Initial medical expenses - NICU charges - Mandatory vaccinations - Congenital condition treatment (if included in policy)	-not covered beyond 90 days after birth, needs to be added as a separate member in the policy.

Did You Know? IRDAI, under the Surrogacy (Regulation) Act, 2021, mandates health insurance coverage for surrogacy. For such coverage, the intending couple must purchase the required insurance coverage, which includes 36 months of coverage for surrogate mothers and 12 months for oocyte donors, and verify the terms and conditions of such policies. Certain insurers, like HDFC Ergo, offer specialized plans with an add-on (Surrogacy and Oocyte Protect) that can be added to their base retail products.

Got your basics clear? Now, let’s see what our experts at Ditto think about maternity coverage in health insurance. 

What’s Ditto’s Take on Pregnancy Coverage?

At Ditto, we suggest using your corporate (employer-provided) health insurance first if it includes maternity cover. If you or your spouse is covered under one, here’s why it works well:

1. No or low waiting periods – coverage may start from Day 1.
2. Higher sub-limits or full reimbursement for delivery expenses.
3. No extra premiums for maternity benefits.
4. Often includes newborn care, vaccinations, and pre-/post-natal expenses.

But if that’s not available, or you want extra protection, a personal health insurance plan with maternity benefits can help.

Before you buy, ask yourself:

• Is the higher premium worth it?
• How long is the waiting period?
• What’s the maternity cover amount—₹25,000 or ₹1,00,000?

Do a quick cost-benefit analysis to make sure you’re getting real value and peace of mind for your family.

Pro Tip: When you choose a plan with maternity coverage, the payout process is usually straightforward because the insurer’s liability is clearly defined. However, problems arise if you don’t opt for maternity coverage but still expect newborn benefits. For example, at Ditto, a case came up where a client didn’t have maternity coverage but wanted immediate newborn coverage, which was ultimately denied. In reality, most standard plans without maternity benefits only cover newborns after 90 days, subject to the insurer’s approval.

When Should You Buy Maternity Insurance?

Most maternity insurance plans have a long waiting period, so timing is everything. Here's when and why you should buy it:

• Start Early ie. Before Conception: Maternity covers usually have waiting periods ranging from 9 months to 4 years. Buying early ensures you're covered when you need it during delivery.
• Lack of Maternity Benefits in Existing Plans: If your current health insurance doesn't include maternity, you may need to switch to a dedicated maternity policy or add a rider.
• Coverage for Newborn Baby: Maternity policies cover the baby from Day 1, including vaccinations and NICU if needed. Ensure this is included and check whether the new born is covered under a separate limit or within the delivery expenses limit.  
• Tax Perks Too: Under Section 80D of the old regime, you can claim tax deductions on the premium paid—a bonus.

Is Maternity Insurance Available for Already Pregnant Women?

Unfortunately, you cannot buy maternity insurance once you're pregnant, as insurers consider it a pre-existing or known event, making it ineligible for new coverage. 

However, there are some workarounds. After delivery, you can explore plans with maternity benefits for future pregnancies. In the meantime, rely on any corporate health insurance you may have, or set aside a dedicated fund to effectively manage out-of-pocket maternity and delivery costs.

For instance, in the rarest cases, women can purchase the Star Health Super Star plan with the “Women Care” add-on by submitting 12- and 20-week scan reports of their pregnancy period. This policy covers the newborn immediately after its birth until the end of the policy year, subject to the terms and conditions of the policy.

Unsure which route to take? Let’s look at Ditto’s policy list on all of this.

Maternity Plans in India (2025) That Make Ditto’s Cut

Most health insurance plans don’t include maternity by default—but some offer it as an inbuilt benefit or through add-ons. A few go the extra mile with broader coverage, shorter waiting periods, and newborn care. Here are Ditto’s recommended maternity plans in India as of 2025. 

Before we discuss the list, here’s how we decide what plans to feature. At Ditto, every health plan goes through our six-point evaluation framework. It doesn’t mean these are the only good plans, but that they stand out after being scored across all six pillars. You can learn more about how we evaluate health insurance plans here.

1. itya Birla Activ Fit Preferred (Maternity Inbuilt)

Aditya Birla Activ Fit Preferred is a comprehensive health insurance plan designed for individuals and families that includes maternity coverage as an inbuilt feature. 

Key Highlights:

• Covers: (a) 2 deliveries (including twins), or (b) 2 terminations, or (c) 1 delivery (including twins) + 1 termination
• Normal Delivery: ₹40,000 and C-Section Delivery: ₹60,000
• Pre- and post-natal expenses covered
• Newborn baby care till 90 days
• Vaccination expenses of newborn up to 2 years

2. Niva Bupa Aspire Titanium+ (Maternity Inbuilt)

Niva Bupa Aspire Titanium+ is the premium variant in Niva Bupa’s Aspire portfolio, offering comprehensive maternity coverage including delivery, IVF, adoption, and surrogacy expenses.

Key Highlights:

• Broad Parenthood Coverage: Includes antenatal check-ups, vaccines, normal & C-section deliveries, surrogacy, IVF/ICSI, infertility treatment, medical termination, adoption, and newborn care—all under the M‑iracle benefit. 
• Unutilised base cover and maternity cover accumulates up to 10x
• Limits by Sum Insured Tier: Covers ₹4k (₹3L SI) → ₹25k (₹50L–₹1Cr SI); waiting period is just 9 months. 
• Day‑1 Newborn Protection: Newborn gets automatic coverage from birth up to the base sum insured which is quite beneficial.
• Comprehensive Vaccine Cover: Includes Tdap, Td, flu shot, and Hepatitis A & B, all wrapped into the M‑iracle coverage.

3. ICICI Elevate (Maternity Add-on)

ICICI Lombard Elevate offers comprehensive maternity coverage with a waiting period of 24 months, which can be reduced to 12 months via an add-on. 

Key Highlights:

• Coverage Scope: Covers up to three claims for delivery, medically advised termination, and pre/post-natal care(upto 30 days post delivery).
• Financial Limits: Offers up to 10% of the annual sum insured, capped at ₹1 lakh.
• Waiting Period: Imposes a 2-year waiting period for maternity-related claims.
• Newborn Benefits: Separate cover of 2x the maternity limit and vaccination costs newborns (up to age 1) at 1% of sum insured, capped at ₹10,000, given both maternity and newborn covers are opted and a maternity claim is accepted
• Eligibility Criteria: Available under family floater policies ( both parents covered) for female insured members aged 18–50 years.

4. Star Health Super Star (Maternity Add-on)

Star Health Super Star is an all-round and comprehensive health insurance plan that includes maternity coverage such as normal and C-section delivery, pre- and post-natal care, assisted reproduction treatments, and newborn hospitalization.

Key Highlights:

1. Option A – Full Maternity Coverage

• Covers both normal and C-section deliveries, including pre- and post-natal care with a 24-month waiting period. 
• Delivery benefits: ₹50,000 or ₹1,00,000 per birth (up to four births) and includes Day‑1 newborn coverage. 
• Annual limits (new born cover) : ₹2 L for SI ₹5–25 L; ₹5 L for SI ₹50 L+ 
• No exclusions for congenital internal defects.

2. Option B – Shorter Waiting, Lower Delivery LimitIdentical to Option A but with only a 12-month waiting period and ₹30,000 per delivery limit. Other terms remain the same.

      3.  Option C – Assisted Reproduction Support

• Covers one assisted reproductive treatment (like IVF/IUI) annually after a 24-month waiting period, with both spouses continuously insured. 
• Limits: ₹1L (SI ₹5–7.5 L), ₹2L (SI ₹10–25 L), ₹4L (SI ₹50 L+).
• Excludes pre/post-treatment, surrogacy, storage, and fertility surgeries

5. Tata AIG Medicare Premier (Inbuilt Maternity cover)

Tata AIG Medicare Premier with inbuilt maternity cover offers comprehensive health insurance with maternity benefits such as delivery expenses (normal and C-section), pre- and post-natal care, and newborn baby coverage including vaccinations.

Key Highlights:

• Coverage - ₹50,000–₹1.2L based on sum insured and child’s gender.
• Exclusions: No pre/post-natal, pre/post-hospitalization, or voluntary termination cover.
• Newborn Care: Covered up to ₹25,000, depending on sum insured.
• Vaccination Cover: Up to ₹15,000 for the first year (girl child), lifetime limit applies.

If your current health insurance doesn't include maternity. You may need to switch to a dedicated maternity policy or add a rider.

Disclaimer: This is not an exhaustive list but one based on our research, Ditto’s advisors may recommend these plans depending on the profile and requirements of customers.

Now let’s take a quick look at the premium comparison for the listed maternity insurance plans. The rates are for a couple (both aged 32) living in Delhi, with a ₹10 lakh sum insured, inclusive of GST.

PLAN NAME	WAITING PERIOD	PREMIUMS
Aditya Birla Activ Fit Preferred (Maternity Inbuilt)	3 years	₹ 18,226.6
Niva Bupa Aspire Titanium+ (Maternity Inbuilt)	9 months	₹ 19,828
ICICI Lombard Elevate (Maternity Add-on)	2 years	₹ 67,670
Star Health Super Star (Maternity Add-on)	2 years	Option A: ₹ 29,542 Option B: ₹ 34,655Option C: ₹ 112,364
Tata AIG Medicare Premier (Inbuilt Maternity)	4 years	₹ 27,329

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Conclusion

Maternity coverage helps manage childbirth and newborn costs. Corporate plans often offer short waiting periods and higher limits, but personal health insurance with maternity benefits is essential if unavailable.

Key Takeaways:

• Corporate plans often offer short or no waiting periods and better maternity limits.
• Personal plans are essential if you lack employer coverage or need extra protection.
• Always check for sub-limits on delivery expenses and coverage for newborns.
• Buy early to navigate waiting periods effectively.

Still unsure which way to go? Book a free call with Ditto's advisors, we'll help you find the best maternity insurance based on your needs and timing.

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