They say it takes a village to raise a child, but they never said it would take a fortune to do so.

However, even without a saying, there’s no denying that it costs a lot to raise a child – especially if you’re in a city like Bangalore or Mumbai in India. And this cost is only rising year after year!

While the prospect of expanding your family may bring happiness, it also needs careful financial planning. Purchasing a health insurance policy that covers maternity could help reduce this financial burden.

However, as with any insurance policy, understanding its features and intricacies is crucial. Let’s explore this further!

What are Maternity Health Insurance Policies?

Maternity health insurance policies cover the costs associated with pregnancy and other expenses that women incur during childbirth.

Despite maternity being a massive step for a couple – financial or otherwise, most of the top insurance policies do not cover maternity by default. Even if they do, there are various sub-limits and restrictions that you must follow to get the claim approved.

A good policy should have the least restrictions – especially no co-payment, room rent limit, and disease-wise sub-limits. You must also consider waiting periods, pre & post-hospitalisation coverage, and newborn coverage.

Heads Up: It takes an average person up to 5 hours to read & analyze a policy, and 10 hours or more to compare different plans and make a decision.
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How to Determine the Best Maternity Health Insurance Plans?

  • Waiting period: Since people who opt for maternity coverage generally expect to have kids soon, insurers impose a waiting period of 2-4 years. You and your spouse must maintain the policy for this duration before being eligible to claim maternity expenses. This means you are looking at some meticulous family planning, or you could opt for a plan with low waiting periods.
  • Coverage: Deliveries frequently bring about medical complications for both the mother and the newborn, necessitating extensive coverage. Ideally, the most desirable option would be to obtain a plan that doesn't impose sub-limits on maternity coverage. For instance, many insurance policies impose specific coverage limits for normal deliveries (e.g., ₹50k), C-sections (e.g. ₹75k), and coverage for newborns. The goal is to optimise protection on all three fronts.
  • Premiums: Since insurers generally expect to make payouts with maternity plans, they tend to seek a higher premium in exchange. So, you have to ensure that the total premiums you pay don’t exceed the total expenses you generally incur during childbirth. However, if you’re worried about your newborn and their overall health, maternity coverage can offer significant protection since insurance policies with maternity benefits generally cover babies from day 1 instead of covering them after 3 months.

What are the best maternity health insurance policies?

  • Star Comprehensive: This is one of the better plans that Star offers with maternity coverage — it only has a maternity waiting period of 2 years and ₹ 15k to ₹ 1 lakh maternity coverage.

This coverage depends on the base sum assured, which ranges from ₹ 5 lakh to ₹ 1 crore! However, the other features could be better—they only offer a one-time restoration if you completely exhaust your cover, co-payments if you’re over 61 years old, and a single private room restriction. Furthermore, the insurer’s credibility metrics reflect that, unfortunately, it is not one of the best insurers in the market.

  • Care Joy: This policy built by Care specifically for maternity comes in two variants – Joy Today and Joy Tomorrow. The main differences between both policies are the maternity waiting period and coverage for newborn birth defects. The base sum insured – being ₹ 3 lakhs and ₹ 5 lakhs – may not also be enough for hospitalisations, and the maternity cover has very basic features that miss out on a no-claim bonus, domiciliary cover, restoration, etc.
  • Niva Bupa Aspire: This is a good policy offering maternity coverage. One of the most unique features of this plan is the Future Ready add-on. Had you purchased the policy with this add-on before getting married and served the waiting period for maternity, you and your spouse need not do so again. Depending on the variant, the waiting period varies from 9 months to 4 years for maternity.
  • Aditya Birla Activ Fit Preferred: This policy is available only as a family floater that offers maternity coverage. It is a decent policy at a good price point, but it is available only for people under 45 and has a 3-year waiting period for maternity coverage.
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Should you opt for a healthy insurance plan with maternity coverage?

Whether or not you opt for maternity insurance depends on one crucial factor – Does your corporate insurance cover it?

If your corporate plan already covers maternity, purchasing it again may be redundant and expensive. Owing to the various exclusions and sub-limits, you may also not get complete coverage.

However, one major advantage to having maternity coverage is that the newborn may be covered from Day 1.

Of course, this depends on the specific policy, but it is a significant advantage. Should the newborn develop any internal congenital disorders, having it covered will give you peace of mind.

But as always, compare premiums with and without maternity coverage to make an informed decision.

If you decide to purchase a policy that covers maternity, here are some pointers for you to keep in mind –

Tips to remember when choosing the best maternity health insurance plan

  • Both spouses should purchase maternity coverage:  Even though the husband does not need it, he must purchase it with his spouse. In some cases, maternity is covered only in family floater policies.

However, one major exception is Niva Bupa Aspire's Future Ready add-on, where you can add your ‘Spouse’ even before getting married. All your waiting periods will also apply to your future spouse.

  • Extensive waiting period: You need to be mindful of the waiting period for maternity coverage to kick in. It is usually higher than the specific illness and pre-existing waiting periods.
  • Check pre and post-hospitalisation expenses: You should look into the extent of coverage for pre and post-hospitalisation expenses for maternity care. Adequate coverage will ease your financial burden a lot.
  • Check for maternity sub-limits: There are usually different sub-limits for normal and C-section deliveries. Some plans may not have adequate coverage for both, which could lead to out-of-pocket expenses.
  • Newborn Coverage: When opting for maternity coverage, newborns may receive immediate coverage from day one. However, without maternity coverage, there might be a waiting period before newborns are covered, typically around 90 days. This 90 days is crucial because babies sometimes develop complications right after they’re born.

Depending on the policy, this rider may provide immediate coverage for the newborn's vaccination expenses and potential coverage for congenital disorders within the first 90 days.

  • External congenital disorders are not covered: As per IRDAI regulations, only internal congenital disorders of the newborn are to be covered by insurers. Disorders that are not visible to the untrained eye are called internal congenital disorders. It may include a heart condition, Down Syndrome, etc.

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Conclusion

Choosing the right maternity health insurance plan is crucial for ensuring comprehensive coverage during one of the most important phases of your life. While selecting policies, consider the waiting periods, sub-limits, pre and post-hospitalisation coverage, etc, to make an informed decision.

With the right plan, you can ensure that the mother and the newborn receive the best care without financial worries. As always, compare different policies and choose one that aligns with your needs and budget.