You’ve just found out that you’re expecting, and the excitement is overwhelming. You begin imagining your baby’s first steps and the joy of holding it for the first time. But as the initial excitement settles, you start thinking about the practical aspects — such as ensuring you and your baby have sufficient health insurance coverage. That's when you begin exploring maternity insurance, only to realise there's a waiting period before you can avail of the benefits.
Surprised? Well, you’re not alone.
Maternity insurance is designed to cover the costs of prenatal care, delivery, and postnatal care, helping new parents financially during this significant life event. However, a lesser-known but critical aspect of maternity insurance is its waiting period.
It is the time frame you must wait before your policy kicks in for maternity-related claims. If you're already pregnant or planning to start a family soon, not knowing about the waiting period could leave you footing a hefty bill.
In this article, we’ll break down the waiting period in maternity insurance, why it exists, and how you can plan ahead to avoid being caught off-guard.
Best Maternity Health Insurance Policies
| Top Maternity Insurance Pan | Maternity Waiting Period | Maternity Features | Insurer Metrics |
|---|---|---|---|
| Aditya Birla Activ One (only for VIP & VIP+ variants) | 2 years | If the cover amount is between ₹50 & ₹75 lakhs, maternity coverage is ₹1 lakh. If the cover amount is ₹1 crore or more, maternity coverage is ₹2 lakhs. |
Network Hospitals: 11k+ Claim Settlement Ratio: 93% Incurred Claim Ratio: 61% |
| Aditya Birla Activ Fit Preferred | 3 years | It is a decent policy at a good price point. Available only as a family floater to people under the age of 45. |
Network Hospitals: 11k+ Claim Settlement Ratio: 93% Incurred Claim Ratio: 61% |
| Care Joy | 9 months for Joy Today, and 24 months for Joy Tomorrow | Comes in two variants – Joy Today and Joy Tomorrow, with ₹ 3 lakhs and ₹ 5 lakhs as base cover, respectively. This may not be enough for hospitalisations, and the maternity cover has very basic features that miss out on a no-claim bonus, domiciliary cover, restoration, etc. |
Network Hospitals: 8.3k+ Claim Settlement Ratio: 90% Incurred Claim Ratio: 58% |
| Niva Bupa Aspire | 9 months to 4 years (depending on the variant) | Policy highlight 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. | Network Hospitals: 8.6k+ Claim Settlement Ratio 91% Incurred Claim Ratio: 57% |
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What is the Waiting Period in Maternity Insurance Plans & when does it start?
Just like any other waiting period, a maternity waiting period is the period after which you become eligible to make maternity-related claims from your health insurance policy. During this period, the policy will not cover any maternity expenses. This ensures that insurance providers are not burdened by immediate claims from new policyholders, especially if they were already planning a pregnancy before purchasing the policy.
However, unlike other waiting periods, the maternity waiting period works differently. In many cases, maternity benefits are only available if you opt for a family floater plan. This means that in addition to the primary insured person, their spouse must also be added to the policy. Most insurers require both the husband and wife to serve the waiting period before maternity benefits can be claimed (even if the husband will never make maternity-related claims). So, the waiting period will start only when you add your spouse to the policy, which can only happen after you get married. This makes it important to plan well ahead if you're considering maternity insurance.
This brings us to the question: What is the standard waiting period for making a maternity-related claim?
What is the Standard Waiting Period in Maternity Insurance?
In maternity insurance plans, the waiting period ranges from 9 months to 6 years! However, many insurers set the waiting period at 2 to 4 years, especially in comprehensive family floater plans that include maternity coverage as part of their benefits. This long waiting period is one of the most significant challenges for couples looking to utilise their maternity benefits soon after purchasing a policy.
Can Waiting Periods in Maternity Insurance be Reduced?
Sometimes, insurers reduce waiting periods depending on the policy. Here are a few ways to potentially shorten or eliminate the waiting period:
- Corporate Policies: Some group health insurance plans employers offer have shorter or even no waiting periods for maternity coverage. If you’re eligible for such a plan, this can be an excellent way to access maternity benefits sooner.
- Add-Ons: Some insurers offer specific add-ons to reduce or waive the maternity waiting period. By purchasing these add-ons when you take out the policy, you may be able to shorten the waiting period for maternity coverage significantly.
What Happens if You Get Pregnant During the Waiting Period?
Unfortunately, if you conceive during the maternity waiting period, you will not be able to claim any maternity-related expenses, such as pre-natal visits, delivery costs, or post-natal care, during that period. However, after the waiting period is over, you can start claiming benefits for any future pregnancies.
For example, if your policy has a 24-month waiting period and you get pregnant 20 months after purchasing it, you would have to pay out-of-pocket for all maternity-related expenses related to that pregnancy. The policy would only cover future pregnancies after the waiting period has passed.
It is also important to note that insurers impose a cap on the number of pregnancies covered. Maternity health insurance policies usually cover the birth of two children. However, this varies from policy to policy, and you should compare different policies and check the policy wording for the exact details.
Best Time to Purchase Maternity Insurance
The waiting periods are standard features in health insurance, and it is essential to understand how it works before choosing a plan. Ideally, you should purchase a good health insurance policy when you are in your twenties so that:
- You are less likely to have pre-existing diseases, which translates to a lower premium. And,
- You can serve the waiting periods without rushing.
However, when it comes to maternity, we understand that purchasing one in your twenties may not always be possible because you need to add your spouse. So, the best time to purchase maternity insurance is well before you plan to start a family. Ideally, you should purchase the policy as soon as you get married so you can serve the waiting period. This ensures that your maternity benefits are available when you need them without any complications.
Apart from this, you can also check if your corporate health insurance covers maternity expenses. In this case, you may not even have to purchase health insurance for maternity. This way, you can save on premiums and have your maternity covered by health insurance.
However, keep in mind that relying entirely on a corporate health insurance plan may not always be the best option. These plans often have limitations and are dependent on your job.
On the other hand, if you can afford a one-time lump sum payment for maternity expenses, opting out of maternity-specific plans may also be a good option. Saving beforehand for these costs can sometimes be more beneficial, especially if you’re confident in your ability to cover expenses without relying on insurance.
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Conclusion
Maternity insurance provides valuable financial protection for expecting parents, but the waiting period is an important factor to consider. Planning ahead and understanding the terms of your policy, including the waiting period, can help you avoid these unexpected costs.
To get the most out of your maternity insurance, it’s important to purchase the policy early to serve the waiting periods. If you need help deciding whether you need maternity coverage by your health insurance plan, feel free to book a call with Ditto Insurance’s IRDAI-certified advisors. We give you honest, spam-free insurance advice so that you can make the best possible decision.
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