Expanding your family is an exciting chapter in life. However, pregnancy, delivery, and caring for an infant also carry substantial medical expenses in today’s healthcare ecosystem. What many families need to realise is that maternity costs are not automatically covered under all health insurance plans. Securing adequate maternity cover in advance is essential to buffer against unpredictable bills.
Read on for an in-depth look at maternity cover policies – what they cover, associated outlays, eligibility norms, and how to select the best maternity coverage health insurance for your needs.
What is Maternity Coverage in Health Insurance?
Maternity coverage is a type of insurance that is designed to help women cover the costs associated with pregnancy and childbirth. It is usually added to a regular health insurance policy and can help pay for things like doctor visits, hospital stays, and care for the baby after birth.
Pre- and post-natal expenses are covered in some cases, under maternity health insurance policies.
However, it is important to note that this benefit usually does not cover pre-existing maternal health conditions, congenital disabilities, or the expenses related to infertility treatments.
Eligibility Criteria for Maternity Health Insurance
In India, women can buy a special type of health insurance that helps cover the costs of having a baby. However, this coverage is generally available for women between the ages of 18 and 45.
It is really important to know that some women with certain medical conditions might not qualify for certain types of health insurance. Also, generally health insurance policies require you to wait for upto 3 years before they start covering the costs of having a baby. So, make sure to go through the details of your insurance policy carefully to understand what is covered and what is not. If you have any questions or worries, don’t hesitate to reach out to Kotak General Insurance.
Top Benefits of Maternity Health Insurance
It is a good idea to have insurance for pregnancy and childbirth. This will help you with the costs of healthcare and planning for your finances. If you’re planning to have a baby, it’s best to get maternity coverage before getting pregnant. Thus, it will help you prepare for the expenses that come with having a baby. There are many benefits to having maternity health coverage before you conceive:
- Access cashless medical facilities at in-network hospitals covered under your health insurance plan
- Pay significantly lower out-of-pocket costs for skilled specialists, advanced treatments, and hospital services
- Claim tax benefits on premiums paid for health insurance with maternity cover under Section 80D
- Minimise the impact of hefty hospital bills on the monthly household budget
- Peace of mind knowing you have financial assistance for mother and baby
What Does Maternity Health Insurance Typically Cover?
Maternity coverage is an additional benefit that helps women who are planning to start a family. With this coverage, you can claim expenses related to pregnancy, delivery, and initial newborn care. This means that if you have an individual or family health insurance plan with maternity benefits, you can get financial support for these expenses. It is a helpful way to ensure that you and your family receive the best possible care during this important time. Here are some common inclusions:
1. Prenatal and Post-natal Care
Maternity coverage often covers prenatal doctor visits and lab tests for expecting mothers before the estimated delivery date. Postpartum care, including follow-up appointments and certain procedures within 60 days of delivery, may be covered.
2. Delivery and Hospitalisation
Normally both delivery and caesarean section delivery expenses are covered under maternity benefits, along with hospitalisation costs like room charges, specialist fees, medications, and more. Post-delivery complications for mother and baby may also be included.
3. New-born Cover
Most insurance policies will cover a baby’s health issues that are noticeable at birth or genetic conditions that are diagnosed within the first 90 days of it’s birth. The insurance will also cover the costs of associated treatments, but only up to a certain limit.
4. Vaccinations
During a baby’s first year after birth, they may receive several important vaccinations to protect them from various diseases. These include shots for illnesses like tuberculosis, measles, polio, and hepatitis B, among others.
Exclusions and Limitations of Maternity Plans
While maternity rider policies can minimise out-of-pocket pregnancy and delivery costs, they do come with exclusions. Below are some of the common exclusions seen with the majority of health insurance plans offering maternity benefits:
- Fertility treatments and procedures
- Costs arising during the waiting period after purchasing the policy
- Stem cell harvesting and storage
- Supplements and vitamins unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure
It is important to read the details carefully when you are looking at health coverage for maternity care. Take the time to understand exactly what is and isn’t covered so that you can make an informed decision about your options.
Key Factors to Consider When Buying Maternity Insurance
Securing sufficient maternity health insurance requires careful evaluation of policy options. There are several important things to keep in mind:
- Ensure exclusions would not preclude necessary care
- Evaluate whether healthcare networks extend to your preferred hospitals
- Opt for adequate coverage limits to cap out-of-pocket liability
It is important to find the best health insurance plans with maternity coverage that suits your needs and budget and gives you peace of mind. You can do this by considering some key factors before you plan to have a baby. Having this extra coverage can help you deal with unexpected expenses and make sure you and your baby get the best care possible.
Conclusion
Maternity coverage is crucial for women who want to start or grow their families. It may come at a cost, but the financial protection and peace of mind it provides make it worth it. Find the best plan for you before conceiving to focus on prenatal care and a healthy pregnancy. Having coverage reduces stress and allows new mothers to enjoy motherhood.
