Importance of adding maternity coverage to your health insurance plan

Parenting is something that all couples look forward to. They and their entire family eagerly look forward to the arrival of their bundle of joy. However, along with happiness, becoming parents brings a major responsibility of the child's upbringing. Right from pregnancy to childbirth, to raising the child involves a financial commitment. Maternity coverage with a health insurance policy helps mitigate some of this cost. Let us understand the importance of adding maternity coverage to your health insurance plan.

What is maternity coverage?

Maternity insurance, as the name specifies, covers all maternity-related hospitalisation expenses. It covers the cost of normal delivery and caesarean (C-section) delivery. Apart from maternity-related hospitalisation expenses, it may also covers pre and post-hospitalisation expenses up to a specified number of days.

New born baby expenses:

Apart from child delivery expenses, maternity insurance may cover medical expenses incurred towards the treatment of the new born child. These expenses are covered when the mother (insured person) is hospitalised for delivery. During and post birth, the child's expenses are covered up to a specified number of days. For the baby's continued coverage, it can be included in the health insurance plan by paying the requisite premium, subject to the company's underwriting policy.

Vaccinations :

Some health insurance plans may cover the new born baby’s vaccination expenses for a specified period as part of the maternity cover. The vaccinations covered are usually as per the National Immunization Scheme (India).

Terms related to maternity coverage

The maternity coverage is subject to specific terms and conditions. Some of these include the following:

a) Waiting period:

 Maternity coverage is subject to a certain waiting period, usually in the 2 to 4 years range. The insured person should have continuous coverage during the specified period since the policy’s inception.

b) Maternity coverage amount :

The maternity coverage amount is specified. It is usually a fixed amount or a specified percentage of the sum insured. Most policies specify the amount separately for a normal and caesarean (C-section) delivery.

c) Scope of coverage :

Apart from child delivery, the coverage may include expenses related to medically necessary and lawful termination of pregnancy. Any deductible applicable to the base health insurance plan will also apply to the maternity benefit. The expenses incurred for the harvesting and storing of stem cells may not be covered under the maternity benefit. The insurer may include an age range during which the maternity benefit may be availed. For example, some insurers specify that the maternity benefit can be availed only between 18 to 45 years.

d) Number of pregnancies :

Most plans specify the number of pregnancies covered (child delivery or pregnancy termination) during the insured person’s lifetime.

Need for maternity cover

In the last few years, medical inflation has grown at a much faster pace than general inflation. Along with other medical procedures, the cost of delivering a baby at the hospital has risen significantly in the last few years. In the metros and Tier-I cities, the hospitalisation bill for a normal delivery can be range between Rs. 25,000 to Rs. 75,000 depending on the city, the hospital, the type of hospital room, the length of hospital stay, etc.

In the case of a caesarean delivery, the hospitalisation bill can range between Rs. 50,000 to Rs. 1 lakh . Any complications during delivery may require the mother/baby to stay longer in the hospital for treatment/observation adding to the hospitalisation bill. In such a scenario, it is important to have maternity coverage as part of your health insurance plan.

Some of you may have maternity coverage as part of the group medical insurance provided by your employer. However, check the maternity cover amount. If the coverage amount is inadequate, it is recommended that you go for a personal health insurance plan with a maternity cover. For availing of the maternity benefit with a personal health insurance plan, consider the waiting period while planning your baby. Check the scope of the maternity coverage under the health insurance plan, and the insurance company's list of cashless network hospitals.

How to avail maternity coverage?

You may avail the maternity cover in one of the following ways:

a) Some health insurance plans provide maternity cover as part of the base health insurance plan.

b) Some health insurance plans provide the maternity benefit as an optional add-on benefit or a rider.

Maternity coverage with ManipalCigna

ManipalCigna Health Insurance provides Maternity, New Born and One Year vaccination expenses as an optional package with ManipalCigna ProHealth Prime a complete healthcare insurance plan. The maternity benefit is provided with the Protect and Advantage variants of the plan.

Maternity expenses :

The maternity benefit covers the hospitalisation expenses related to a baby's delivery (normal or caesarean). It also covers the pre and post-natal maternity expenses. The coverage amount is 10% of the sum insured (subject to a maximum Rs. 1 lakh) per delivery.

The maternity coverage is provided for a maximum of 2 deliveries or terminations during an insured person's lifetime. The female insured person should have been continuously covered under the policy for at least 36 months before availing of the maternity benefit.

The deductible applicable to the base health insurance policy also applies to the maternity benefit. The medical expenses incurred on the harvesting and storing of stem cells are not covered.

New born baby expenses 

The maternity benefit covers expenses incurred towards the treatment of a new born baby when the insured mother is hospitalised for delivery. The expenses incurred on the baby during and post birth up to 90 days from the delivery date are covered. For continued coverage, the baby can be included in the policy by payment of requisite payment and subject to the company's underwriting.

First year vaccinations 

The expenses incurred towards the new born baby's vaccinations are covered under the maternity benefit. The vaccinations covered are as per the National Immunization Scheme (India) till the baby completes one year. The list of vaccinations covered includes the following.

Maternity cover: Be financially prepared to welcome your bundle of joy 

As discussed earlier, the hospitalisation cost of delivering a baby has increased significantly in the last few years. However, don't let that cost come in the way of welcoming your bundle of joy into this world. Be prepared with a comprehensive health insurance plan with maternity coverage. That way, the insurance company will take care of the delivery expenses. It will set you free to focus on the celebrations related to the arrival of your child.