Bringing a new life into the world as a baby is an extremely joyful and life-changing experience. In India, the journey of pregnancy and delivery can be financially difficult, making maternity insurance an important consideration for expectant mothers.
However, the landscape of maternity insurance can be complex, especially when considering coverage after pregnancy. This article aims to expand on the scope of maternity insurance in India, addressing the possibility of getting coverage while already pregnant along with its scope, limitations, considerations and much more.
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What is maternity or pregnancy insurance?
Maternity or pregnancy insurance is a special health insurance policy designed to cover medical expenses associated with pregnancy, delivery, and sometimes postpartum care. This serves as protection against the substantial costs incurred during this critical period, including antenatal doctor visits, hospitalizations, delivery charges and certain complications that may arise during delivery.
Can you get insured under Maternity Health Insurance when you are pregnant?
In India, getting maternity insurance after pregnancy can be challenging. Most insurance providers prescribe a waiting period before the policyholder can claim maternity benefits, which often ranges from 9 to 36 months. As a result, purchasing a maternity insurance plan while already pregnant may not provide immediate coverage for the ongoing pregnancy. It is important to understand that insurance companies hesitate in taking out such policies due to the increased risk and potential adverse selection.
However, some insurers may offer plans with shorter waiting periods or extend coverage for pregnancy in specific circumstances, but these are the exception rather than the standard. Intended parents are encouraged to research insurers that may provide coverage for pregnancies in progress and review the policy terms carefully.
Also Read: Waiting Period in Health Insurance
What is not included in maternity insurance?
Maternity insurance generally comes with exclusions that policyholders need to be aware of. If the policy is purchased after pregnancy the usual exclusions include pre-existing conditions related to pregnancy. Additionally, expenses related to infertility treatment, voluntary termination, and certain complications arising from pre-existing health conditions may not be covered.
What is included in maternity insurance?
While the specifics of coverage may vary across plans, typical inclusions in maternity insurance include delivery (normal or cesarean), antenatal and postnatal counselling, diagnostic tests, medicines and sometimes, newborn for a limited period after delivery. Child care involves the cost of hospitalization.
Additionally, some policies extend coverage to include complications that arise during pregnancy or delivery, such as gestational diabetes, pre-eclampsia, emergency cesarean section, and other medically necessary procedures.
Maternity insurance cover with health insurance
Many health insurance plans in India include maternity benefits as an add-on or rider. These plans often require a long waiting period before offering maternity coverage. Thus, individuals considering pregnancy should opt for health insurance plans with maternity riders in advance to ensure coverage when needed.
Things to keep in mind while buying maternity insurance
When purchasing maternity insurance, it is important to consider several important factors:
- Waiting Period: Understand the waiting period prescribed by the insurer before the maternity benefit is accessible. Plan and secure insurance before you plan a pregnancy.
- Coverage and Limits: Evaluate the extent of the coverage offered, including specific inclusions and limits, maximum payment limits and any co-payment clauses.
- Network Hospital: Check the list of network hospitals affiliated with the insurer to ensure access to preferred healthcare facilities during pregnancy.
- Premium and affordability: Assess the premium cost compared to the coverage provided. Consider your budget and long-term financial implications before finalizing a plan.
- Policy Renewal and Continuation: Review the policy renewal terms to ensure uninterrupted coverage continuity for any complications that may arise during subsequent pregnancies or deliveries.
- Claim Process and Documentation: Familiarize yourself with the claim process, required documents and the ease of filing a claim for maternity related expenses.
Frequently Asked Question About Maternity/Pregnancy Insurance
Q: Can I buy maternity insurance after pregnancy?
Answer: While challenging, some insurers may offer coverage under specific circumstances or with a shorter waiting period, but there is almost no chance of getting this, so the suggestion is that you should plan ahead.
Q: Are antenatal checkups covered under maternity insurance?
Answer: Yes, most policies cover expenses related to antenatal consultation, tests and medicines.
Q: Does maternity insurance cover complications during delivery?
Answer: Some policies extend coverage for complications arising during pregnancy or delivery, but the specifics may vary.
Q: Can I claim for a planned caesarean section under maternity insurance?
Answer: Yes, subject to the policy conditions, both planned cesarean section and normal delivery are usually covered.
Q: Will newborn care be covered under maternity insurance?
Answer: Some policies provide limited coverage for newborn care immediately after delivery.
Question: Are there any maternity insurance plans with no waiting period?
Answer: No, often maternity insurance plans have a waiting period. This period usually ranges from the beginning of pregnancy to the first nine months of 3 years, after which insurance facilities are available.
Conclusion
Navigating maternity insurance in India, especially while pregnant, requires careful consideration of the policy terms, waiting period, coverage specifications and the insurer’s offerings. While securing coverage after pregnancy poses challenges, proactive planning and selecting appropriate insurance plans in advance can reduce the financial burden associated with pregnancy and delivery.
Ultimately, a comprehensive understanding of the nuances of maternity insurance enables prospective parents to make informed decisions, ensuring an easier and more secure journey to parenthood.