Maternity Cover In Health Insurance

Most of the health insurance plans do not cover maternity and related conditions but some companies like Apollo Munich, Max Bupa, HDFC Ergo, Royal Sundaram and Care health insurance have specific plans which cover maternity after specified waiting periods generally 2-4 years.

What is covered under maternity benefit?

It includes any hospitalization related to child birth, and also includes medical termination of pregnancy and pre/post-natal expenses. Maternity cover includes the following expenses:

  • Maternity related hospitalization - pre-hospitalization/post hospitalization expenses are covered up to specified number of days in some plans while excluded in others.
  • Delivery including Pre and post-natal expenses - Maternity insurance covers expenditure related to both caesarian and normal delivery, as well as post-delivery complications for the mother. Benefit limit for maternity and new born baby related claim is capped between Rs. 15,000-30,000 for normal deliveries and between Rs. 25,000 - Rs. 50,000 for caesarian births.
  • Hospitalization costs- This usually includes room charges, nurse and surgeon charges, anesthetist consultation charges, medical practitioner fees, and emergency ambulance charges.
  • New Born Baby cover (Day 1-90) - Coverage is also extended to infants in case they are diagnosed with a congenital disorder or some critical illness.

What is the waiting period?

Most health insurance plans cover maternity after a waiting period of 3/4 years. Care health insurance though has a specialized maternity plan, JOY, which covers maternity after a waiting period of 9 months only but the policy has to be taken for 3 years; also there's another option in the plan where waiting period is 2 years and policy is renewed annually..

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