What is Maternity Insurance | Maternity Insurance in India | SBI Life
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What is Maternity Insurance | Maternity Insurance in India | SBI Life

Insurance Basics & Financial Advice Wondering what is maternity insurance? It is a specific health insurance plan that offers coverage for expecting and pregnant mothers and couples planning to start a family soon. It can be summed up as insurance for pregnancy, which covers various expenditures associated with childbirth that are not otherwise covered by regular health insurance policies.

What is Maternity Insurance | Maternity Insurance in India | SBI Life

8 Minute |

What is Maternity Insurance | Maternity Insurance in India | SBI Life

What is Maternity Insurance?

Wondering what is maternity insurance? It is a specific health insurance plan that offers coverage for expecting and pregnant mothers and couples planning to start a family soon. It can be summed up as insurance for pregnancy, which covers various expenditures associated with childbirth that are not otherwise covered by regular health insurance policies. Sometimes, it can also be an add-on coverage with a family health policy, which helps families prepare for this major milestone without any financial worries.

When purchasing maternity insurance, you should closely look at the waiting period, which will vary between 6 months and 2 years in most cases. You can file claims under this policy for the costs that are covered after the expiry of this waiting period. Some insurance companies may offer coverage to pregnant women, although it will be costlier in case you wish to waive this waiting period.

Why Do You Need Maternity Insurance

Maternity insurance plans can be advantageous for newly-wed couples and those planning to start a family down the line. It offers the following benefits:

  • These plans ensure higher financial security, especially with the increase in healthcare and treatment costs. It is always important to safeguard your family with not just life insurance but also adequate health and maternity insurance. These plans can cover the costs of welcoming your baby, thereby helping you avoid dipping into your savings and investments.
  • They also enable higher mental peace since a financial crisis or depleting funds may be problematic when you’re bringing your baby home.
  • You can easily file cashless claims across network hospitals, which makes the whole process simpler, enabling you to avoid lengthy and complicated paperwork. You can enjoy the birth of your little one without worrying about all these aspects.
  • There are tax benefits on the premiums you pay for maternity insurance under Section 80D of the Income Tax Act, 1961.

What Does Maternity Insurance Cover?

Various expenditures are covered under maternity insurance plans, including the following:

  • Post- and pre-hospitalisation costs for childbirth: This category includes the doctor's consultation fees, charges for operation theatres, emergency ambulance charges, and so on. Some insurers offer coverage for up to 30 days of hospitalisation expenditures before delivery and post-hospitalisation costs for up to 60 days after the delivery.
  • Post- and pre-natal expenditure for mothers and children: Expectant mothers will usually require frequent trips to the hospital or clinic for testing, medication, and other consultations. Maternity insurance may also offer coverage for these costs.
  • Medical costs for newborn babies: In most cases, these plans offer coverage for the expenditure required to maintain the infant’s health for up to 90 days from birth. This includes doctors’ fees, hospitalisation costs, and so on. This is helpful in case of any unwarranted complications.
  • Vaccination expenditure: Infants usually require multiple vaccinations within the first year of birth. These costs may also be claimed with maternity insurance plans.

It is essential to remember that the inclusions under these policies depend on the insurer and the type of policy.

What Is Not Included Under Maternity Insurance Plans?

Here are the exclusions under maternity insurance policies:

  • Health supplements purchased by the expecting mother
  • Costs for infertility treatments
  • Costs of storing and harvesting stem cells
  • Expenditure on pre-delivery medical testing and consultation in some cases
  • Ectopic pregnancy-related costs
  • Hospital cash benefits
  • Post-hospitalisation costs in some cases
  • Regular medical checkup costs
  • Pre-hospitalisation costs in some cases
  • Surrogacy expenditure

When to Purchase Maternity Insurance?

It is important to buy maternity insurance at the right time to harness its benefits more effectively. You should ideally purchase this coverage well ahead of expected delivery in case of a planned pregnancy. This is because most of these policies have waiting periods. In an ideal scenario, you should buy it at an early stage after you get married or anytime you both choose to start a family in the future. This will help you get coverage for pre-existing medical conditions like diabetes and high blood pressure, which may require treatment during delivery. Getting this coverage at least two years before starting a family will help you cross the waiting period in most cases.

Importance of Maternity Plan

Maternity insurance plans are immensely important, considering how they offer financial safety to those starting a new family. Healthcare costs are rising steadily and may go up even more in the future, so this plan matters because it offers coverage for almost all kinds of maternity-linked hospitalisation and other costs.

It also ensures financial coverage for newborn babies for up to 90 days from birth. This helps meet the necessary expenses in case of any congenital or critical ailments. The expenditure of both normal and Caesarean deliveries will be covered seamlessly, along with post-delivery complications, if any. These policies help you avoid breaking investments or depleting your savings to meet such expenses. You can focus on the birth of your baby without worrying about your finances. This brings higher mental peace, which matters a lot.

Features of Maternity Plan

Here are some of the expected features of maternity insurance policies (which may vary across insurers):

  • Coverage for daycare treatments
  • Ambulance coverage
  • Hospitalisation coverage (operation theatre, room rent, anaesthetist, doctor fees, C-section delivery, normal delivery)
  • 9-36 months in waiting periods
  • Cashless claims in network hospitals
  • Post- and pre-hospitalisation up to 60 days and 30 days, respectively
  • Newborn cover (vaccination, medical treatments)

What Factors Should You Consider While Buying a Maternity Insurance Policy?

Here are a few crucial factors that you should remember while purchasing maternity insurance plans.

  • Waiting periods: You must complete these periods before you can claim benefits under these policies. Look for policies with shorter waiting periods in this case.
  • Eligibility: Some plans may have specific age limits and other eligibility factors. Narrow down your search by shortlisting policies for which you are easily eligible.
  • Newborn benefits: Intensive care may be necessary for an infant's first few months of life. Hence, look for newborn baby coverage and benefits, including vaccination coverage.
  • Number of kids: Most of these policies offer coverage for up to two children.
  • Additional advantages: Look for coverage for expenditures arising due to medical complications and other aspects.
  • Medically-necessary abortion: Doctors may sometimes advise the termination of a pregnancy owing to severe complications. Look for plans that cover the costs of the same.

Documents Required to Claim Maternity Insurance

The applicant's age is usually between 18 and 45, although it may vary. Maternity coverage may also be offered for up to two deliveries. On that note, here are the documents that are usually necessary to purchase maternity insurance.

  • Pre-authorisation/insurance claim form, which is filled up
  • Policy documents
  • Original medical treatment reports/bills/receipts
  • Discharge details from the hospital
  • Passport-sized photograph
  • Doctor’s consultation bills and prescriptions
  • KYC documentation

FAQs

Is maternity insurance worth it?

Maternity insurance is always worth it since it covers the costs of hospitalisation and delivery while also offering coverage for the newborn until a certain time in most cases. It helps stay financially secure in terms of meeting these costs.

Which insurance is best for pregnancy?

Maternity insurance is the best insurance plan for pregnancy. You should take it when you are starting a family or planning to start one. It will cover all costs related to delivery and medical treatments linked to childbirth.

How to claim medical insurance for maternity?

You can get cashless claims from network hospitals in case you inform your insurer within 24 hours. Then, you will have to fill up a pre-authorisation form, get the request verified, and then your claim will be sanctioned. It will be settled directly with the hospital thereafter. For reimbursement claims, you have to pay the bills and keep all the receipts and other documents securely. You can then register your claim with the insurer, submitting all these documents to support the same. The insurer will verify your claim and then approve/reject it as per its stated guidelines.

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