Maternity insurance takes care of expenses related to childbirth for women, extending to pre and post-natal care, newborn child health expenses and even vaccinations in the first year. The insurance industry may not have standardised this section as there is a wide variance in the offerings. Compared to unknown risks that are covered in insurance, the planned nature of hospitalisation in maternity may be the reason for lack of maternity insurance.

We look at the few policies that offer maternity coverage and the associated conditions that one must be aware of before signing on.

Base covers

Group insurance provided by employers is at the top of the pecking order as regards maternity coverage as these policies have day one coverage. The sub-limit may range from ₹25,000 to ₹50,000 for a normal delivery and 10-20 per cent more for a caesarean or c-section. Compared to other insurance that may have a waiting period ranging from two to four years, day one coverage and sufficient cover make group covers highly appropriate. Depending on the plan negotiated, other expenses associated with maternity (newborn baby cover and natal care) may also be covered.

Care Health Insurance offers a discount on maternity charges up to ₹25,000 for procedures undertaken in its network of hospitals. This is provided from day one, so effectively makes for a decent cover even if actual maternity cover is not provided. Tata Medicare provides maternity cover in its base policy, which implies that cashless transactions and other features of the base policy can be applied to maternity cover as well. These would include ambulance, pre- and post- hospitalisation expenses and others. But the waiting period for maternity cover is four years.

Also read: New-age insurance covers for women

Tata Medicare provides a sub-limit of ₹60,000 in case the newborn is a girl child and up to ₹50,000 in case of a boy child. Bajaj Allianz also has a longer waiting period of six years for maternity. But on the other hand, it provides a cover for the newborn for a period of 90 days. The sub-limit, though, at ₹15000 and ₹25000 for caesarean delivery may fall short in any facility, Tier-I to Tier-III.

These features for Care Health, Tata Medicare, and Bajaj Allianz are for a sum insured of ₹5 lakh and mostly remain the same for higher sum insured limits as well. Digit insurance has an increasing sub-limit with a waiting period of 9 months. The maternity sub-limit starts from ₹15,000 in the first year (after nine months) and increases by ₹10,000 every year till an upper limit of ₹1,00,000. This is called the maternity wallet and the same cover is made available to the newborn as well for a period of 90 days.

Other insurers including Niva Bupa, SBI General Insurance, and Aditya Birla may not provide maternity covers in their base policies but may offer it as an optional add-on. Aditya Birla offers a maternity add-on that covers maternity expenses, new born baby cover and vaccination packages.

Targeted covers

Star Health’s Woman Care insurance offers a comprehensive package in this regard and is targeted at women policyholders. The waiting period is two years for maternity coverage and the sub-limit is ₹25,000 for the procedure, which is offered twice in the policyholders’ lifetime. The newborn is covered by the existing policy of the woman policyholder who was covered in the maternity plan. The newborn is offered a sum insured of 25 per cent of the policyholder’s sum insured for the first year. From the second year, the child would have to be included in the plan for a fee for coverage.

Policyholders who are already pregnant can also purchase the policy, which allows for newborn coverage even if maternity will not be covered (since two-year waiting period is needed).

Additionally, the policy covers assisted reproduction treatment in the base policy itself. These treatments provide a sub-limit of ₹50,000 for a ₹5-lakh policy and gradually increase up to ₹3,00,000 for a ₹1 crore policy per year. Even outside of maternity covers, such treatments, which cover IVF and other procedures, are rarely included in other insurance policies.

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