While a maternity insurance may cover a host of pregnancy related expenses, there are few things the policy may not cover. This includes expenses arising due to harvesting and storage of stem cells when carried out as a preventive measure against possible future illnesses. The cover is also often only limited to the birth of two children.
Hospitalisation expenses are skyrocketing and medical inflation in India is in the double digits. The average cost of delivering a baby typically ranges between Rs 50,000-70,000. This could be higher in private hospitals or in the case of complicated deliveries. Taking a health insurance plan that has a maternity cover can take care of these expected expenses instead of paying out-of-pocket during hospitalisation.
What are the inclusions and exclusions of maternity health insurance?
The benefits offered under a maternity cover may vary from insurer to insurer.
It typically covers any expenses related to the delivery of the baby, including hospitalisation and room rent charges up to the specified sum insured, Nikhil Kamdar, Appointed Actuary at Digit Insurance told CNBC-TV18.com.
“Caesarean section deliveries, commonly known as C-section deliveries are also covered under the maternity cover. Any expenses arising due to pregnancy complications are also covered. Additionally, the policy covers any number of medically necessary and lawful terminations. Hospital expenses of the baby up to 90 days are also covered and include any post-natal care and required vaccinations during the specified period as well. Some insurers may also cover infertility treatment opted by the spouse,” Kamdar said.
While a maternity insurance may cover a host of benefits, there are few things the policy may not cover. This includes any expenses arising due to harvesting and storage of stem cells when carried out as a preventive measure against possible future illnesses. The cover is also often only limited to the birth of two children.
Ectopic pregnancy (a pregnancy in which the fertilised egg implants outside the uterus) is covered under the in-patient accidental and medical treatment, and is not considered under maternity benefit.
ALSO READ | COVID-19 health insurance policies — Check premiums of 'Corona Kavach' and 'Corona Rakshak'
"Any doctor's visits for regular check-ups or diagnostic tests, too, aren't usually covered by the insurer. However, the same may be covered if the insurance policy contains coverage for outpatient treatment," Kamdar told CNBC-TV18.com.
What is the minimum waiting period for maternity cover?
The waiting period under maternity plan varies from insurer to insurer and may range anywhere between six months to four years in retail health insurance policies.
The maternity waiting period, if applicable, is insured-member specific and the female partner in the policy must have completed the specified waiting period before the coverage is applicable for the couple.
There is typically no waiting period for maternity benefits under the group medical cover offered by insurers to corporate companies.
How to choose the best maternity cover?
According to Kamdar, it is best to buy a maternity cover early if any couple is planning to start their family in few years.
"In many individual health insurance policies, maternity benefit might be an exclusion. Policyholders must check with their insurance providers if their plan covers maternity benefit or not. Buying a plan early can ensure any waiting period imposed is over by the time the couple plan to start their family," Kamdar said.
Also, the premium for any health insurance policy rises with age. Hence, buying a cover early in the married life may make more sense. Few insurers may also impose deductible, co-payment, or any other limitations or exclusions.
"Just like any other health insurance policy, customers must check the insurer’s claims settlement ratio, list of cashless network hospitals empanelled by the insurer in the city," Kamdar added.
Is there tax benefit?
All health insurance policies offer tax exemption of up to Rs 25,000 in a financial year under Section 80D of the Indian Income Tax Act.
A deduction of up to Rs 50,000 is available in case the family floater plan has a senior citizen member. However, tax exemption would not be applicable if the maternity benefit is being offered by the employer under a Group Medical Policy and the premium is being borne by the company.
ALSO READ | Insurance 2022: Consumer-friendly rules, tech adoption major trends — what's in store for 2023?