What to Look For In a Maternity Insurance Plan Before Buying?

What is maternity health insurance? 

As the name suggests, this type of health plan has been specially crafted to allow coverage for pregnant ladies. Childbirth often involves heavy hospitalisation charges and surgery costs, too. Certain costs even continue post-childbirth. A maternity health plan targets to cover medical expenses for both the mother and the newborn during pregnancy and also during the postpartum phase up to a certain extent.  
 
However, in India, there is no standalone health insurance plan. Most maternity health insurance plans are comprehensive indemnity health insurance plans with maternity benefits. 

Factors to consider while choosing the best maternity health insurance in India: 

While purchasing a comprehensive maternity health plan, you need to consider certain crucial aspects to ensure the best coverage: 

1. Sum Insured 

Your chosen sum insured amount must be sufficient enough to cover all the relevant costs. Considering the sum insured amount, the features of the chosen plan might vary, too. Make a comparative study among all competent potential policies to choose the best-suited one.  

2. Exclusions 

Irrespective of the plan type or the sum insured amount, no health plan allows 100% coverage and maternity insurance is also no exception. Understanding the exclusions of the plan is essential to avoid any misunderstandings during emergencies and claim settlements. Certain common exclusions include PED waiting periods, initial waiting periods, etc.  

3. Waiting period 

The waiting period refers to the pre-determined tenure before the completion of which you cannot raise any claim for the concerned ailment(s) as per the terms of the chosen plan. Almost all maternity covers maintain certain waiting periods. You need to clarify all these details beforehand to avoid any unpleasant last-minute surprises.  

4. Newborn coverage 

A maternity insurance plan must typically cover for both the mother and the newborn. The newborn childcare expenses are always high, especially if there is even a minor glitch like neonatal jaundice or pre-term delivery, etc. Usually, newborns are allowed up to 90 days of coverage after delivery. However, this tenure may vary depending on the terms of the chosen plan. 

5. Premium 

Ideally, a comprehensive maternity insurance plan must allow extensive coverage at a reasonable rate. Pregnancy and childbirth require several expenses like new clothes, a cot/crib, hiring a nanny, etc. Therefore, maintaining a plausible financial budget and balance is crucial. 

6. Sub-limit 

This sub-limit refers to the optimum amount you can comfortably avail yourself of. If there is a capping on the ambulance charges, you need to pay for the excess amount. The sub-limit clauses vary from plan to plan. Consider it before zeroing in on any particular plan. 

7. Comparative study 

A critical comparative analysis between multiple competent plans is essential to make an informed decision before purchasing the best-suited maternity cover plan. It will reveal the optimum benefits that can be availed, maintaining an affordable approach.  

8. Network hospitals 

Every health insurance provider maintains tie-ups with several hospitals and healthcare facilities. Choose an insurer which maintains a wide network of hospitals to ensure better availability and accessibility to cashless hospitalisation facilities across the country.  

9. OPD benefits 

Ensure that your chosen maternity cover allows OPD coverage benefits or not. Ideally, it must include this facility. However, it varies depending on the terms of the concerned plan chosen.  

10. Riders 

You can enhance the coverage extent of the base plan by adding befitting riders to it. Insurers usually allow this facility in exchange for an additional premium for each rider chosen. However, to ensure the best coverage, try to stick to only the most suitable riders; otherwise, you may face unnecessary financial drainage.  

Benefits of having the best maternity insurance plan 

Maternity health insurance comes with a host of benefits: 

1. Financial backup: Considering steep medical inflation, having a reliable health plan always acts as a financial shield, especially during contingencies. 
    
2. Mental peace: Having a maternity insurance plan ensures you retain your peace of mind and enjoy the moment to the fullest without financial worries. 
    
3. Quality services: Having a maternity insurance plan allows you to access quality healthcare and services without worrying about the costs.  
    
4. Comprehensive coverage: An ideal maternity health cover allows coverage for much beyond basic hospitalisation costs. Depending on the terms of the chosen plan and the SI amount, this coverage may vary.