What do You need to Know About Maternity Coverage in Health Insurance?

Childbirth is that phase where, as parents, you need to plan for your future and that of your newborn. Since there is a child born, it will need medical attention. Moreover, the birthing process also requires special procedures to get the child out. All this can drive up expenses and gradually deplete your savings. So, in such cases, buying maternity health insurance would be the right thing to do. However, you should be careful about it and not jump off to buying one just because you may think it has all you need.


What is a Maternity Health Insurance Policy?


You must know as much as you can about health insurance with maternity coverage before buying one. The first step to buying maternity health insurance is to learn all you can about the available plans, the lenders that offer them, and, more importantly, the coverage. Many lenders, such as NAVI, offer comprehensive maternity plans. So, you ought to check for them.


Though complicated, you can still get the most out of your maternity insurance policy. So, do some research, gathering information about the different plans. Maternity insurance plans are add-ons for regular health insurance. These plans cover maternity-related expenses, including child delivery and care, infertility, and pregnancy termination. Since health insurance with maternity cover are add-ons, you will need to buy health insurance before availing of them.


What Does Health Insurance with Maternity Cover?


Most maternity health insurance plans are comprehensive and cover the following maternity-related expenses.


1) Hospitalization:

Maternity health plans also cover pre-hospital and post-hospitalization expenses, not to mention maternity-related hospitalization charges.


2) Pre-natal and Post-natal Expenses:

These policies also cover pregnancy-related charges, including pre-natal and post-natal expenses.


3) New Born Baby Care:

Most maternity health insurance plans are comprehensive enough and cover caring for the newborn.


4) Vaccination:

Maternity health insurance also covers vaccinating newly born infants.


Need for a Maternity Health Insurance Policy:

Maternity insurance comes with many benefits, especially for young couples, although it is an add-on for regular health insurance.

These policies help couples who are about to have a child, or even those, getting ready to marry, plan for, and secure their child’s future.

So, here’s what buying a maternity health insurance policy can do for couples:


1) Financial Stability:

Buying maternity insurance plans can help the couple become financially stable and secure their and their child’s future. These policies don’t cost as much as regular ones since they are add-ons, and you can avail of them quickly.


2) Smooth Transition to Parenthood:

Maternity insurance covers almost all aspects of parenthood, from child delivery to newborn care and beyond. So, as parents, you can rest assured that your child’s future is in safe hands.


3) Coverage for Legal and Medically Necessary Terminations:

You need to terminate the pregnancy in some cases due to complications. These terminations are legal and medically necessary, and maternity insurance covers the hospitalization and procedures.


4) Other Long-Term Benefits:

Maternity insurance offers various other long-term benefits for parents. For instance, you can get up to a 200% increase on the sum insured when your second child is born. However, you must use the same benefits you used for your first child.


What Does Maternity Health Insurance Not Cover?


A maternity health insurance policy covers most things related to pregnancy and childbirth. However, some aspects are exempt, as outlined in the terms and conditions of the policies. These may include:

  • Supplemental medications (tonics and vitamins).
  • Diagnostic tests and doctor consultations.
  • Infertility treatment costs.
  • Charges incurred for harvesting and keeping away stem cells safely as a precautionary measure.
  • Additional costs incurred as per the terms and conditions.


Benefits of Maternity Insurance Plans


Medical expenses are high in India, especially concerning pregnancy and maternity. So, buying a maternity insurance policy is sensible, as it helps cut costs. However, that’s only part of what a maternity insurance plan can do for the policyholder, and you have various other benefits.

  1. Maternity insurance covers hospital expenses, including room rent and other costs.
  2. It also covers pre- and post-hospitalization expenses, thereby reducing the overall cost.
  3. Similarly, pre-and post-natal care cost coverage is another benefit of maternity insurance.
  4. There are tax benefits under Section 80D for the premium that you pay for your maternity insurance coverage, according to the Income Tax Act of 1961.


Claiming Maternity Health Insurance


Claiming your maternity health insurance requires submitting documents and going through standard processes. However, you must first know if you can buy a maternity health insurance policy.


1) Eligibility:

You must be between 18 years and 45 years to buy maternity health insurance. You can also buy these plans for your children if they are at most 24 years, although it may vary, depending on the insurance provider.


2) Documents:

You will need to submit a set of documents for processing your claims. Though these may vary depending on the provider, having the following documents ready can help you when filing a claim.


  • A duly filled claim form.
  • Policy documents.
  • Admission advice form
  • Discharge summary form
  • Fitness certificate.
  • KYC documents.
  • Doctor consultation fees.
  • Medication bills.
  • Original hospital bills.


3) Process:

There are two ways to claim your maternity insurance: cashless and reimbursement. As mentioned, most insurance providers have standard procedures for processing maternity health claims that may involve the following steps.


  1. Let your insurance provider know about the hospitalization and delivery.
  2. The hospital verifies and sends the claim documents to the insurance company.
  3. The insurance company will then directly pay for the expenses covered in the policies if the hospital is part of the network.
  4. If the particular hospital doesn’t come under the network of hospitals that the insurance company caters to, you cannot file a cashless claim, and you will get a reimbursement.
  5. The insurance company will process the reimbursements after you pay the bills upon discharge and submit the documents.




There may be cases where you cannot file claims. So, remember to go through the terms and conditions of your policy carefully before buying maternity health insurance. That way, you will also know what the plan covers, and you can plan how to go about it. Maternity health insurance plans are add-ons for regular health insurance and are not separate insurance policies. So, while they are much cheaper than standard health insurance plans, many are comprehensive and cover most expenses related to pregnancy and maternity.

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