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Check waiting period for maternity cover

Entire expense of a delivery may not be covered. There are specific limits for both normal and caesarean deliveries

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Maternity is one of the most joyous moment in a woman's life. Today, you can plan for this financially by securing maternity-related expenses with new-age insurance products. If you are considering this option for yourself, here's what you should know before purchasing health insurance with maternity benefits:

When to avail maternity benefits and waiting period

Benefits of maternity insurance policies vary across insurance companies. Many provide basic benefits to cover the delivery of the child while there are others that go the extra mile too.

To avail the benefit of health insurance with maternity, the one thing to keep in mind is that you need to enter into such plans well in advance as the product comes with a waiting period that ranges from nine months to six years. This means, benefits in the policy are not applicable if you are already pregnant. This is because the maternity term is considered pre-existing by insurance companies.

Many plans provide the maternity benefit for up to two deliveries. But there needs to be a gap between the two deliveries as specified in the policy (generally two years) for the second baby to arrive. Such plans are useful for couples who are planning a second baby.

Most common coverages

Pre- and post-natal expenses - These include expenses incurred prenatal (before birth) and post-delivery (after birth expenses) involving treatment and training to ensure a healthy pre-pregnancy, pregnancy, labor and delivery for the mom and baby. Most of the policies do not have a separate limit for the same. So the maternity amount limit covers this.

Maternity expenses - This includes the delivery charges whether normal or caesarean section for a maximum of up to two deliveries. These expenses vary as per the insurer. The cost ranges from:

Normal delivery : Rs 15,000 to Rs 50,000

Caesarean section delivery : Rs 35,000 to Rs 50,000

Newborn baby cover - This covers costs incurred for taking care of an infant's support system, special medical procedures, or birth defect-related issues upto a certain limit.

Pre- and post -hospitalisation expenses

This is related to the pre- and post-hospitalisation expenses during maternity. The number of days for pre-hospitalisation is 30 and post hospitalisation is 60 days in general.

Vaccination cover - There are few insurance policies that will cover the costs of specific vaccinations which are made mandatory by the Government of India.

There are specific exclusions applicable to the maternity benefits. Some of them are :

An ectopic pregnancy is not covered

If a pregnancy is terminated within the first trimester, those expenses are not covered. A woman more than 45 years of age cannot claim maternity benefits

Policies may not always cover the entire expense of a delivery, normal or caesarean. There are specific limits mentioned for both

The major downside of these policies is the higher premium. Few employees are also covered by group mediclaim policy that's provided by the employer which covers maternity and new born expenses. One must utilise that first and for the balance look for individual covers as per their needs.

WHAT IS NOT COVERED

  • An ectopic pregnancy or a pregnancy terminated within the first trimester 
     
  • Entire expense of a delivery may not be covered. There are specific limits for both normal and caesarean deliveries

The writer is Assistant Vice President-Insurance Practice, 5nance.com

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