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Motherhood is one of the joyous periods of any woman’s life and this feeling of happiness comes as soon as you get to know about your pregnancy. However, pregnancy and motherhood come with a lot of responsibilities and expenses as well. From diagnostic tests to sonography to see the growth of your little one, everything cost much these days.
It is seen that in this roller coaster ride of 9 months before bringing a life into this world, you not only come across physical changes but financial changes as well. Since medical costs in India are rising day by day, it many times become difficult for a middle-class family to meet up all the expenses of pregnancy. In order to get funds for this beautiful experience, many couples are opting for medical insurance plans in India that provide maternity coverage.
You can purchase a standalone maternity insurance plan or add it as a rider in your existing health insurance policy. Generally, a standalone plan offers more coverage than a rider; however, it entirely depends upon you what you want to choose.
Enlisted are top 5 things that every expecting or one who is planning to conceive couple must know about maternity insurance plans in India:
1. Inclusions of a maternity insurance policy: #what is covered
According to IRDA’s circular on maternity insurance in the year 2013, all the health insurance providers in India have to include any hospitalization related to childbirth in their health plan. This may include medical termination of pregnancy, miscarriage, and other pre and post-natal expenses. Some common maternity expenses that are included in most of the policies are:
- Delivery Expenses: Be it normal delivery or a cesarean section, maternity insurance policies cover both. Apart from this, post-delivery health issues with the mother are also covered in most of the policies.
- Hospitalization Related to Maternity: Usually, all maternity insurance plans bear the pre & post hospitalization related to pregnancy as well. Most of the plans offer 30-days of pre-hospitalization and 60 days of the post-hospitalization period.
- Costs of Hospitalization: The room charges, fees of surgeon and nurse, anesthesia charges, fees of a medical practitioner, and the cost of the ambulance are covered in the majority of plans.
- Covers Infants (1 to 90 days): If your newborn is diagnosed with some critical illness or congenital disorder, then he/she is also covered from day 1 to day 90 in your medical policy for maternity.
2. Understand the Waiting Period of Your Maternity Plan
Every maternity policy has a waiting period which may vary from 2 years to 4 years. So, it is suggested to opt for a policy that has a waiting period according to your requirements. In this way, it is essential to purchase maternity health insurance soon after your marriage, even if you are not planning to have a baby soon. To check the waiting period, read the policy documents carefully.
3. Premium
One of the downsides of these plans is the high premium rates. Since the changes of filing a claim for such plans is 100%, thus the insurance providers offer them at high premium rates. So, in order to avail the financial benefits offered by a maternity plan, you have to pay a high premium.
4. Know the Exclusions
Like inclusions, it is also necessary to know the exclusions of your maternity insurance plan. The common exclusions that most of the maternity insurance policies possess are:
- The age of the insured willing to claim the maternity benefits can be up to 45 years.
- The maternity benefits offered by the insurance providers also have capping. For a normal delivery, the claim is capped in the range of Rs.15,000 to Rs.30,000. On the other hand, for a cesarean section, the claim is capped between Rs.25, 000 to Rs.50, 000. This is for sure insufficient, especially in the A grade hospitals of metro cities, but it can work as a help to reduce the burden of the incurred expenses.
- Pregnancy termination within 12 weeks from the conception date is not covered in most of the maternity plans.
- Medical termination of pregnancy due to ectopic pregnancy is also not covered in the majority of the plans.
5. How to Buy a Maternity Plan and Manage the Expenses
- Never make maternity cover the only criteria for purchasing your health insurance plan.
- In case you are working and your employer has provided a health insurance plan to you that offer coverage for maternity expenses, file claim from that plan without touching your own health insurance policy.
- Apart from that, if the incurred medical expenses exceed the cover offered by the policy of your employer, you can easily claim the balance from your own health policy.
- Try to fund your maternity expenses on your own. You can do that by investing your money in mutual funds and fixed deposits.
- It is always wise to purchase a maternity plan before you get pregnant as no maternity insurance provider covers an already pregnant woman. This is because there is always a waiting period associated with every plan. Therefore, it is suggested to decide the time to purchase the plan properly.
Final Words
A constant rise in the maternity costs over the years is the main force behind every purchase of medical insurance policies that offer maternity coverage. This is the reason most of the health insurance providers highlight the maternity benefit that they provide in their plan. However, before purchasing either a standalone maternity plan or an add-on, it is suggested to completely understand its inclusions, exclusions, and cost of the premium. Moreover, planning a separate medial fund to meet these requirements is recommended. So, plan accordingly and then purchase.
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This post is written in collaboration with Nidhi Mahajan —a partner of The Good Men Project.
Photo by Heather Mount on Unsplash