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Maternity Health Insurance Plans - An Overview

Maternity health insurance covers are designed in such a way that they provide coverage against the maternity expenses faced by a person. These covers typically come with a waiting period before coverage can come into effect.
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What is Maternity Health Insurance?

Maternity insurance provides cover for maternity-related expenses. According to latest reports, the average age of women becoming mothers has risen to 32 to 33 years in India. There is a view that women who have their first child in their early 30s are more likely to have complicated pregnancies. Significantly, the ratio of caesareans to normal deliveries stood at 65:35 in metropolitan cities, according to a study done in the recent past. Several women are, therefore, increasingly opting for health insurance plans which offer maternity expenses as well. Typically, maternity insurance plans come with high premiums and long waiting periods.

Maternity-related expenses are covered in the form of riders of a health insurance product (policyholders will be charged additional premium for the cover). In some cases, maternity coverage comes under the ambit of OPD related expenses. In other cases, group policy in the company encompasses maternity insurance.

Features and Benefits of Maternity Health Insurance:

The salient features and benefits of health insurance for maternity coverage are listed in the table below:

Features Description
Waiting period Most maternity health insurance policies have a waiting period of 3 to 6 years in that a policyholders can claim benefits only after the said period of time post commencement of insurance policy. Group insurance policies which offer maternity coverage have a waiting period of 9 months (sub-limit not above Rs.50,000)
Inclusions/Coverage Varies according to the insurance provider but the general expenses which may be covered are as follows:
  • Hospitalization expenses (with a cap)
    • Pre-hospitalization expenses:30 days
    • Post-hospitalization expenses: 60 days (room charges, nursing expenses, anesthetist charges)
  • Delivery expenses
  • Vaccination of the infant (some cases)
  • Ambulance charges
  • Pre and post-natal expenses (depends upon the type of delivery - caesarean and normal)
  • Baby cover (if newborn is diagnosed with congenital disorders)
  • Emergencies (several insurance providers cover emergencies for up to Rs.50,000)
Premium A health insurance policy with maternity benefit is expensive as it is considered a high risk product owing to almost 100% claim ratio as opposed to other insurance policies. Premium, which is typically higher than basic policies, depends upon various factors as listed below:
  • Type of industry
  • Risk factors
  • Age profile
  • Number of employees (group policies)
  • Company location (group policies)
Maternity Insurance Plans

What's the Right Time to Seek?

Maternity is a life-altering journey for a women in more ways than one. With rising medical inflation and overall expenditure, childbirth-related expenses have become expensive. Lack of proper planning may result in you burning a hole in your pocket which may override the happiness of being blessed with a child. According to experts, you should plan well in advance given that maternity health insurance policies, typically have a long waiting period, which may prove to be tricky for most consumers.

Given that most insurance companies do not offer maternity health insurance to women who are already pregnant, deeming it as a pre-existing condition, women who wish to take maternity insurance should apply for it before they conceive. It is important to note that most maternity health insurance policies have a waiting period of 3 to 4 years. Maternity health insurance is, therefore, a critical aspect of a planned pregnancy.

Exclusions of Maternity Health Insurance:

  • Non-allopathic treatment costs
  • Consultation fees
  • Regular check-ups
  • Medicine costs
  • Congenital diseases
  • Termination of pregnancy (under 12 weeks)
  • Pre-existing ailments or injuries diagnosed within 48 months of the policy commencement
  • Expenses related to self-inflicted injuries, drug use or alcohol
  • AIDS treatment-related expenses
  • Dental treatment expenses
  • In-vitro fertilisation and infertility-related expenses

Maternity Health Insurance Claims Process:

While the claim process may vary from one insurance provider to another, in most cases, policyholders have to follow the below mentioned procedures

  • Claim intimation (Emergency cases within 24 hours of hospitalisation and planned hospitalisation within 48 hours)
  • Cashless pre-authorisation entails the following:
  • Fill out the pre-authorisation form available at TPA desk or download it from the insurance provider’s website.
    • Upon receiving the pre-authorisation form, the claim management team of the insurance company sends a letter of approval
    • You can then file for your re-imbursement claim
  • Re-imbursement claim process entails the following:
    • You have to fill in and submit the claim form in addition to the documents required to the insurance company
    • Upon receiving the said form, the claim management team of the insurance company sends a letter of approval

Some of the Maternity Insurance Plans:

The following are some of the maternity health insurance plans available in India:

Company Name Plan Name Link to Plan Details
Max Bupa Heartbeat Family Floater Read more
Religare Joy Tomorrow Read more
Apollo Munich Easy Health Young Family Read more
Royal Sundaram Lifeline elite Read more
Star Health Wedding Gift Read more
HDFC ERGO Health Suraksha Gold Read more

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

Maternity Health Insurance Plans Reviews

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  • HDFC Ergo Health Insurance
    "Very good benefits"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance from HDFC ERGO which was purchased by me in the year of 2018 because the benefits are very good. The claim process was simple and they have more number of hospitals for cashless. I have paid 18,800 for one year and took 3 years policy for myself and my wife. The medical coverage is 10L for myself and 5L for wife.
    Was this review helpful? 1
    , bangalore
    Reviewed on Jan 14, 2019
  • HDFC Ergo Health Insurance
    "Good"
    0.5 3.0/5 "Satisfactory"
    I have taken health insurance from HDFC Ergo which was offered along my personal loan. I have received the insurance paper and its been couple of months. It covers critical illness and need to go through the policy benefits. Always the customer is good.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 14, 2019
  • ICICI Lombard Health Insurance
    "Good Health insurance provider"
    0.5 3.5/5 "Pretty good"
    This policy was part of my employment, I took the medical coverage of Rs. 5 lakhs for the tenure of one year, this medical benefits for my entire. They have good networks of hospital with major disease cover. But I think it doesn't have no claim bonus.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 11, 2019
  • Reliance General Health Insurance
    "On time approval with reliance"
    0.5 4.0/5 "Great!"
    For my spouse operation I used the health policy, I approached them for the claim through hospital. I submitted the form and they send the papers to the Reliance insurance company. I got the cash less treatment, but I paid some amount which was not covered. But they gave me the on time approval.
    Was this review helpful? 0
    , kolkata
    Reviewed on Jan 11, 2019
  • Cigna TTK Health Insurance
    "On time service"
    0.5 5.0/5 "Blown Away!"
    On time Cigna TTK have activated the policy which provided by the company, the policy which I hold it has the coverage of Rs. 4 lakhs its covers for me. They are providing coverage for the pre existing with the tax benefits but there is no claim.
    Was this review helpful? 0
    , dandeli
    Reviewed on Jan 10, 2019
  • Cigna TTK Health Insurance
    "Its Good"
    0.5 5.0/5 "Blown Away!"
    In Cigna TTK, they are providing pre existing disease cover, but they don't have no claim bonus features. The response is good they have good customer care working 24/7 , the medical coverage is good for me and entire family. They have many hospital which they got tie up in Mumbai.
    Was this review helpful? 0
    , mumbai
    Reviewed on Jan 10, 2019
  • Apollo Munich Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    I had taken this insurance policy a while back and i had been paying the premium amount on an annual basis. The premium method has been convenient and the premium amount has not been high. There has been many hospitals covered in my locality and their customer support has also been helpful.
    Was this review helpful? 2
    , pune
    Reviewed on Jan 09, 2019
  • ICICI Lombard Health Insurance
    "Good policy"
    0.5 4.0/5 "Great!"
    My organization has provided me a health insurance with ICICI Lombard. I have not claimed anything from this policy. My entire family has been covered in this policy. They have given me a coverage value of Rs. 3 lakhs. This is a cashless policy.
    Was this review helpful? 0
    , new delhi
    Reviewed on Jan 09, 2019
  • Star Health Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    My company has offered a health insurance from Star Health with the coverage of 1L, its for the family, Still I have not used the policy and am gone utilize the policy within 15 days for my family.They covers a major disease. I have called the customer service and the response is good. I am planning to go for reimbursement, they do have minor network of hospitals for cashless. I can recommend after completing my claim.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 09, 2019
  • National Insurance Health Insurance
    "Good"
    0.5 5.0/5 "Blown Away!"
    My company has provided me a health policy from National insurance with the coverage of 2L. It is for the family members and no claim. I never contacted the customer service. Every year it was renewed by the company. They have limited networks of hospitals for cashless. It does not cover only eye problems, if we got admitted in hospital for 24hrs then applicable for claim.
    Was this review helpful? 0
    , pondicherry
    Reviewed on Jan 09, 2019
  • ICICI Lombard Health Insurance
    "Good"
    0.5 4.0/5 "Great!"
    I have taken a health policy from ICICI Lombard by last month. They have offered the policy based on my credit card experience. They have charged 10,800 rupees as a premium per annum. The policy period us 3 years. Am satisfied with the policy benefits. The customer service is excellent and they have explained well.
    Was this review helpful? 0
    , pondicherry
    Reviewed on Jan 09, 2019
  • Apollo Munich Health Insurance
    "Good medical cover with Apollo"
    0.5 5.0/5 "Blown Away!"
    I got the medical cover of Rs. 3 lakhs its covers for my four persons, they got tie up with major hospital. I don't have any medical card but if I want to go for claim. There is a person who coordinate for Tata employee. They do have cash less treatment.
    Was this review helpful? 1
    , mumbai
    Reviewed on Jan 09, 2019
  • Star Health Health Insurance
    "Its Good"
    0.5 3.5/5 "Pretty good"
    I have taken the policy personally from my end for my parents. Star Health is providing pre existing disease cover, and major disease cover like heart disease and they do have no claim bonus. Senior citizen plan is good for the elders it has the medical coverage value around Rs.3 lakhs.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 09, 2019
  • review Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have been taken my health insurance with Adiyta birla health insurance, i have taken this insurance for all my family, per annum it is 25,00,000 policy coverage is there , and i have not yet took any claim yet, and there is tie up with many hospital and they have shared me those hospital location, the premium amount they have charged me up to 6000 for two years ,i use to pay.
    Was this review helpful? 0
    , ghaziabad
    Reviewed on Jan 08, 2019
  • Future Generali Health Insurance
    "Should include all the benefits"
    0.5 3.5/5 "Pretty good"
    For my wife I use my health policy for the maternity, the policy cover is not sufficient. For Normal delivery the money goes high, I got the 80% of reimbursement but when my child not well I requested for the admission of 24 hours, but they didn't accept for normal fever.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 08, 2019
  • Religare Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have been using my health insurance with Religare insurance from past few years, there service is good, they have tie up with many hospital , and they have shared me an excel with there location, and the agent had explained me clearly about the policy benefit, my company pay this health insurance premium.
    Was this review helpful? 0
    , jaipur
    Reviewed on Jan 08, 2019
  • Star Health Health Insurance
    "Best policy"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance policy with Star health from last 2 years, a premium of Rs 13000 has to be paid for this insurance policy. I have no claim experience so far with this insurance. They gave a coverage value of Rs 6 lacs and it is for family.
    Was this review helpful? 1
    , bangalore
    Reviewed on Jan 08, 2019
  • Bajaj Allianz Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    It has been four years since i had taken this health insurance policy and i had been paying the premium on an annual basis. The premium amount has been nominal and is not too high, most of the hospitals are covered in my locality and there has been cashless treatment available as well.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 08, 2019
  • Star Health Health Insurance
    "Good but need to improve little communication with the custo"
    0.5 4.0/5 "Great!"
    My health insurance policy was bought from Star. I did not have any claim experience so far. From 2009 onwards i have been renewing the policy with Star. They have to give free health check up to the pre-vilege facility. I purchased this policy for my family. Yearly i pay the premium of Rs. 10000 for the coverage value of Rs. 5 lakhs.
    Was this review helpful? 0
    , bangalore
    Reviewed on Jan 08, 2019
  • HDFC Ergo Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have taken my health insurance with HDFC ERGO, there service is good, there agent had explain me about the policy which is covered in this insurance and they have tie up with many hospital and they have shared me there location , and the premium amount they have charged me was nominal,they have charged me up to 5000 on yearly basis for 4,00,000 coverage,i use to pay through on line.
    Was this review helpful? 0
    , chennai
    Reviewed on Jan 08, 2019
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