How Does maternity Health Insurance Work?

Planning to have a baby? That’s great news! You can use maternity health insurance to cover pre- and post-delivery expenses and much more. Learn more here!

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Everything You Need to Know About Maternity Health Insurance

Motherhood is one of the best experiences in a woman's life and is often considered a divine process that shows us exactly how wondrous nature can be. But it is also a fact that motherhood comes with its fair share of problems. It becomes nearly impossible to deal with these issues and problems until and unless one is well-prepared for it. Apart from the medical issues that accompany pregnancy, financial expenses are also a cause of concern for many families. This is where the utility of maternity health insurance comes to the fore as it is a health insurance plan offered by various insurers and is specifically targeted toward women who are planning to have a family in the near future.

What exactly is maternity health insurance?

Maternity insurance, in simple words, refers to the insurance coverage that females receive concerning the medical expenses that accompany pregnancy as well as post-pregnancy procedures and treatments. Now, corporate enterprises also offer such facilities for their female employees by subscribing to maternity insurance policies for their benefit. However, these policies generally have a fixed upper limit, and upon exceeding that, the mother will have to pay out of her pocket.

Benefits of maternity insurance

Now the big question – what benefits can you receive from investing in quality maternity insurance? Here are some of the most interesting benefits of maternity health insurance: -

  • Maternity insurance can be your lifesaver in the case of unplanned pregnancies and also during planned pregnancies when the couple or the mother is/are not financially secure to bear the financial burden of all of the pregnancy-related costs. In fact, according to studies, the cost of delivery in a hospital can sometimes run into lakhs of rupees, depending on the situation. Maternity insurance provides much needed financial support in such situations.
  • Many expenses will arise in the baby's natural course post-delivery, such as those related to vaccinations and basic sanitation necessities. Having maternity insurance can help you avoid the full burden of all the expenses and at the same time, keeps your financial condition healthy and secure.
  • While most maternity insurance policies only cover the cost of up to two deliveries and babies, maternity insurance also offers insurance coverage of the room rent payable at the hospital. Maternity insurance does not kick in only after a baby is born. More and more insurance providers are not offering insurance coverage for infertility-related treatment, any costs arising out of pregnancy-related complications, and medically and legally justifiable terminations of pregnancy.
  • Many insurance policies targeted toward to-be mothers also offer insurance coverage on the newborn baby's expenses for a fixed period that the insurance companies decide. Expenses toward timely vaccinations of the baby and other related medical costs are included in most maternity insurance policies. However, in the event of an ectopic pregnancy, insurance coverage is generally not provided under the maternity insurance policy, rather is part of the insurance coverage offered under a health insurance policy that covers hospitalization charges and surgery costs.

Mode of payment under Maternity Health Insurance

In terms of the mode of payout, there are typically 2 options available under maternity insurance policies,

  • The first one is the cashless claim facility. It is regarded as the best option since it eliminates the hassle of handling tedious paperwork and making the payment upfront, and then going for a reimbursement. This mode of payment can be availed at partner hospitals of the insurance provider. While opting for the cashless claim facility, the medical expenses for pregnancy and any related treatment covered under the maternity insurance policy will be paid to the healthcare institution directly by the insurer.
  • The second option is filing a reimbursement claim for the expenses incurred during the pregnancy and delivery you wish to be compensated for after paying them from your pocket. Reimbursement claims are opted for if the hospital is not a network partner of the insurance company, and therefore, cashless claims are not provided for by them.

Who can buy maternity insurance?

Young women or couples who wish to start a family after a year or two are the primary customers of such maternity insurance policies. Additionally, parents who already have a child and wish to be prepared for a second one can also subscribe to a comprehensive maternity insurance plan. Last but not least, any woman or couple who are not particularly planning for children or a family in the foreseeable future but are simply taking steps to secure their financial status can also benefit from a maternity insurance policy.

One can only secure the benefits covered under the maternity insurance policy after the minimum waiting period that the insurance provider decides. Therefore, if the minimum waiting period is that of 1 year since the purchase of the policy, then any pregnancy-related costs incurred within 1 year of purchasing the policy will not be covered by the maternity insurance policy. Moreover, if you have already made use of the same maternity insurance policy for two children of yours, the third birth will not be covered under most insurance policies.

What are the advantages of maternity insurance policies?

Mentioned below are some of the standout benefits of a maternity insurance policy that you must be aware of,

1) Security of finances in unprecedented situations

Well, first and foremost, purchasing a maternity insurance policy will ensure that your finances remain safe and secure in the long run, even in the case of an unprecedented or unexpected pregnancy situation. Moreover, the costs incurred during the pregnancy will be part of the maternity insurance coverage and will, therefore, take the financial burden off your shoulders.

2) Focus can stay on parenthood

While childbirth can be the happiest event in your life, you won't be able to address it with your complete focus if you are worried about your financials. Purchasing a maternity insurance plan can help you offer complete attention to your child right from the time of birth.

3) Financial protection against medically terminated pregnancies

Suppose the unfortunate situation arises wherein a medical termination of pregnancy is required legally permissible. In that case, you can depend on the insurance coverage offered by the maternity insurance policy.

Maternity insurance policies are extremely necessary for today's time, specifically for young couples who wish to secure their financial situation in the long term without jeopardizing their family's future. There are various maternity insurance plans for you to choose from and a vast range of plans and benefits that can be tailored to meet your specific needs. Therefore, investing in maternity insurance is likely to be one of your best decisions, especially if you plan on having your children (or child) in the future!


  • When should I buy maternity health insurance plans?

    Ideally, you should consider investing in a maternity health insurance policy when you plan on having children with your partner in the foreseeable future. However, that future must start after the minimum waiting period of the insurance plan you choose. Additionally, you could invest in a maternity health insurance policy if you simply wish to financially safeguard yourself against unexpected costs of pregnancy and childbirth!

  • Can I get a maternity health insurance plan when I'm pregnant?

    It is highly unlikely that you can purchase a maternity health insurance policy and expect insurance coverage for a pregnancy present at the time of purchasing the policy. This is because most health insurance plans, especially maternity insurance policies, have a minimum waiting period of at least 9 months. The policyholder can claim no benefits under the policy. An existing pregnancy at the time of purchase is viewed as a pre-existing condition and is typically not covered under maternity insurance policies.

  • What is the waiting period for maternity insurance?

    Most maternity insurance providers stipulate a minimum of 9 months from the date of purchasing a given maternity insurance policy as the waiting period before the benefits under the maternity insurance policy can take effect. However, different insurance providers stipulate different waiting periods for maternity insurance, and these waiting periods can even be as high as 2 years. Therefore, be sure to double-check the waiting period for the benefits of the policy you wish to purchase and ensure that it falls in line with your long-term plans.

  • What are the eligibility criteria for maternity health insurance?

    The eligibility criteria are that one must be an adult and below 45 years of age (in most cases) to secure a maternity health insurance policy.

  • What is maternity health insurance, and how does it work?

    Maternity health insurance refers to the insurance coverage offered by health insurance providers as either a rider on an existing health insurance policy or as a separate insurance policy altogether and is targeted toward financial security in the event of pregnancies and deliveries of children. While certain pre-natal and post-natal expenses are not covered under most insurance schemes, the majority of the expenses and post-birth expenses of a child for up to 90 days (on average) are covered by maternity insurance policies. Typically, maternity insurance schemes kick into action only after completing the minimum waiting period, following which most medical expenses related to the pregnancy and the subsequent childbirth are paid for by the maternity insurance policy provider. This payout could either be cashless (available at hospitals that are a part of the insurance provider's network) or through reimbursement claims made by the policyholder.

  • How do I get health insurance for my newborn?

    Typically, most maternity health insurance policies offer health insurance coverage for newborn children for up to 90 days after their deliveries. After 90 days of their delivery, they become eligible for health insurance policies. Any medical expenses incurred toward their health in those 90 days after their deliveries are handled or covered under the maternity insurance policy.

  • What are the pregnancy insurance benefits for young couples?

    Young couples are likely to benefit from maternity insurance policies because it helps them secure their long-term financial goals and conditions despite being burdened with high costs that generally come along with a pregnancy. Moreover, it helps them stay relaxed about the prospect of parenthood and allows them to focus entirely on the quality upbringing of their children rather than constantly worrying about the costs related to childbirth and pregnancy.

  • Is pregnancy considered a pre-existing condition for health insurance?

    Yes, an existing pregnancy is considered a pre-existing condition for health insurance and is therefore barred from receiving the benefits under the policy for that specific pregnancy.

  • Is pregnancy termination covered under maternity insurance?

    Termination of pregnancy is covered under maternity insurance only under two conditions that are dependent on each other. The first condition is that the law must allow for the termination of pregnancy to be a legitimate one in the eyes of the law. Further, the termination of pregnancy must be required to preserve the health of the policyholder and must be deemed medically necessary to that extent.

  • Is 2nd childbirth covered under maternity insurance?

    Yes, 2nd childbirth is covered under maternity insurance. However, third childbirth is generally not covered under the same maternity insurance policy as most of these policies only allow for insurance coverage of up to 2 childbirths and pregnancies.

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