Are Maternity Benefits Covered Under Group Health Insurance?

In recent times, we have seen more and more corporates becoming highly employee-centric and leaving no stone unturned to provide their employees with need-based benefits. Thus, in many corporate group health insurance policies, maternity coverage is provided under the group insurance policy. It's important to review the specific terms and conditions of the group health insurance policy to understand the extent of maternity coverage provided.

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Whom do you want to insure?

  • Employee, spouse & kids

  • Employee only

Common Inclusions in Maternity Benefits

Here are some of the common maternity benefits cover in group insurance policy:

  • Both normal, as well as C-section deliveries. However, the sum insured for C-section delivery is different from that of a normal delivery
  • Doctor visiting charges, surgery expenses and room rent
  • In most cases, the maternity cover period ranges from 60 days before and up to 90 days after hospitalization
  • Vaccination costs
  1. Waiting Period

    One of the most important aspects is to check the group health insurance waiting period while selecting a group health plan. Most companies offer group health insurance and cover maternity benefits from day one of the employee’s joining. However, there can be some plans with a period of 9 months of waiting.

  2. Cover for the Newborn

    A group insurance policy covers a newborn baby immediately after birth. This is not the case under a standard policy, which usually doesn’t cover newborns until 90 days. Customization in terms of setting limits for sum insured for the newborn can also be done. It can either be up to the maternity limit or the total sum insured available to the employee.

  3. Late Pregnancies

    Since late pregnancies (35 years or above) are becoming a norm, group health policies usually cover them making it quite helpful for employees.

  4. Cover for Abortion

    Most group insurance plans cover the cost of lawful termination in case of emergency or life-saving abortions but do not cover voluntary abortions.

  5. Co-payment Clause

    In terms of co-payment, insurers, in most cases, do not provide such options as the claims benefit is usually capped for maternity benefits. However, it is always a good idea to check with the insurer or customize the plan accordingly.

Final Word

With the increase in child-birth-related expenses and medical inflation, group insurance with maternity benefits can come to the rescue for many employees. It can help them financially and enjoy the beautiful phase without worries. Thus, the maternity benefit cover in group insurance gives employees the liberty to focus on the newborn and not the bills.

Written By: PolicyBazaar - Updated: 11 August 2023

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