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Maternity Riders in Health Insurance

Nothing in this world is predictable, you can’t wait to throw a party for good news or build a rampart for a bad one. They come like air from a window and you cannot control them. A strong earthquake of 7.5 magnitude or a small bathroom slip that could gift you a facture, nothing can be forecasted. Knock, knock… ok don’t want to scare you anymore! Actually, emergencies can shoot up at any moment irrespective of its type, and there comes the need of a parachute, called insurance, as we all are aware of, but, is maternity an unplanned emergency?

Undoubtedly, people are getting enlightened about the necessity of an insurance cover, spreading the word of being insured .But in this rush race we tend to step in small pits and remain “under insured”. The label might exclude cover against various diseases along with the need of maternity insurance cover.  Gone are the days, when there were no maternity covers in the market. Today, the increasing childbirth expenses have changed the scenario by offering individuals and family floater policies that reimburse maternity expenses as well. Maternity insurance can be availed as an individual product or as a rider on a main health insurance package.

Maternity Plans-

Maternity health cover has become one of the hot topics among the young - would be – parents of today and in order to meet this escalating demand, the supply of such policies has increased from the insurers’ end. Max Bupa Health, ICICI Lombard, Cholamandalam, Apollo Munich, Bajaj Allianz, The New India Assurance, HDFC Ergo, United India, and Tata AIG offer maternity insurance benefit within their health insurance products.

Some of the popular plans available in the market are listed below with their features-

Maternity Plans

Star Wedding Gift ICICI Lombard Health Advantage Plus
  • Cover for maximum 2 deliveries
  • Cover for New-Born
  • Covered for Normal / Caesarean delivery up to the limits (includes pre-natal and post-natal expenses)
  • Post delivery Complication cover for mother after delivery.
  • Cost of test incurred for detecting any disorders in the Fetus up to Rs. 1,000/- (after a waiting period of 27 months).
  • Specially designed for women, this policy offers maternity benefits under the OPD expenses category under Health Advantage Plus (HAP).
  • It provides reimbursement of cost incurred to purchase medicines, drugs, ambulance charges as well as hospital stay.

Royal Sundaram Total Health Plus and Max Bupa HeartBeat plans offer maternity benefits upto two deliveries.

Inclusions and Exclusions -

Inclusions Exclusions

Various insurers have launched health insurance policies for women (especially in the group insurance policy) irrespective of their age or profession and maternity benefit is the USP of the same. Although every insurance firm has its own explaination and ceilings in the coverage, there are some basic inclusions that form a good maternity cover:-

  • All pregnancy related hospitalization overheads
  • Pre and post-hospitalization expenses for pre-determined number of days
  • Surgeries and pregnancy related complications and
  • Expenses incurred during pre and post-natal period, new born coverage and vaccinations
  • Maternity health insurance policies have various exclusions, irrespective of the insurance provider. Majorly, these policies do not provide any reimbursement for the monthly health check-ups, doctor’s consultation fee or the cost of medication consumed during nine months of pregnancy.

  • There is generally some waiting period also for the same that varies from one insurer to the other (apart from group or corporate insurance policy). Some more exclusion includes- abortion charges or cost of treatment for termination of pregnancy due to unavoidable circumstance in the first 12 weeks.


Aspects before Considering a Maternity Plan

Waiting Period-

Generally, the waiting period varies from 2- 4 years from the date of policy purchase. Even in the case of corporate insurance policy, an employee is required to complete a period of minimum nine months for availing the benefits of maternity cover. Acting as an unavoidable hindrance, this hitch creates difficulty in planning for anything.

Sub Limits on Maternity Expenses

A cap is decided for maternity insurance which basically focuses on the delivery type, where for a normal delivery the limit might range from Rs 25000-15000 and in case of a cesarean delivery, the limit would range somewhere around Rs. 40000 to 20000. Irrespective of the overall cover amount of the health insurance policy, maternity limits will be pre decided in all the cases.


Maternity cover might turn out insufficient with limits and exclusions, like – the cap on delivery, pre and post hospitalization charges, reimbursement for child care in case of complications with premature baby etc. A group mediclaim would take care of the aforementioned issues, whereas buying just a Maternity health insurance might not be sufficient enough to do the same. You can opt for a maternity insurance as an additional rider with your individual health insurance policy, but it still might not compensate for various hospitalization and other delivery charges. Additionally a rider would put extra strain on the cover amount, which might result in making the cover insufficient, in-turn defeating its core purpose. Therefore it is best advised to buy these two plans separately for this would make one more secure against any medical issues and unforeseen expenses.

Tips to the Young-Would-Be Parents-

  • Today, most of the companies offer mediclaim policy to their employees under the corporate insurance scheme and hence one should confirm if they are being offered maternity insurance under the same.
  • If in case you are holding a health insurance scheme without maternity cover then you can avail it in form of a rider. Generally, insurance firms are generous in offering such rider to the customers who have been doing business with them for some time.
  • Unlike group insurance plans with a waiting period of 9 months, the general health insurance policies offer you maternity benefits only after a waiting period of 2-4 years. Timely purchase pays a vital role in such a situation. Maternity insurance cannot be bought once the woman is pregnant as the pre-existing conditions need waiting period for getting treated.
  • Every insurer offers different cover for the type of delivery i.e. normal or caesarean. Even the number might vary from one insurer to the other. Often the coverage is limited to an amount of Rs. 50,000.
  • It is essential to check the features, benefits, inclusions and exclusions before finalizing the maternity policy/ rider.