Welcoming a new member to the family is a joyous occasion, but it also comes with considerable planning—both emotionally and financially. From prenatal check-ups and delivery costs to postnatal care and vaccinations, maternity-related expenses can add up rapidly. Fortunately, insurance for pregnancy can offer some much-needed relief by covering many of these medical costs under a health insurance policy.
In India, maternity insurance is typically offered as an add-on or benefit under a family health insurance plan. With rising healthcare expenses, it’s becoming increasingly common for couples—especially young, working professionals—to consider policies that include maternity benefits. But what exactly is covered under these plans? And what should you keep in mind while choosing one?
Let’s take a closer look.
What Is Pregnancy Insurance?
In simple terms, insurance for pregnancy refers to a type of health insurance policy that provides financial cover for expenses incurred during pregnancy. This includes costs related to prenatal care, childbirth (both normal and caesarean), hospitalisation, and sometimes even the newborn’s health for a limited period post-delivery.
While standalone maternity insurance plans are rare, most insurers offer maternity coverage as part of medical insurance plans or as an optional rider that you can include in your primary health policy. It's worth noting that such coverage usually comes with specific terms and conditions—like waiting periods, sub-limits, and exclusions—which are important to understand beforehand.
Key Inclusions Under Maternity Insurance
While the specific benefits may vary slightly across insurers, here are the standard inclusions you can expect under a maternity cover:
1. Hospitalisation for Delivery
Whether it’s a normal delivery or a caesarean section, maternity insurance typically covers hospitalisation charges. This includes room rent, nursing fees, doctor’s fees, anaesthesia, surgical team charges, and other operating theatre costs.
The cover is applicable up to a specified limit, which differs from plan to plan. Some health insurance plans for family offer fixed payouts for maternity claims, while others cover actual hospital expenses up to a capped sum insured.
2. Pre and Postnatal Expenses
Modern maternity insurance policies go beyond just delivery costs. They often include expenses related to prenatal and postnatal care such as:
Routine check-ups
Ultrasounds and diagnostic scans
Pathology tests
Postnatal consultations
Generally, these expenses are covered for a certain number of days before and after delivery, usually 30 days prior and 60 days post-delivery, but this varies depending on the policy.
3. Newborn Baby Cover
Some policies extend coverage to the newborn for a fixed duration—typically the first 90 days from birth. This may include:
Vaccinations
NICU (Neonatal Intensive Care Unit) charges if the baby requires special medical attention
Consultations and medication
However, after this initial period, the baby would need to be formally added to the policy as a new member under your family health insurance plan.
4. Medicines and Consumables
Maternity insurance generally includes charges for prescribed medicines, IV fluids, syringes, gloves, and other consumables used during the delivery process.
5. Emergency Ambulance Charges
If an ambulance is used to transport the expecting mother to the hospital, the cost is often reimbursable under the maternity cover, subject to a maximum limit.
Waiting Periods and Why Timing Is Key
One of the most important aspects of maternity insurance is the waiting period clause. Unlike general health insurance which becomes active shortly after purchase, maternity benefits typically come with a waiting period ranging from 9 months to 4 years.
This means you cannot claim maternity-related expenses if delivery occurs before the completion of the waiting period. For this reason, buying a maternity-inclusive plan before planning a family is critical. If you delay, the entire point of having insurance for pregnancy may be defeated.
Couples planning for children in the near future should ideally opt for medical insurance plans with maternity benefits well in advance. The earlier you enrol, the better your chances of reaping the full benefits when the time comes.
Sub-limits and Exclusions
Not all expenses are covered in full, even within maternity insurance. There are sub-limits and exclusions to be aware of:
Sub-limits: Most plans cap the amount payable for maternity expenses. For instance, a policy may offer ₹25,000 for a normal delivery and ₹50,000 for a caesarean. Any costs beyond this will need to be borne out of pocket.
Room rent limits: Policies may restrict room eligibility. Choosing a higher room category than what’s covered could lead to proportionate deductions on the overall claim.
Pre-existing conditions: Some policies may not cover complications arising from pre-existing illnesses like diabetes or thyroid disorders unless explicitly mentioned.
Infertility treatments: Expenses related to IVF, IUI, or other fertility treatments are usually excluded from standard maternity insurance coverage.
Termination of pregnancy: Most policies exclude coverage for elective abortions or terminations unless medically necessary and legally compliant.
Understanding these limitations helps avoid surprises during claim time.
Choosing the Right Family Health Insurance Plan
When selecting a family health insurance plan that includes maternity cover, keep the following factors in mind:
1. Adequate Maternity Cover Limits
Review the maximum amount offered for delivery expenses. Compare across different health insurance plans for family to ensure the limit is in line with the average costs at your preferred hospital.
2. Lower Waiting Period
Opt for policies with shorter waiting periods, especially if you’re planning to start a family soon. Some insurers offer plans with waiting periods of just 9 or 12 months.
3. Newborn Coverage
Ensure the plan includes coverage for the newborn, even if it’s only for the initial few months. After this period, don’t forget to include the baby in the policy to maintain continuous health coverage.
4. Cashless Network
Choose insurers with a wide hospital network for cashless claims. Maternity hospitalisation is planned in most cases, so knowing which hospitals are part of the network helps streamline the process.
5. No-Claim Bonus and Restoration Benefits
Some medical insurance plans offer a no-claim bonus that increases your sum insured for every claim-free year. Others offer restoration of sum insured in case it's used up. These benefits can be particularly helpful in case of complications or back-to-back claims.
Why Early Planning Makes Financial Sense
Maternity-related costs are not minor. Depending on your city and choice of hospital, expenses can range from ₹60,000 to over ₹2 lakhs. Add prenatal tests, postnatal care, and vaccinations, and you're easily looking at a ₹3-4 lakh expenditure. And that’s without factoring in possible complications.
By incorporating insurance for pregnancy into your long-term financial planning, you not only cushion yourself against these expenses but also get access to better healthcare facilities. It reduces the pressure of dipping into savings or taking out emergency loans to manage costs.
Moreover, when your maternity cover is part of a broader family health insurance plan, it protects other members of your family too, offering better value and comprehensive health protection under a single umbrella.
Conclusion: Make Parenthood Financially Comfortable
Pregnancy is a major life milestone, and your insurance choices can make a world of difference to how comfortably you navigate this phase. Whether it’s covering hospitalisation charges, securing postnatal care, or ensuring your baby is protected right from birth, a well-designed maternity insurance policy can ease your financial burden and offer peace of mind.
Among the many options available, Niva Bupa stands out with flexible health insurance plans for family, inclusive maternity benefits, and strong network support. For young couples and families looking to secure their future and that of their newborn, exploring maternity-inclusive policies from Niva Bupa could be a wise decision.
Plan early, choose wisely, and step into parenthood with confidence—supported by the right health insurance coverage.
