Basic Coverage: Maternity Insurance

Maternity expenses are very common but are mostly either under-insured or uninsured today under a regular health insurance policy offered by general insurers. There is no standalone maternity insurance cover in India. Insurers say that maternity cover is so exact in nature which will witness 100% claim ratio. But they can be covered under the group cover offered by the employer.

OPTIONS

You can also choose maternity insurance as a rider to the main health cover on an individual basis. ICICI Lombard General Insurance, for instance, offers maternity insurance under the OPD expenses benefit within the Health Advantage Plus plan. Similarly, Star Health and Apollo DKV offer maternity insurance as part of their health insurance policy. A working woman or a homemaker (whose spouse enjoys a group health cover), has access to maternity cover insurance after the waiting period. But every company specifies a limit on maternity benefits under group health, which are usually Rs 50,000 for a Rs 2-lakh cover. In the case of self-employed professionals, they can only cover for pre-natal expenses through a general waiting period.

WAITING PERIOD

There is a waiting period of nine months in group health cover offered by employers. Ideally, the employee should have completed nine months in the organisation before the conception stage. In an individual mediclaim, an individual has to wait for a period of four years or more (depending upon the policy) to avail of maternity benefits.

MATERNITY COVER DETAILS

Ideally, maternity insurance should cover all expenses in the pre-natal, hospitalisation and post-natal phase. However, the group health insurance offered by employers covers only the act of delivering the baby, be it normal or caesarean. It doesn't cover the pre-hospitalisation period, which includes ultra-sound, regular check ups, termination of pregnancy within the first 12 weeks and the doctor's consultation fee.

Similarly, the group cover doesn't compensate for posthospitalisation expenses such as extra oxygen given to a premature baby etc. In individual mediclaim, you can cover pre-natal expenses if you have taken the maternity insurance as an further condition. But it doesn't compensate for hospitalisation, delivery and post-natal charges. If you don't have a group mediclaim then you have to rely on your regular mediclaim policy to over for all the expenses. But the cover amount and ceilings are very low and hardly cover for even one-fouth of the maternity expenses.

Source: [Economic Times]