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Protection for your HEALTH PLAN

Maternity Health Insurance

Maternity coverage is one of the 10 essential health benefits that must be covered by all health insurance plans offered to individuals, families, and small groups. Health insurance for pregnancy, labor, delivery, and newborn baby care became mandatory in 2014 under the Affordable Care Act.The new born baby is also covered by the maternity health insurance plan till a certain period.

Why Do You Need Maternity Insurance ?

As a responsible parent, you must prepare suitably for the cost related to pregnancy and the delivery of the baby. With the medical costs soaring high, one has to be well prepared for all expected and unexpected expenses. And this is why you should consider a Maternity cover in your Health Insurance Plan.
Covers Your Maternity Expenses: Most regular-joe medical health insurance policies does not cover maternity costs and thus are of no use when the time comes for the baby's delivery. Safeguard Against the Rising Healthcare Costs: With healthcare inflation about 15-18% each year, the cost of hospitalization will be more than twice within the next five years.
Mentioned below are some important aspects of a Mediclaim policy:
  • Premiums: The premiums paid for Mediclaim policies differ from one insurer to another however, the factors that influence the amount are constant. Age, sum insured, policy period, etc., are a few of the factors that affect the premium.
  • Age: Mediclaim policies can be bought only if the consumer falls in the specified age group. Usually, insurers have an entry age of 18 years and an exit age of 65 years. However, sometimes the age group can start at 5 years and go up to 80 years.
  • Family cover: In a family cover, the policyholder can pay a master premium to cover his/her entire family instead of buying individual policies.
  • Overseas Mediclaim policies: Many insurers provide overseas Mediclaim policies under which the insurer can seek treatment in both India and abroad. However, such policies have certain conditions attached to them.
  • Claims: Claims are usually made through third-party administrators (TPA), but some insurers deal with claims in-house.
  • Types: Mediclaim policies cater to different needs and different individuals. One can choose from individual policies, group policies, critical illness policies, senior citizen policies, and maternity policies.
  • Tax benefits: Under section 80D of the Income Tax Act of India, 1961, policyholders can claim a tax deduction of Rs.25,000 against the premium paid for Mediclaim policies. The exemption limit is Rs.30,000 for senior citizens. Policyholders can claim an additional exemption of Rs.25,000 if they are paying the policy premiums for their parents.
  • Features of Maternity Health Insurance Plans :
    • Comprehensive coverage
    • Pre and post-natal care for the new born
    • Hospitalization coverage
    • Cashless facility
    • Claim-free bonus
    • Tax savings
    • Flexibility to select your sum insured
  • Benefits of Maternity Health Insurance Plans
    • Outpatient services like hospital room rent, medicines and doctors consultation fees, and treatments like lab studies, gestational diabetes screenings, etc.
    • Inpatient services like doctors fees, pre and post hospitalization, etc.
    • Pre and post-natal care for the new born.
  • Claim Process for Mediclaim Policies
    • Cashless claims at Any Network Hospital of your Insurance Company: Submit the filled up claim form that your hospital provides you at the time of hospitalization The hospital authorities sends the claims form to your insurance company, along with your doctor's reports The Claim Experts of your insurer may raise queries, which the hospital/you have to reply to. If your claim is approved, your insurer will pay your hospital directly as per the sum insured that you are eligible for.
    • Reimbursement of Claim for treatment at any hospital that is not a network hospital of your insurance Company: Submit the filled up claims form post-hospitalization to your insurance company along with the required documents like receipts and bills of reports and medical treatments, etc. The Claim Experts of your insurer may raise queries, which you have to reply to and submit the additional information or documents, if required. If your claim is approved, your insurance company will reimburse you as per your eligible sum insured
  • Covered & Not Covered in Maternity policies
    • Waiting Period
    • Limits On Maternity spend
    • Coverage