Every parent wishes to give a beautiful life to their children. So he sets up everything right before they are born. The step towards this plan is applying for a health insurance plan. Do you know that every year there is a rise of 15-18% in healthcare facilities? Do ordinary people able to cover these expenses? So to help you, many banks and insurance companies come up with insurance policies. But, what about benefits during the maternity period for your child and spouse? Is there anything that could cover this period? The answer is yes. Some insurance companies (not some but many) provide benefits and cover all the mother and child expenditures during the maternity period. So in this article, we will discuss maternity insurance plan, Maternity Benefits Of Health Insurance Plans in detail. Let’s go!
What Is A Maternity Insurance Policy?
A maternity insurance plan is nothing but a cover that protects and covers all the maternity period expenditures. It covers expenses like pre-delivery, post-delivery, child care expenses, pre, and post-natal expenses. Child care expenses include diagnostic tests, medicines, and hospitalization. Generally, a maternity insurance plan consists of two types one that includes health insurance plans, and the other is specific health insurance that only includes maternity health insurance plans. Whether it may be a type one or type two insurance policy, you always have to wait to claim the policy’s benefits.
The waiting period may vary from months to years. In the former type of maternity insurance plan, you may end up waiting for 3 to 4 years because it includes all the health insurance policies to check other than maternity. But in the latter one, the waiting period is less for 9 months to 2 years. It includes only maternity health insurance. But what are the benefits of a maternity insurance policy?
Maternity Benefits Of Health Insurance Plans
1. Hospital Expenditures
- It covers pre-hospitalization expenditure. The term policy covers are 30 days before the date of admission.
- It also covers post-hospitalization expenditure for 60 days. Infertility related treatments are also covered in this policy. Generally, this period of cover will vary from one insurance company to another.
- Whether it may be a normal or cesarean delivery policy covers all the delivery expenses. When there is a miscarriage or illness to the mother, the expenses are also covered in the maternity health insurance plan.
- It also covers pre and post-natal expenses and baby expenses when he/she faces medical illnesses.
- It covers charges for ambulance services, medicines, hospital room rent, and doctor consultation fees like lab studies, gestational diabetes screening, etc. If there is an emergency to the childlike organ donation, the policy also these operation fees.
2. Day-Care Treatment
- When a person is admitted to the hospital for less than 24 hours, then that treatment is said as daycare treatment. Expenses related to daycare treatment can also be claimed back through this maternity health insurance policy.
3. Maternity Leave
- For private organizations, the company provides 26 weeks of permission as a benefit during the pregnancy period for women employees. 6 weeks leave before her delivery period and 20 weeks after her delivery period.
- A woman should get pay even during this maternity leave. There should be some paperwork that confirms her job even after her maternity leave from the respective organization.
4. Work From Home Scenario
- They provide better facilities and insurances during this crucial period. The thing is that every company takes care of its employees with these benefits. Nowadays, there also chances for work from the home scenarios for women in her maternity times.
What Is Not Covered In Maternity Health Insurance?
i. Expenses like buying supplements and vitamins are not covered under the treatment plan.
ii. Some may not provide cover for daily check-ups during the gestation period and regular doctor check-ups.
iii. Medical expenses like harvesting and storing of stem cells and voluntary termination of pregnancy during the first 12 weeks from the date of conception.
Points To Be Noted
a. The policy should be taken before the pregnancy period because according to the company’s terms and conditions. Please note that expenses are not covered when you apply for a maternity insurance policy after your delivery. It’s ok when you apply for policy for your next kid.
b. The premium on a maternity insurance policy is normally more than a regular health plan. This is because the money you claim is absolute, so they ask for a higher premium. If you grow older, then the premium will also increase for the maternity insurance plan.
c. It is crucial to check every detail before taking a policy because many factors will differ from one insurance company to another. For example, the waiting period for claiming benefits of insurance might change from one company to another.
d. According to section 80D of the income tax Act, 1961, tax benefits apply to maternity health policy. Also, you can select on your own how much money you can insure for maternity expenses.
- Almost every insurance company provides maternity policy from Rs.15,000 to Rs.50,000. Only a very few companies will provide policy up to Rs.1 lakh. Sometimes they provide a 200% increase in policy loan as a token of gratitude for second childbirth. The main benefit of this maternity cashless facility. This offer is only at the hospitals where company policy holds. Sometimes you can get a free bonus when you don’t raise claims against the policy.
- If the company fails to provide all the benefits they assured, you can go to a nearby police station to file a complaint, But I think no company will neglect this kind of policy.
- Women have to keep a note of all the expenses during her maternity period to benefit from the health insurance policy.
How To Apply For Maternity Insurance Policy?
It is better to apply for a maternity insurance policy right after your marriage. Because the waiting period is more, we can never imagine or expect situations under our control. As today’s world is growing faster and medication is also becoming expensive, normal people should apply for a health insurance policy. To apply for a maternity insurance policy, below is the list of documents that are asked for:
i. Proofs like Aadhaar card, certificate of birth, passport if required, Passing certificate of standard 10th or 12th, driving license, etc.
ii. Proof of Address (PoA)- Electricity Bill, Driving license, Ration Card, etc.
iii. If the policyholder age is above 45 years, then they have to submit Medical check-up reports.
iv. Passport size photos.
v. Note that a woman should work for 80 days and not be migrated from another country during this maternity period.
How To Claim A Maternity Insurance Policy?
Based on the situation at the time of pregnancy, the claiming process as follows:
In case of cashless hospitalization at any Network Hospital, the following steps have to be taken cautiously;
a. The person has to get the claim form from the hospital, which is usually provided at the time of hospitalization.
b. Please fill-up the form and then submit it to the hospital itself.
c. The application form, along with the doctor’s report, will be sent to your insurance company itself from the hospital itself.
d. The respective person/ the hospital has to answer to the queries which are from the insurance expert.
e. If the claim is approved, your insurer will consult the respective hospital and then covers the expenses as per policy norms.
To get reimbursement from a hospital which is not in the companies network, follow the below steps:
- Provide a filled-up form along with withe receipts and bills from the hospital for post-hospitalization to the company where you have taken a policy.
- You have to answer the queries questioned by the company and then wait for your policy approval.
- Once your policy is approved, then your company will reimburse the money that you claim.
Documents Required For Claim Settlement With Pregnancy Insurance Policy
- Original maternity health insurance policy document.
- Cashless health card, if the hospital is the in-network hospital of their insurer.
- Pregnancy proof.
- KYC documents for Pregnancy Insurance.
Frequently Asked Questions
1. Which provides a better maternity insurance plan?
Plans from banks like HDFC, Kotak Mahindra, etc. are best for a maternity insurance plan. JOY (Religare health insurance) has a low waiting period and extra benefits during the maternity period.
2. Why is maternity not covered in insurance?
If you have applied for a maternity insurance plan after pregnancy or when you are already pregnant, then companies don’t provide cover-up to your expenses. Many companies think that it is a pre-existing condition, and policies are only for future events.
3. For how many months do children get covered with maternity insurance plans?
The newborn child gets covered from day one to 3 months, and if there are any emergencies, they also get included in a maternity insurance plan.
4. Does HDFC Ergo cover pregnancy?
Yes, it covers maternity expenditures with two of its policies, namely Health Suraksha Gold and Medicare Classic.
5. Where can I go if I’m pregnant with no insurance?
Based on your condition, sometimes companies provide your health insurance if you are already pregnant. The government also implemented some schemes to help the ladies during their labor times. You can also get low-cost or free prenatal care from community health centers or other family planning centers.
6. What is an admissible claim?
Expenses like bed and room charges, medical treatments, doctor consultation fees, nursing charges, medicines, drugs, operation theatre charges, etc. are said as Admissible Expenses.
7. What is the grace period for oriental health insurance?
30 days is allowed for payment of renewal premium.
Every person will phase different issues in different phases. It is the duty of parents to give a financially stable family with the right insurance policies, and it is also the duty of children to make parents happy at their older stage. So be careful while taking insurance and policies. Never feel unsafe when many companies and government schemes are helping you!