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I am 25 years old. I plan to buy a health insurance policy that also comes with maternity benefits. However, some of the plans being offered have a waiting period of three years and are also expensive. What kind of cover can I go for? What kind of protection is one provided under a maternity plan? Please also explain how the waiting period works.
Usha
Having maternity benefit cover in your health insurance means you won’t have to spend out of your own pocket when you have the baby and have a stress-free delivery. Healthcare costs are on the rise and the cost of childbirth in a private hospital can today range anywhere between ₹70,000 and ₹1 lakh. This can also go up in case of any pregnancy-related complications or caesarean procedures. It is important to plan ahead for this most-certain expense in your life.
A maternity plan provides coverage for expenses incurred during pregnancy, including cost of delivery, hospitalisation, pre- and post-natal care. It also typically pays for medical tests, medicines, and newborn baby expenses up to a certain period. Any medically necessary termination is also covered under this plan. A few covers also compensate for expenses arising out of fertility issues and cover treatments such as IVF.
Buying a health insurance plan with maternity benefits essentially has two aspects. One, any health insurance plan that offers maternity benefits is more expensive than a normal health insurance plan. Two, the maternity benefits typically have a waiting period ranging at 3-4 years. In simple terms, waiting period means the time period one will have to wait after buying the policy and before one can avail the benefit related to that treatment or condition. So, if your policy has a waiting period of three years, it means you can avail yourself of the maternity benefits only after three years of buying the policy.
If you don’t want to opt for waiting period of three years or more, there are plans with reduced waiting periods of up to 9 months. However, do note that such plans could be expensive. There are multiple options you can look at for sufficient maternity cover that is well within your budget.
If you have a group medical cover from your workplace, check if the same covers maternity benefits. Group medical covers typically offer maternity benefits with very low waiting period. However, this may have a cap on the sum insured for maternity benefits. But it is possible to make a claim from both your group medical cover and personal health insurance plan in case the claim amount surpasses the capped sum insured. This way, you can ensure that the hospitalisation expenses during childbirth are comfortably covered.
The second option is to look at health plans specifically designed for youngsters. Some insurers offer early start plans wherein one can avail maternity benefits with a waiting period of as little as nine months. Such plans offer a wallet-based maternity benefit cover wherein the wallet sum insured keeps getting boosted for every non-claim year. The advantage of such plans is, they are 25-45 per cent cheaper than other similar health insurance plans that come with a maternity benefit of nine months.
Before deciding which health plan to opt for, carefully check a few important aspects of the health plan. These include no limit on room/ICU rent, no co-payment, cumulative bonus being provided, consumables cover, pre- and post-hospitalisation coverage and no zone-based restrictions, among others. The decision should not be based solely on the maternity cover being offered. One should make sure the plan opted for has a good sum insured of at least ₹10 lakh.
The writer is CMO and Head of Direct Sales, Digit General Insurance
Send your queries to insurancequeries@thehindu.co.in
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