Is Maternity Coverage Included In Health Insurance By Default?

Maternity coverage usually does not come under the standard, individual health insurance policies by default, and often demands an added premium or, in some cases, is only available through employer-provided group plans. It is generally treated as an optional add-on cover or rider benefit of a health insurance plan. Some insurance providers may not provide maternity coverage for women who do come under the exclusion criteria. One should also know that there is always a waiting period that differs between insurers; it is usually between 12 months and 3 years. Insured persons are not eligible to claim any maternity benefits before completing the waiting period. Infertility treatments and congenital disorders are often excluded from coverage. Typically, women aged between 18 and 65 are covered by maternity insurance plans.

Why is a medical policy with maternity coverage important?

The average cost of Normal or C-section deliveries is skyrocketing and can reach up to ₹2 lakhs and above in most cities across India. Pregnancy and going through labour pain are crucial phases of a female’s life. The joy of becoming a mother, most women experience the accompanying anxiety as well. But one thing you do not need to worry about during this time is hospitalisation expenses. If you have an insurance policy that offers coverage for maternity expenses, you can enjoy your pregnancy period and focus on your health rather than worry, knowing that all the costs are taken care of.

With the skyrocketing medical costs along with the surging cost of delivery expenses in private hospitals, opting for maternity insurance extra add-on cover, especially the maternity insurance plans without a waiting period, is a wise approach to tackle expenses.

Now you can wonder, Does health insurance cover pregnancy benefits if a woman is already pregnant? So the answer is: many standard policies generally do not include maternity benefits if they are purchased after conception, as the insurance company considers it a pre-existing condition. Nevertheless, some insurance providers offer pregnancy insurance after pregnancy with lesser waiting period (e.g., 12–24 months), but coverage typically begins only after the waiting period. The main benefit of maternity coverage in your existing health insurance plan is access to medical facilities, including the verified hospitals that are formally affiliated with your insurer’s network. You can also avail yourself of a tax rebate for premiums paid for your healthcare insurance plan, offering maternity coverage under section 80D of the Income Tax Act of 1961.