Understanding the Difference Between Planned and Emergency Maternity Coverage

Individuals planning to start their family should get maternity coverage with their health insurance policy. However, you cannot avail the benefits of maternity coverage immediately as it comes with a waiting period. Here comes the need for planned adoption of maternity coverage to ensure the waiting periods are over before you need it.

If you are already pregnant, you can get emergency maternity coverage with no or lesser waiting periods so that the benefits can be availed immediately. With maternity coverage, you can cover the expenses of hospitalisation related to pregnancy, delivery, pre- and post-natal medical expenses, newborn care, etc.

How do Planned and Emergency Maternity Coverage Differ?

Planned maternity cover refers to the standard maternity plan that includes up to a 2-4 year waiting period. One cannot avail the benefits of maternity cover during the waiting period. Therefore, early planning is necessary to avail coverage at the time of need.

Emergency maternity coverage is also called zero- or no waiting period maternity coverage. Under these policies, you can claim maternity cover benefits immediately after purchasing the policy. Though it seems attractive, such maternity plans are limited. Only employer-sponsored group health plans offer such facilities.

Why is a Waiting Period Necessary in Maternity Coverage?

In most cases, pregnancy is planned, so the coverage for related expenses comes with waiting periods. If there were no waiting periods, most individuals would purchase maternity insurance after becoming pregnant and make immediate claims. This would have increased maternity insurance premiums.

Here are some of the reasons why a waiting period is necessary for maternity insurance:

• It helps prevent insurance claims from the first day of the policy's purchase.


• Higher expenses are associated with pregnancy and delivery, especially if there are complications. This could lead to higher claim volumes if there were no waiting periods.


• Waiting periods help keep the health insurance premiums stable, keeping the policy pricing affordable.


• It also encourages buying health insurance at an early stage, ensuring maternity coverage is a part of long-term planning.

Why is Maternity Coverage in Health Insurance Essential?

Maternity benefits in health insurance cover pregnancy-related expenses, providing financial security during your pregnancy. It includes the following expenses before and after your childbirth:

Pre- and Post-natal Expenses

Expenses incurred before and after childbirth, including medical checkups, doctor’s consultation, medication, etc., for both mother and newborn, are covered under maternity coverage.

Hospitalisation Costs

It also covers the expenses of your hospital stay, which includes nursing fees, accommodation, and other related charges.

Delivery Expenses

With maternity benefits, you can seek coverage for the delivery-related expenses such as the medical staff charges, surgeon fees, etc., for both normal and caesarean delivery.

Newborn Coverage

Maternity insurance also covers the newborn baby for one year. It includes the expenses of vaccination, checkups, prescribed medicines, etc. If ventilation support is required for the newborn, it will be covered under the maternity coverage.

Pre- and Post-hospitalisation

The expenses incurred before and after hospitalisation of the insured for pregnancy-related requirements are covered under the maternity insurance. However, the coverage duration may vary as per the limits and conditions of your health plan.

Thus, planned and emergency maternity cover both offer similar benefits, but the difference lies in waiting periods. In planned maternity cover, you need to complete the waiting period to avail the benefits, and in emergency maternity cover, you can opt for plans with zero waiting periods for immediate insurance claims.