The most important question which pops into the mind of every couple before having a child is, ‘Are we ready for it?’, and even though this question comprised profoundly of both the emotional as well as the financial part, the significance of the latter is changing now, more than ever. With steep costs and the variety of so many baby items, all the parents are extensively looking on how to have the cheapest yet best things for their child and for themselves too.
Maternity costs can be financially challenging and insurance provides a sense of certainty in the cost budget. Therefore, in this article, we will be discussing the most important things you need to look out for before opting for any cover.
What you got to know about maternity insurance? ( Common for all the plans in INDIA )
There are absolutely no plans available in India which only cover maternity insurance. They are either covered in your personal health insurance or family floater insurance plans.
Check with your company’s insurance plan whether or not it covers maternity insurance. Some companies do offer maternity cover for their female employees. Do not forget to check the cover and sum insured ( the maximum amount which will be reimbursed) in your plan.
If you think company’s maternity cover may not be able to meet the expenses you can take the option of buying a separate maternity insurance plan. In that case, if the expenses are low later, claim the expenses from the company’s plan so that you can reap no-claims benefit from your insurance plan.
No insurance companies include maternity cover without a specific waiting period. Plus there is also limit to the amount of waiting period. Not every company offers lifelong waiting period. So do check the upper and lower limits before buying any plan.
Some plans try to include some alluring perks in maternity plans to make you buy the complete health insurance. Don’t make maternity cover and benefits your sole criteria. Do look out for the other benefits which health insurance/family floater plan has to offer. Family-floater plans can be a little complicated to choose with so many diversified options and benefits. Make sure that you go with your needs first before looking out for anything else.
Premiums almost double as soon as you include the maternity insurance. This is because the average age when the women want to conceive has gone up to 30-31 years in India. Pregnancy after 30 can lead to various complications, not to forget it also increases the chances of having a C-section. C-section increases the cost of operation, recovery, medicines etc. Prepare to pay high premiums beforehand.
What is the correct time to opt for maternity insurance plan?
The best time to opt for is when you get married. Since most couples now wait for at least 2 years before having a kid. Planning beforehand and researching properly (try to meet insurance agents personally) will maintain financial uniformity.
Religare health insurance is probably the only cover which offers just 9 months of waiting period.
What costs are covered under the plan?
Expenses include both before and after delivery charges. Eg: pre-hospitalisation charges for 60 days and post-hospitalisation charges for 90 days. This includes routine check-ups, room rents, ambulance charges etc.
Newborn’s cost cover: Some plans cover vaccination charges while other don’t. You may even want to know if they will cover any complications that can occur in your baby.
You would receive Tax benefits as mentioned under section 80D. It allows you to receive tax deductions on premiums paid on your own medical insurance or on behalf of your family. There are some exemption limits on this. Read this article here to know more.
Know beforehand any caps(maximum amount of money that will be received under your insurance) on the claim amount.
Do read all the terms & conditions properly.
Divided up costs: In Religare insurance, only Rs.35000/- is given for delivery whether it’s normal or Cesarian. So do check, if this upper limit is given on any other particular expenses such as room rent etc.
What are the exclusions?
- Non-allopathic treatment costs
- Consultation fees
- Regular check-ups
- Medicine costs
- Congenital diseases
- Termination of pregnancy (under 12 weeks)
- Pre-existing ailments or injuries diagnosed within 48 months of the policy commencement
- Expenses related to self-inflicted injuries, drug use or alcohol
- AIDS treatment-related expenses
- Dental treatment expenses
- In-vitro fertilisation and infertility-related expenses
What is the claims process?
DO NOT forget to check the process of filing your claim. Each insurance plan has separate policies on how and when will they reimburse the amount. In most cases this is the followed procedure:
Claim Initiation: Emergency cases within 24 hours of hospitalisation, planned cases within 48 hours of hospitalisation.
Cashless pre-authorisation: Complete the pre-authorisation form at the hospital’s insurance/TPA’s desk or download from the insurance provider’s site. Send this by email/fax. Wait for the approval. As soon as you receive the approval you can file for your reimbursement.
Reimbursement claim form submission: Submission of claims form along with any required documents or terms & conditions (another important reason so as to why you shouldn’t skip reading it carefully). The form can be downloaded from the site. You will receive the approval and your reimbursement.
It really is another hectic procedure so keep all the documents handy.
Suggested companies:
- Religare Health Insurance
- Bharti Axa
- Max Bupa
- Apollo Munich Insurance
- Star health insurance
- ICICI Lombard health insurance
If you are planning your delivery in a high-end hospital your costs might not be covered by the claims. Even if you think they do, it’s always wise to keep some savings aside for your delivery. Bringing a whole new life into this world and giving her/him all the love, care etc. is certainly not going to be a cake walk. There will be times when your planning will be thrown out of the window but still preparing yourself beforehand is definitely better than anxiously waiting for what’s going to happen.