Maternity Health Insurance Plans: Add-ons & Coverage

1. Care Joy Maternity Insurance Plan  
2. Future Generali Health Total Plan  
3. Edelweiss Health Insurance Plan  
4. Kotak Mahindra Premier Plan  
5. Oriental Happy Family Floater Plan  

1. SBI Arogya Premier Plan  

Maternity Health Insurance Plans in India

The various maternity insurance plans in India are mentioned in brief below - 

What is Covered in Maternity Health Insurance Plans?

The following benefits are included in maternity insurance plans -  

1. C-section procedure 
2. Labour and delivery expenses 
3. Pre-natal expenses 
4. Post-natal expenses 

1. Hospitalization costs for patients 
2. Expenses of the newborn baby 
3. Expenses of baby’s vaccination 
4. Complications in pregnancy 
5. Expenses of medically necessary termination 

1. Preservation of stem cell 

What is not Covered in Maternity Health Insurance Plan?

The expenses listed below are not covered by maternity insurance - 

1. IVF treatment 
2. Ectopic pregnancy 

1. Expenses of pre-hospitalization 
2. Expenses of post-hospitalization 
3. Regular check up 
4. Expenses of surrogacy 

Who is Eligible to Avail Maternity Health Insurance?

The minimum entrance age for eligibility for maternity insurance benefits at 18 years, with a maximum entry age of 45. It ranges from 1 day to 24 years for children, though it may fluctuate between insurance carriers. 

Documents Required to Avail Maternity Health Insurance

The documents needed to apply for maternity health insurance are mentioned below - 

1. Application form filled duly 
2. Address proof like telephone bill, electricity bill, Aadhaar card, etc. 

1. Passport size photo 
2. Identity proof like passport, Aadhaar card, Pan card, etc. 

How to Raise a Claim for Maternity Health Insurance?

To raise a claim for maternity health insurance, follow the steps mentioned below - 

Step 1: Submit the properly filled-out claim form to the insurance company after notifying them via the website or toll-free number. 

Step 2: The hospital will check the necessary paperwork you've supplied and then send it on to the insurance provider. 

Step 3: Following verification, the insurance provider will pay the hospital immediately as part of the cashless claim payment if you are admitted to a network hospital. 

Step 4: If your claim was denied under the cashless payment system because you could not be admitted to the network hospital or for another reason, you are still eligible to receive payment through the reimbursement system. 

Step 5: For the situation mentioned above, you will pay the hospital on discharge; however, you will be repaid after giving the provider your paperwork and the bill. 

Features & Benefits of Maternity Insurance Plans in India

The various features and benefits of maternity plans in India are mentioned below - 

1. Maternity insurance pays for the costs associated with a vaginal delivery as well as a caesarean delivery option. So, regardless of the surgery that is required, you won't worry about the cost. Additionally, some policies additionally cover pre- and post-hospitalization costs, covering all pre-hospitalization costs for up to 30 days and post-hospitalization costs for up to 60 days. Additionally, the coverage also covers other medical costs including the price of the surgeon, the cost of the doctor's consultation, the cost of the room, and nursing. 
2. Due to the costs associated with having and maintaining a child, most couples these days take their time while planning their pregnancy. With the advent of maternity insurance policies with sub-limits ranging from 1 to 4 years, depending on the insurance provider, you may now prepare for a child without worrying about your finances. 
3. Typically, newborns are not covered by health insurance until they are 90 days old. However, a maternity insurance policy begins to pay benefits as soon as the baby is born. Some of these plans even cover the cost of the newborn's immunizations to the conclusion of the policy year. 
4. Private hospitals are in high demand nowadays because consumers want access to high-quality treatment. However, the cost of care at these hospitals is high. In a private hospital, a regular delivery may cost between Rs.50,000 and Rs.70,000, and a caesarean section may cost an additional Rs. 50,000 to Rs. 1 lakh. Additionally, pregnancy is prone to difficulties and is highly unpredictable, so you may not be aware of all the factors that influence the final cost. A maternity insurance policy can provide financial comfort in this situation, allowing you to take your first steps toward motherhood without worrying about money.

Health Insurance Policy for Surrogate Mother in India:

1. Earlier this fiscal year, the Insurance Regulatory and Development Authority of India (IRDAI) directed all insurance companies to offer coverage for surrogacy-related expenses.  
2. The policy is expected to include all medical costs associated with pregnancy, delivery, and postpartum care for the surrogate mother.  
3. The intending parents or the person looking to have a surrogate baby are the ones who need to get surrogacy insurance. 

What are the Surrogacy Rules in India?

In India, the regulations governing surrogacy include a crucial stipulation regarding mandatory insurance coverage, as outlined in the Surrogacy (Regulation) Rules of 2022. The Insurance Regulatory and Development Authority of India (IRDAI) has issued a directive to all insurance companies. This directive mandates insurance companies to provide coverage for expenses related to surrogacy, emphasizing the need for a specific insurance cover when intending parents are covered under a family floater policy. The directive facilitates the availability of dedicated insurance options for surrogate mothers within the broader framework of health insurance, recognizing the unique medical circumstances associated with surrogacy. According to these rules, parents or couples embarking on the surrogacy journey are obligated to procure a general health insurance policy specifically tailored for the surrogate mother. This insurance coverage is designed to address the entirety of the surrogate mother's medical expenses, encompassing aspects related to pregnancy, delivery, and postpartum care. 

The regulations are discussed below:  

1. Insurance Coverage Requirement: Intending parents or couples seeking surrogacy are required to obtain a general health insurance policy specifically for the surrogate mother. This insurance coverage is designed to address the medical expenses incurred by the surrogate mother during the course of the pregnancy, delivery, and postpartum care. 
2. Policy Duration: The insurance policy for surrogacy should have a specified duration of 36 months. This duration aligns with the timeline associated with the surrogacy process, covering the period from conception through pregnancy and postpartum recovery. 
3. Insurance Provider: The insurance policy must be acquired from a recognized insurance company or an agent sanctioned by the Insurance Regulatory and Development Authority of India (IRDAI). The involvement of IRDAI ensures that the insurance provider adheres to regulatory standards, promoting transparency and reliability in the surrogacy insurance process. 
4. Coverage Amount: The coverage amount specified in the insurance policy should be substantial enough to address all potential expenses related to pregnancy complications and postpartum delivery complications. This ensures that the financial aspects of the surrogate mother's medical care are adequately covered, offering financial protection to both the surrogate mother and the intending parents. 

What is Covered under the Health Insurance Policy for Surrogate Mothers in India?

The health insurance policy for a surrogate mother in India covers the following expenses:  

1. Hospitalization and Delivery Charges: Covers expenses for hospital stays and childbirth, ensuring financial support for the surrogate mother's well-being during birth.
2. Treatment for Pregnancy Complications: Provides coverage for addressing any complications that may arise during pregnancy, safeguarding the health of the surrogate mother and the success of the surrogacy.
3. Postpartum Care: Ensures necessary support and medical care for the surrogate mother during the recovery period after childbirth, promoting her overall well-being.
4. Coverage for Medical Conditions Resulting from Surrogacy: Protects against potential long-term health issues stemming from the surrogacy process, ensuring the surrogate's future health and well-being.
5. Maternity Expenses: Tailored coverage for the unique maternity needs of surrogate mothers, addressing specific health requirements associated with surrogate pregnancies.
6. Antenatal Care and Checkups: Financial support for regular checkups and medical assessments during pregnancy, contributing to the surrogate mother's well-being and the success of the surrogacy journey.

1. Treatment for Delivery Complications: Comprehensive coverage for medical interventions during delivery complications, prioritizing the safety of both the surrogate mother and the baby.
2. Expenses Related to Delivery Complications: Covers unforeseen costs related to delivery complications, providing financial security during critical phases of the surrogacy process.
3. No Waiting Period for Maternity Coverage: Immediate access to maternity coverage without waiting periods, ensuring prompt medical support in case of pregnancy-related complications.
4. Coverage Duration: Extended coverage for 36 months to provide continuous support throughout the surrogacy journey, including pregnancy and potential postpartum complications.