Waiting Period in Maternity Health Insurance

The waiting period for maternity insurance is a time in which policyholders can not file a claim request for childbirth expenses such as delivery, pre and post-natal care, etc. In simple words, it is a duration in which policyholders can not claim maternity-related benefits from the plan. The purpose of the waiting period is to ensure that policyholders maintain the insurance plans for extended periods.

If the policyholder makes a maternity insurance claim before completing the waiting period, the insurance provider can reject the claim request. The waiting period for maternity insurance can vary from insurance provider to provider.
The waiting period for maternity insurance can usually range between a few months and several years. However, some insurance providers offer the shortest waiting period, which is usually 3 to 6 months.

A health insurance policy with maternity coverage comes with various waiting periods. These waiting periods have different objectives and purposes. Here, we will learn in detail about the types of waiting periods in health insurance with maternity coverage.

Initial Waiting Period

Every medical insurance plan comes with an initial waiting period. Under this waiting period, policyholders cannot raise a claim request except for accidental claims. The initial waiting period usually lasts between 30 days to 90 days based on the insurance provider’s terms and conditions.

Maternity Waiting Period

Another type of waiting period that comes with health policy is the maternity waiting period. Since maternity is considered a pre-existing condition, policyholders can not make claims for maternity-related expenses until the waiting period is over.

The waiting period for maternity insurance varies from insurance provider to provider and can be between a few months and several years.

Pre-existing Disease Waiting Period

Another common type of waiting period is for individuals with pre-existing conditions. In simple words, individuals with pre-existing medical conditions such as PCOD/PCOS, etc., need to wait a certain time before raising a claim request.

For this waiting period to take effect, individuals need to provide their health history when purchasing a health insurance plan. Pre-existing disease usually comes with a waiting period of 1 to 3 years.

Specific Disease Waiting Period

This kind of waiting period is applicable for specific diseases or procedures. For example, laparoscopy is a treatment plan for individuals suffering from ovarian cysts. The waiting period for specific diseases and procedures is usually between 2 and 4 years.

The waiting period for maternity insurance is straightforward. When you buy a health insurance plan with maternity coverage or a standalone maternity insurance policy, it comes with a waiting period.

The waiting period for a health policy starts on the policy issuing date and is clearly specified in the policy documents. Policyholders need to renew the policy every year. Once the waiting period is over, policyholders can raise a claim request related to maternity benefits.

Let's understand how the waiting period for maternity insurance coverage works with an example. Aditi purchased a health insurance plan with maternity coverage on 19 February 2020.

The plan's initial waiting period is 30 days, and the maternity waiting period is 4 years. During this time, Aditi renewed her medical insurance plan in a timely manner.

Aditi became pregnant in January 2024, so according to the medical policy terms and conditions, she is eligible to file a maternity claim.

Also Read: How does Health Insurance with a Waiting Period work?

The waiting period for maternity insurance has been added so that insurance providers can handle risks and provide extensive coverage to policyholders. Below are some pointers that justify the importance of the waiting period for maternity insurance.

Financial Planning

One reason for incorporating a waiting period in maternity insurance plans is to offer enough time for individuals and couples for financial planning. With the waiting period in place, newlywed couples buying a health insurance plan with maternity coverage have enough time to plan for their first child.

Long-Term Commitment

Another reason for having a waiting period for maternity insurance is that it encourages policyholders to make a long-term commitment to their insurance plan.

With the waiting period, policyholders can not make instant claims for maternity after purchasing a plan. They have to wait and maintain their insurance plan for a prolonged period.

Discourages Adverse Selection

The waiting period for maternity insurance discourages adverse or hasty insurance purchases. With no waiting period clause in place, policyholders will purchase a plan when they are likely to conceive.

This results in a situation where individuals purchase maternity insurance with the sole intent of covering immediate expenses related to pregnancy or childbirth without truly benefiting from the policy's long-term coverage

Reasonable Premiums

A waiting period for maternity insurance also results in reasonable premiums for policyholders. With waiting periods, insurance providers can lower the risks more effectively with no instant claim request. This, in turn, helps keep premiums at a reasonable level for all policyholders.

Comprehensive Protection

Another reason for having a waiting period in maternity insurance is that it offers comprehensive protection to policyholders.

The benefit offered a wider range of health services during pregnancy and the postpartum period. These could include prenatal care, doctor visits, screenings and post-delivery care, as well as any complications that may arise.

Also Read: Health Insurance Covers Pre And post-natal Expenses

In India, getting maternity insurance without waiting periods is not possible. Individuals or couples must wait for a specific time before availing themselves of maternity insurance benefits. The waiting period for maternity insurance can vary from insurance provider to provider.

The lowest waiting period for maternity insurance is between 3 months and 6 months. However, the highest waiting period can range between 2 to 4 years. Considering this, couples and individuals who want to have kids purchase maternity insurance must plan early in their lives.

If you are willing to purchase a medical insurance plan with maternity coverage and short waiting periods, you can do so. However, some factors need to be considered when purchasing a plan.

Evaluate Your Needs

If you are looking for the shortest waiting period for maternity insurance, you first need to evaluate your needs. This means knowing what kind of medical insurance plan you need based on your healthcare needs.

Decide Your Budget

Another crucial factor to consider while looking for maternity coverage with shorter waiting periods is budget. Usually, maternity insurance plans with shorter waiting periods come with a higher premium. If you are looking to buy such a plan, you need to decide your budget in advance.

Do a Proper Research

Another crucial factor in choosing a maternity plan with shorter waiting periods is research. Various insurance plans are available in the market that offer lower waiting periods for health insurance with maternity coverage. It is best to do proper research before purchasing a plan.

Compare Different Plans

Before purchasing maternity insurance with a lower waiting period, compare different plans online. Different insurance providers may have varying waiting periods for maternity coverage, ranging from a few months to a few years.

Compare these to determine which plan offers the shortest waiting period without compromising on coverage.

Buy Policy Online

Once you are certain that the plan provides comprehensive coverage, fits your budget and meets your specific requirements, you can confidently move forward with the purchase.

This approach helps you avoid surprises down the road and ensures that you will be fully protected when the time comes to use the maternity benefits.

Also Read: 5 Things to Know About Maternity Insurance in India

The waiting period for maternity insurance directly impacts the premium cost. A shorter waiting period, such as 3 to 9 months, typically results in higher premiums because the insurance provider has a risk of having to pay out claims sooner. Simply put, the insurance providers charge higher premiums to balance the potential for early claims.

On the other hand, a longer waiting period, such as 2-4 years, reduces the insurance provider’s immediate risk, allowing them to offer lower premiums. This can be a more cost-effective option for those who are not planning to conceive immediately.

A health insurance plan with maternity coverage is crucial for dealing with pregnancy and childbirth expenses. However, to acquire maternity health insurance, you need to meet the eligibility criteria laid out by the insurance provider. Some of the general requirements for maternity health insurance in India are:

Age Limit

One of the essential requirements individuals need to meet to acquire health insurance with maternity coverage in India is the age criteria. The policyholder needs to fit into the age category decided by the insurance provider. The minimum entry age is 18 years, and the maximum exit age is 45 years.

Number of Maternity Claims

Another important factor in maternity coverage is the limit on maternity insurance claims. The insurance provider has a limit or number of deliveries for which the policyholder can make claims for maternity benefits. Most insurance providers offer maternity benefits for up to 2 deliveries.

Pregnancy Status

Most health insurance with maternity coverage will only cover pregnancies that occur after the policy has been activated and the waiting period has been completed. If you are already pregnant at the time of purchasing the policy, maternity expenses related to that pregnancy will not be covered.

Waiting Period

A waiting period is often required for maternity coverage. This can range from a few months to a few years, depending on the insurance provider. You must wait until the waiting period ends before claiming maternity benefits, so the policyholder needs to ensure they plan accordingly.

A medical insurance plan with maternity coverage comes with a waiting period of a few months to several years. Understanding the waiting period for maternity insurance is crucial before making a purchase decision.

As discussed, maternity insurance with shorter waiting times, usually between 3 months and 6 months, is available. However, the premium of such plans is very high. Considering this, it is best to buy a health insurance policy with maternity coverage in advance.

TATA AIG offers tailored medical insurance plans that are customised to your unique healthcare needs. For instance, our family medical insurance is designed to offer medical coverage to families. Under a single plan, medical coverage is offered to spouses, children, etc. The sum insured by this health policy is distributed among all family members.

We also offer maternity coverage as an add-on to our health insurance policy. The policy comes with a waiting period of 4 years. Other than this, we also provide gynaecologist consultation as an add-on with our plan. With this in mind, buy our health insurance policy with maternity coverage now.