Is Maternity Insurance Available for Already Pregnant Women?

Maternity coverage in health insurance plans offers specialised coverage for women. It helps cover the costs associated with pregnancy, such as delivery expenses, pre and post-hospitalisation expenses, new-born coverage, vaccination coverage, more.

It provides a financial safety net to individuals and couples planning to have a family. The benefits of the maternity cover in health insurance are usually available after completing the required waiting period.

Does this mean women who are pregnant cannot get maternity insurance? Let us discuss this in detail.

Also Read: Pregnancy Health Insurance

As stated above, usually, maternity coverage comes with a waiting period since it is considered a pre-existing condition. This means policyholders have to wait for a certain period to avail of maternity insurance benefits. The waiting period for maternity coverage in a medical insurance policy is typically 2 to 4 years.

So, getting maternity insurance for already pregnant women in India is possible, but benefits will be available after a waiting period. In simple words, the policyholder cannot avail of maternity benefits for an existing pregnancy. However, if they plan to have a second child after some time and by that time, if the waiting period is fulfilled, then they can take advantage of maternity coverage.

Considering this, it is best to buy a health insurance plan with maternity coverage before planning your pregnancy. However, if you have a group health insurance plan, you can take maternity coverage benefits without waiting periods. This plan offers immediate financial support to employees and expecting mothers.

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

If you are looking to buy pregnancy insurance after getting pregnant in India, you need to consider various aspects to get the best coverage in your special times.

Waiting Period

One key consideration when buying maternity coverage for pregnant women is the waiting period. Most health insurance plans with maternity coverage come with a waiting period of 2 to 4 years. So, before buying any maternity insurance, make sure the waiting period aligns with your pregnancy insurance needs.

Also Read: Waiting Period in Maternity Health Insurance

Coverage for Complications

Another crucial consideration for buying maternity insurance for already pregnant women is checking if the policy covers pregnancy-related complications. The coverage for maternity may vary from insurance provider to provider.

Policy Terms and Conditions

Another important thing policyholders need to check while purchasing maternity coverage in a health insurance plan is the policy terms and conditions. This will help them understand what is covered under the plan and what is not covered.

Number of Pregnancies Covered

Most health insurance plans with maternity coverage come with a pregnancy limit. In simple words, the limit is how many pregnancies the maternity insurance will cover. Typically, a maternity insurance plan covers 2 pregnancies.

The decision to buy maternity coverage in a health insurance policy usually depends on the individual’s needs and life scenarios.

However, with the rising medical treatment cost and inflation, it is recommended to buy maternity coverage early in life. Below are some scenarios where buying maternity coverage in a medical insurance policy is crucial.

• Newly married couples who want to have kids at some point should invest in a health insurance plan with maternity coverage.

• Furthermore, married couples under 40 and without children should also invest in a health insurance plan with maternity coverage.

• Moreover, couples who are planning to have a second baby should also consider investing in a maternity insurance plan.

• Individuals or couples who are not yet married but are thinking of getting married in 2 to 3 years can also consider buying maternity coverage.

There are some criteria women need to consider when acquiring maternity coverage in India. These include:

Age Limit

Most health insurance plans with maternity coverage in India have an age limit. The minimum age for acquiring maternity coverage with a health insurance plan is 18, and the maximum age limit is 45.

Pregnancy Status

Since pregnancy is considered a pre-existing condition, most health insurance plans with maternity coverage do not cover an existing pregnancy when the plan is purchased. In simple words, if you are pregnant while purchasing a plan then that pregnancy will not get covered under the plan.

Waiting Period

Another criterion individuals or couples need to respect while buying health insurance with maternity coverage is the waiting period. Most health insurance plans with maternity coverage come with a waiting period. The policyholder can avail of the maternity benefits only when the waiting period is successfully over.

The health insurance plan with maternity coverage covers a wide range of maternity-related expenses. Some of these expenses are listed below:

Delivery Expenses

One of the expenses covered in a medical insurance policy with maternity coverage is delivery expenses. This means the plan will cover the cost related to the baby's delivery, including labour room charges, doctor fees and more.

Pre and Post Hospitalisation Expenses

Another crucial expense covered under the maternity coverage in the health insurance plan is pre and post-hospitalisation expenses. The plan will cover the hospitalisation expenses 30 days before the delivery and 60 days after the delivery.

Newborn Medical Treatment Coverage

Most health insurance plans with maternity coverage also cover newborn medical treatment expenses. The plan usually covers the newborn from day 1 to up to 90 days. However, for premature and complicated deliveries, it is better to enquire with insurance providers.

Vaccination Coverage

Many health insurance policies with maternity coverage also include vaccination coverage. Vaccination is crucial for a newborn baby, so maternity insurance coverage includes a vaccination benefit.

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

Maternity coverage in health insurance plans also comes with certain exclusions. This means that the plan will not offer coverage in certain scenarios. These exclusions include:

Pre-existing Disease

Any complications caused by pre-existing conditions that affect pregnancy, such as high blood pressure, are not covered.

Congenital Diseases

Congenital diseases are generally inherited medical conditions that occur in children during birth or before birth, such as Down syndrome, heart disease, etc. These are excluded under health insurance with maternity coverage.

Infertility Treatment

The health insurance plan with maternity coverage also does not provide coverage for infertility treatment such as IVF, fertility medications and other assisted reproductive technologies.

Additional Medicines Cost

Most pregnant mothers prefer to take additional supplements, such as vitamins and ayurvedic supplements, for a smooth pregnancy. These supplements, which a doctor does not prescribe, are generally not covered under the health insurance plan with maternity coverage.

Regular Check ups and Appointments

Most health insurance plans with maternity coverage generally do not offer coverage for regular check-ups and appointments, such as doctor visits, physical screenings, etc., unless specified in the policy documents.

With so many health insurance plans with maternity coverage in the market, choosing the suitable plan can be daunting. Therefore, we have listed down some tips to help you choose the best maternity insurance coverage.

Understand Your Needs

One essential tip for buying maternity coverage is understanding what kind of coverage you want such as coverage scope, limit, inclusion and exclusions. This will help you in choosing the plan that aligns with your requirements.

Compare Different Plans

With so many maternity insurance policies available in the market with unique offerings, it is best to compare plans. By comparing different policies based on the budget, inclusion and exclusion, you will be able to shortlist plans that align with your pregnancy needs.

Check Waiting Period

While choosing health insurance with maternity coverage, it is crucial to check the waiting period. Maternity coverage comes with an initial waiting period, which is usually 2 to 4 years. Knowing the waiting period will help you choose a plan that aligns with your family planning goals.

Claim Settlement Process

Another crucial tip for customers to follow is to always know about the insurance provider's claim settlement process. This will help them understand how cooperative insurance providers are during the claim process. It is best to go with an insurance provider that has a high claim settlement ratio.

Read Feedback and Reviews

It is important to always check the insurance provider’s reputation and customer feedback before choosing a health insurance plan with maternity coverage. Reading reviews and feedback will help you choose a reliable insurance provider.

Maternity insurance is a crucial addition to your financial planning. Pregnancy-related expenses can be hefty, putting additional financial strain on individuals and couples. Considering this, investing in health insurance with maternity coverage is crucial.

However, in case of maternity insurance for already pregnant women, the policy will not cover the costs related to that pregnancy. The policyholder needs to fulfill the waiting period to avail the benefits. That is why it is crucial to buy maternity insurance in advance before planning a pregnancy.

Additionally, TATA AIG offers various health insurance plans that are tailored to meet your unique healthcare needs. For instance, we have health insurance for senior citizens that offers financial protection to individuals over 60 years of age.

Moreover, our health insurance plans come with various benefits, such as cashless hospitalisation, tax benefits, wellness programs and more. Secure yourself and your family with our customisable and affordable health insurance plan now.

Can maternity insurance claims get rejected?

Yes, maternity insurance claims can be rejected if the waiting period has not been completed, if the pregnancy is pre-existing, or if there is non-disclosure of health information. Furthermore, claims can be denied for procedures that are not included in the policy documents.

Is it necessary to buy health insurance with maternity coverage?

While it is not strictly necessary to buy health insurance with maternity coverage, it is highly recommended if you plan to have children. Maternity expenses can be significant, and having maternity coverage can help reduce the financial burden of prenatal care, delivery and postnatal care.

Can an unmarried woman buy a health insurance plan with maternity coverage?

Yes, an unmarried woman over 18 years of age in India can purchase a health insurance plan with maternity coverage.