Things You Must Know About Maternity Insurance | Tata AIG

Maternity insurance is a type of health insurance that provides coverage for pregnancy-related medical expenses. It can either be a standalone policy or offered as an add-on to a base health insurance policy.

A maternity insurance policy typically covers costs such as prenatal care, delivery (normal or C-section), postnatal care and newborn baby care for a limited period. It is an essential component for couples planning a child and is often bundled with comprehensive health insurance products.

Maternity insurance operates like most health insurance policies, but it is governed by specific clauses such as a maternity health insurance waiting period and sub-limits.

Here’s how pregnancy coverage under insurance works:

• You either buy health insurance with built-in maternity coverage or opt for an add-on rider.

• After completing the waiting period (usually 9 months to 4 years), you can claim expenses
  related to pregnancy.

• Upon hospitalisation or delivery, you submit the required documents to avail cashless or reimbursement-based claims.

• The insurer covers expenses as per the inclusions and sub-limits mentioned in the policy.

Note: You cannot buy a maternity insurance plan/add-on if you are already pregnant while buying the policy.

• Comprehensive Coverage: Includes prenatal, delivery and postnatal expenses.

• Newborn Baby Cover: Many policies extend coverage to the newborn for up to 90 days.

• Cashless Hospitalisation: Available at all authorised hospitals (network/non-network) for eligible maternity claims.

• Financial Protection: Safeguards your savings during a medically and financially intensive phase.

• Tax Benefits: Premiums paid are eligible for tax deduction under Section 80D of the Income Tax Act.

• Maternity insurance offers financial protection against a wide range of expenses associated with pregnancy, childbirth and postnatal care. Exact inclusions and exclusions vary by insurer and are listed in the maternity insurance policy details.

What is covered under maternity insurance?

The following are typically covered under most maternity health insurance plans in India:

• Hospitalisation for Delivery: Covers expenses for both normal and cesarean deliveries, including room rent, nursing charges and operation theatre fees.

• Pre-natal Expenses: Includes doctor consultations, ultrasounds, blood tests and other medically advised screenings during pregnancy.

• Post-natal Expenses: Covers medical care and follow-up visits for the mother after delivery, typically up to 60 days post-birth.

• Newborn Baby Care: Offers coverage for the baby from day one, including vaccinations, NICU (if required) and medical treatments for initial complications. Coverage typically lasts up to 90 days.

• Ambulance Charges: Includes transportation to the hospital in case of emergency during delivery.

• Doctor Consultations and Diagnostic Tests: Regular monitoring and prescribed tests during the pregnancy period.

What is not covered under maternity insurance?

While maternity insurance is comprehensive, it does come with certain exclusions:

• Pre-existing Complications Not Disclosed Earlier: Any pregnancy-related issues not disclosed during the policy application may not be covered.

• Infertility Treatments and IVF: Most plans exclude expenses for in-vitro fertilisation (IVF), artificial insemination or other infertility treatments.

• Already Pregnant at Time of Purchase: If you are already pregnant when buying the policy, claims related to maternity may be rejected.

• Ectopic Pregnancies: Some plans may exclude or limit coverage for ectopic pregnancies (pregnancy outside the uterus).

• Congenital Defects in the Baby: Congenital anomalies or birth defects that develop during or after pregnancy are generally not covered.

• Unregulated Hospitals: Treatment at unregulated hospitals may not be eligible for cashless claims.

• Cosmetic Procedures: Non-essential procedures like stem cell storage or cosmetic surgery
  post-delivery are not covered.

The waiting period in maternity insurance is the duration you must wait before raising a claim. It generally ranges from 9 months to 4 years, depending on the insurer and policy. This is why financial experts recommend purchasing maternity insurance early, ideally before planning a pregnancy.

If you are already pregnant, you will not be eligible for maternity coverage in a new plan.

TATA AIG offers pregnancy coverage under insurance as an add-on to its comprehensive health insurance plans. It is not available as a standalone product.

Key features of TATA AIG Maternity Insurance include:

• Coverage for pre and post-natal care

• Expenses for both normal and cesarean deliveries

• Newborn baby cover

• Network hospital access for cashless claims

• Waiting period applies as per policy terms

1.Inform TATA AIG at least 48 hours in advance for planned hospitalisation and within 24 hours for unplanned hospitalisation.

2.Submit the pre-authorisation form through the hospital.

3.Once approved, bills are settled directly between TATA AIG and the hospital.

For reimbursement claims, submit all original documents (bills, discharge summary, etc.) within the stipulated time via our Claims page.

You need to know a few things in advance about maternity insurance coverage. They are;

• The first thing to remember is that a maternity insurance plan typically does have a limitation. For instance, your basic health insurance policy's sum covered is ₹ 5,00,000 doesn't mean you have the complete sum protected for maternity-related charges. Your policy paperwork will specify the pregnancy plans sub-limit.

• Maternity insurance coverage, in general, covers all expenditures associated with childbirth, including hospitalisation, medical care, and fees incurred by the insured woman member before and after delivery. In addition, costs such as lodging fees, ambulance charges, and surgery fees are all covered. Any issues that arise within ninety days of delivery/post-natal will also be covered.

The cover is suitable for both normal and caesarean deliveries. It also covers the costs of a medically advised and legal pregnancy termination. Some insurance providers also include insurance for the child after birth in this package. The care provided for the child will be for a limited period of time and includes the first few visits to the doctor and vaccines.

• Every health insurance provider has a list of inclusions and exclusions they adhere to when it comes to maternity insurance plans. You need to carefully read the fine print and see what the insurance provider offers you. Check if you are being offered what you are looking for and choose a maternity insurance policy for yourself only if it has most of the things you are looking for and is the right fit for you.

• One important piece of information to remember is that pregnancy insurance does have a waiting period provision, which indicates you can only submit a suit for maternity-related expenditures after a specified amount of time has passed after you purchased the insurance. The waiting period differs by insurer and program; it typically varies between 9 months to 8 years.

But some medical plans may be tailored to meet specific needs. For example, they can cover pregnancy from day one with no waiting periods. This is why it is even more important to read the fine print and do your research before buying a policy. The difference could be between having a waiting period and not having one.

• Many insurance companies will not offer you coverage if you are already pregnant. They will see your pregnancy as a pre-existing condition and will label it as being beyond the scope of their cover. Thus, it is always recommended that if you are thinking of starting a family or are trying for one, you should get health insurance that covers pregnancy. It increases your chances of getting coverage and helps you throughout your pregnancy journey.

Understanding the things to know about maternity insurance is crucial if you are planning to start a family. From knowing the maternity health insurance waiting period to understanding what is covered under maternity insurance, every detail matters.

TATA AIG offers reliable maternity cover as an add-on, ensuring both the mother and newborn receive quality care without financial strain. Always buy health insurance early to make the most of your maternity benefits.

Can I buy maternity insurance if I am already pregnant in India?

The best health insurance policy for maternity is one with a short waiting period, high sub-limit for delivery, and comprehensive newborn care.

Are C-section deliveries covered under maternity insurance?

Yes, both normal and cesarean deliveries are usually covered under maternity benefits.

Can miscarriages be covered under maternity coverage?

Yes, some maternity insurance policies may cover miscarriages, including hospitalisation, medical treatment and related expenses.

What to do in case of denial of health insurance with maternity coverage?

If your health insurance with maternity is denied, check the terms of your policy to determine the reasons for rejection, such as waiting periods or exclusions. You may appeal the decision and submit documentation as necessary.

Are IVF procedures included under maternity insurance?

Standard maternity insurance does not cover the procedures for IVF (in vitro fertilisation) as they are considered elective or infertility treatments. That said, certain policies may cover fertility treatments through specialised plans or add-ons, so it is important to examine the particular conditions of your policy.