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Benefits of Health Insurance for the Pre and Post-Natal Expenses

By Juhi Walia
04 October 2022, 1:34 PM

Among the various types of health insurance plans, one of the most sought-after ones is maternity health insurance. It ensures that the entire process of childbirth is hassle-free and beautiful without having to constantly think of money. However, these health insurance plans do not just include the hospitalisation costs when the baby is born. They also cover pre and post-natal expenses ranging from medical tests, regular check-ups with the doctors, medicines, etc.

How Does Maternity Health Insurance Work?

There are no standalone health insurance plans in India. So maternity health insurance plans refer to comprehensive indemnity health insurance plans with maternity benefits. Or it is an add-on cover that can be taken with a family floater health insurance plan.

Under maternity health insurance claims, three areas are taken care of broadly. These are prenatal expenses, labour expenses, and postnatal expenses.

So, prenatal means all the expenses that occur before the childbirth or delivery process. It includes regular USG scans and gynaecologist check-ups to ensure the baby's and the mother's health. There might also be other tests needed to be done when one buys maternity health insurance. One must check they cover up.

Following this, the labour expenses or those in the delivery process include the hospital expenses: The bed, the surgery, medicines, etc.

Finally, postnatal expenses are those that one must pay for after the baby's delivery. So, these are for the mother as well as the baby. Such expenses might vary from vaccinations and medication for the baby to the mother’s regular checkups and hospitalisation if required. Health insurance plans with the maternity policy must take care of all these aspects.

Pre and Postnatal Expenses a Maternity Health Insurance Plan Must Cover

The clauses remain pretty much the same across all good health insurance plans.

  1. Prenatal expenses account for check-ups with doctors, medicines, tests, etc., till the day that the mother is hospitalised from a month before.
  2. For postnatal expenses, a good health insurance plan must cover consultations for both the baby and the mother, tests, medicines, and, most importantly, various immunisation programs like vaccination for the baby.

However, if one has access to a more elaborate policy, they can also be paid for hospitalisation or extended surgery costs in case of a complex pregnancy. The valid period of postnatal expenses is also generally a month after the delivery. So, maternity health insurance runs for around 60 days and pays for the expenses during that period.

Read more - Taking Help of Health Insurance to Cover Pre and Post Natal Expenses

Additional Benefits of Maternity Insurance Plans

So, along with the staple pre and postnatal expenses, there are a number of other health insurance benefits too that the maternity plans cover.

  1. To begin with, these include hospitalisation charges during the labour or delivery process. This is applicable for both normal and cesarean deliveries, depending upon the situation.
  2. However, most indemnity plans have a specific limit for coverage of both normal and cesarean deliveries.
  3. In case there is any complication in the middle of labour or for cesarean childbirths, the expenses of anaesthetists, nurses, and obviously, doctors are taken care of.
  4. Also, ambulance and other travel expenses are inevitable expenses that are also covered by a good maternity health insurance plan.
  5. Depending on the chosen plan, bed or cabin and OT room charges are also catered to.
  6. Finally, once the child is born, the post-delivery expenses, including NICU (neonatal ICU) or other special care expenses necessary for the child, will be included in the plan.
  7. Some plans also cover vaccinations of the child for the first year. In fact, some plans cover vaccinations up to 12 years of age of the child as well.

Read more - Women Need Health Insurance Plans with Maternity Benefit

Expenses a Maternity Health Insurance Plan Will Not Cover

There are various pre-delivery, delivery, and post-delivery expenses that a maternity health insurance plan covers, but there are certain things that it does not. These also need to be kept in mind:

  1. If the mother has any illness that can negatively affect the pregnancy, substantially complicate or delay it, the health insurance will not cover it. Similarly, if there is any need for additional surgeries or extensive medication due to the illness, the maternity policy will not cover it.
  2. In case the couple is infertile, either or both parents, curing it or going for certain measures to curtail it before the actual childbirth process does not fall under the alias of any maternity insurance plans. Some new-age health plans also cover fertility treatments, such as IVF and surrogacy, but after a specific waiting period of 36 to 48 months.
  3. Maternity health insurance plans will only pay for those medicines that are prescribed by the concerned doctor. Any kind of uncharted medicine will not be paid for.
  4. Certain plans might not cover the regular check-up expenses, but they mostly do. However, if there are abnormalities or other issues that need additional consultation, they will not be covered.
  5. Maternity insurance plans also do not cater to the treatment of any congenital diseases that might occur in the child unless specifically mentioned in the plan.

However, the total coverage provided would be only up to the specified limit for maternity claims as mentioned in the policy document, up to the total sum insured of the plan.

Processing the Maternity Insurance Claims

There are a few steps that need to be taken care of:

  1. To begin with, the insurance provider must be communicated with. This can be done online or on the phone. The form needs to be printed and filled up properly.
  2. After submission, it will be verified by the hospital authorities.
  3. There are also a number of required documents like policy and KYC documents, all the bills, fitness certificates, discharge summaries, etc., which must be submitted to the health  insurance provider.
  4. Once the admission is confirmed, with cashless health insurance, the company will automatically pay for the hospital expenses, and the patient party need not think about the money.
  5. In case of any issues regarding the cashless system or unavailability in the connected hospital, the company will pay the party for all the expenses as reimbursement. 
    In that case, the party must pay the hospital bill while checking out, but they will be reimbursed for submitting the bill and the required documents.

Final Take

Childbirth is one of the most beautiful and happiest feelings that parents might ever get to enjoy. Monetary thoughts must not tarnish it. This is exactly why maternity insurance plans can be a real boon. Along with the hospital costs of childbirth, a good maternity health insurance policy will take care of all pre and postnatal expenses without any failure.

Read more - Foolproof Financial Plan for Your Maternity Leave


1.What are pre-hospitalization expenses in maternity?

So, these are the expenses that the insured party undergoes before the mother is admitted to the hospital for the delivery of the baby. They may range from tests to medical bills but are all covered by a maternity health insurance plan.

2. Can pre and postnatal expenses be claimed in health insurance?

Yes, pre and postnatal expenses are a crucial part of any maternity health insurance and they must be claimed. Postnatal expenses usually also cover vaccination and treatment of the baby in case of any critical illness.

3. What is not covered by maternity insurance?

To tell in very few words, any complications that existed before or irrespective of the pregnancy, like infertility do not fall under the alias of maternity insurance and hence their treatment usually will not be paid for. However, there are some latest policies that also cover these issues.

4. Is there any separate maternity health insurance?

No, there is no such health insurance in India. However, you can avail of comprehensive indemnity health insurance plans that also cover the medical expenses of maternity, starting from regular ultrasounds and tests to check-ups to medical bills. Otherwise, you can get maternity cover as an add-on with a family floater health insurance.

5. Can maternity insurance from 2 companies be claimed?

Yes, it is technically possible if the insurance money from one company is not enough. But, at the same time, the total premium for both must not be more than the total expenses that need to be paid.

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