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Maternity Coverage in Pregnancy Health Insurance

20 March, 2013

Pregnancy is a magical journey for families, especially for a mother. But with the joys of motherhood also come the anxieties of childbirth and bringing up a child. Most of it has to do with the rising cost of health care during and after pregnancy. If unprepared, it can pose both an emotional and financial challenge. To ease the journey of pregnancy and the complications that may arise during it, most health insurance companies provide a maternity cover.


What is a maternity cover in health insurance?


A maternity cover is a type of coverage that bears the expenses associated with pregnancy and childbirth. One can get it on a standalone basis or as an optional add-on to cover the needs of expecting mothers and new-borns. The scope of coverage depends on the type of cover and the insurance company. This coverage is usually provided after a waiting period of 1-4 years, so it is advisable to get a maternity cover in advance.


What are the features of a maternity cover?


Generally, a maternity cover does not provide:


  • Coverage for pre- and post-delivery expenses (usually for up to 2 deliveries)
  • Coverage for regular/ natural and caesarean delivery
  • Coverage for pre-hospitalization expenses. For instance, diagnostic tests, doctor consultations, ambulance services, tests for detecting congenital diseases, etc.
  • Coverage for in-patient hospitalization (pre-natal) expenses including cost of delivery procedure, day-care treatment, room rent, doctor’s fee, nurse’s fee, consultation fee, medications, etc.
  • Coverage for post-hospitalization (post-natal) expenses
  • Coverage for new-borns including the cost of healthcare, vaccinations, and specific
  • childbirth defects

Generally, a maternity cover does not provide:


  • Coverage for pre-existing diseases
  • Coverage for non-allopathic/ alternate treatment
  • Coverage for expenses arising due to self-inflicted injury, alcohol or drug abuse
  • Coverage for HIV/ AIDS-related expenses
  • Coverage for tests and treatment related to infertility and artificial fertility methods like in-vitro fertilization
  • Coverage for extra medications like vitamins and supplements (unless included under the maternity cover)

Maternity benefits in a medical insurance policy


One can avail maternity benefits in a medical insurance policy as an add-on cover/ rider. Or buy one along with the base health insurance plan. The policyholder can get the benefits listed above with the payment of extra premium. The premium and extent of benefits provided may differ from provider to provider.


How to choose health insurance based on maternity cover?


Consider the following factors before choosing a maternity cover:


  • Coverage and sub-limit: Ensure that your health insurance policy or maternity cover provides adequate coverage for all pregnancy-related costs (pre-, post- and in-hospitalization expenses.) Check if the sum insured and sub-limit offered is enough and in sync with the current standards of maternity healthcare.
  • Waiting period: A waiting period is the amount of time you have to wait before making a claim under the health insurance policy. It starts from the date of issuance of the policy. Check the waiting period of the health insurance policy offered by the insurance company. Most insurance companies offer plans that have a waiting period of 9 months/ 1 year to 5-6 years. That is why it is wise to buy a health insurance policy with a maternity benefit or separate maternity cover in advance, so you can get the coverage required at the right time.
  • Policy term: Ensure that the duration of the health insurance policy keeps you covered for a considerable period (1-3 years).
  • Terms and conditions: It can be easy to get swayed with the offerings of a maternity cover without reading the terms and limitations attached to it. Before buying one, do go through the detailed clauses and terms and conditions with care.

Lifeline 2.0 by Royal Sundaram


If you are looking for a health insurance plan that gives a comprehensive maternity cover, check out Lifeline 2.0 Elite offered by Royal Sundaram. The maternity health plan offers a sum insured between ₹2 lakhs and ₹50 lakhs to cover all pregnancy-related costs for up to two deliveries.


It also gives the benefit of a new-born baby cover and offers up to 25% of the sum insured. Additionally, it bears the expenses (up to ₹10,000) for vaccinations of new-borns for one year.




To get a maternity cover suited to your needs, you can compare the health insurance policies offered by different insurance companies in India. With pregnancy-related costs rising with each passing day, it is advisable to not delay buying one.