Preparing to welcome a child involves joy, anticipation, and often significant medical expenses. Delivery costs, tests, doctor visits, and newborn care can quickly add up. Maternity health insurance is positioned as a solution, but it comes with nuances that every family should understand before relying on it.
This guide breaks down what maternity health insurance truly covers, where it falls short, and how to evaluate plans if you choose to buy one.
What Is Maternity Health Insurance?
Maternity health insurance is a specialised form of health coverage designed to meet medical expenses related to pregnancy, childbirth, and early newborn care. It may be included within a regular health insurance policy or offered as an optional add-on.
Unlike standard health insurance-which usually excludes maternity expenses-these plans may cover:
- Delivery (normal or C-section)
- Pre and post-natal care
- Hospitalisation related to pregnancy complications
- Newborn medical care for the initial period
However, this benefit is almost always subject to sub-limits and waiting periods, which significantly impact both usability and cost of premiums.
The Disadvantages of Maternity Health Insurance
While maternity coverage seems essential on paper, these policies have structural limitations that make them less cost-effective for many families.
- High Premiums – Maternity claims are almost guaranteed, so insurers price these policies higher. In most cases, you pay substantially more compared to a standard health insurance plan that does not include maternity benefits.
- Strict Sub-Limits – Every policy caps the amount payable for maternity-often much lower than actual delivery costs in metro hospitals. This leads to large out-of-pocket expenses even when you are “covered.”
- Long Waiting Periods – Most plans require 9 months to 4 years of continuous coverage before you can make a maternity claim. For many, this defeats the purpose unless planned well in advance.
- Limited Benefit Scope – Coverage is typically focused on delivery-related hospitalisation. Wider needs such as fertility treatments, surrogacy, adoption-related costs, or extended post-partum complications may not be included unless explicitly mentioned.
- Both Partners Need Continuous Coverage – Many policies require both spouses to be on the same policy and complete the waiting period together. Even if you have been insured for years, adding a spouse later can reset or extend the waiting period for maternity.
A Smarter Alternative: Use Your Employer’s Group Health Insurance
If your employer offers maternity benefits under a group health insurance policy, that is often the most efficient route to cover maternity expenses:
- Typically no waiting period on maternity
- Maternity claims do not impact your personal health policy’s No-Claim Bonus
- Claims are generally more straightforward and less restrictive, up to the specified limit
- Your individual policy’s premiums and bonuses remain unaffected
In most cases, it is better to utilise your corporate group cover for maternity and keep your personal health insurance clean-focused on long-term coverage, lower premiums, and intact bonuses.
What Does Maternity Health Insurance Typically Cover?
While the details differ across insurers and products, most maternity benefits include some or all of the following:
- Delivery Expenses – Both normal and C-section deliveries are covered, up to a defined limit. This usually includes room rent, OT charges, nursing, and basic medical consumables.
- Pre- and Post-Natal Care – Consultations, scans, blood tests, ultrasounds, and medications before and after delivery for a certain number of days-commonly 30–60 days pre-hospitalisation and 60–90 days post-hospitalisation.
- Pregnancy-Related Complications – Conditions such as ectopic pregnancy, medically necessary terminations, or complications during pregnancy may be covered, subject to policy terms.
- Newborn Baby Cover – Costs related to the baby’s treatment immediately after birth (e.g., NICU admissions, congenital complications identified at birth) are often covered for a limited initial period, typically up to 90 days.
How to Choose the Best Maternity Health Insurance Plan
If you decide that you still want maternity cover within your personal health insurance, use the following criteria to evaluate plans:
- Waiting Period – Prioritise plans with shorter waiting periods, especially if you intend to start a family soon. A waiting period of 9–24 months is more workable than 3–4 years.
- Maternity Sub-Limits – Check the exact limit for normal and C-section deliveries. Compare this with current delivery costs in the hospitals you are likely to use. A low sub-limit in a metro city will not offer meaningful protection.
- Pre- and Post-Natal Coverage – The broader this window, the more practical the coverage. Look at how many days before and after hospitalisation are covered, and what exactly is included (tests, scans, consultations, medicines).
- Newborn Coverage – Newborn coverage should be evaluated carefully to understand the extent of protection offered immediately after birth. Check whether the newborn is covered from Day 1 and how long this initial coverage lasts, as some policies extend it for a defined period such as 90 days.
- Insurer Quality – Beyond the policy benefits, it is essential to evaluate the overall quality of the insurer. Key indicators include the claim settlement ratio, complaint volume, the insurer’s network hospitals, and the availability of cashless tie-ups, as these factors directly impact convenience and the ease of receiving treatment.
Features of Select Plans Covering Maternity
Below is a quick reference table based on the information available. Always refer to the latest policy wording or speak to NYVO advisor before making a decision.
| Plan Name | Delivery Expenses Limit | Waiting Period | Pre- and Post-Natal Coverage | Newborn Coverage from Day 1 |
|---|---|---|---|---|
| ICICI Lombard Elevate | Maternity benefit available as an add-on – up to 10% of base sum insured, capped at ₹1 lakh | 2 years (can be reduced to 1 year with an add-on) | Yes | Newborn cover available up to 2× maternity limit till 90 days |
| Aditya Birla Activ Fit Preferred | ₹40,000 (normal delivery); ₹60,000 (C-section); up to 2 deliveries/terminations | 3 years (available on family floater) | Yes | Yes – newborn baby expenses covered within maternity limit |
| Niva Bupa Aspire Titanium + | Varies by sum insured | 9 months | Yes | Newborn coverage available; child can be added within 90 days |
| Care Joy | Today/Tomorrow variants – up to ₹50,000 (linked to sum insured) | Tomorrow – 2 years; Today – 9 months | Yes | Yes – newborn baby expenses covered, up to ₹50,000 (as per policy terms) |
About the Author
Harsh Soni is the Founder of NYVO, with over 16 years of experience across fintech, insurance, and investment banking. As a father of two-Nysha (6) and Neel (2)-he brings not only professional insight into health insurance and financial planning but also personal experience, having navigated the maternity journey twice. His perspectives blend industry expertise with real-world understanding of the practical challenges families face.