Does maternity care require special insurance?

K. ARAVIND

Earlier, personal health insurance policies did not cover maternity care. Only group insurance policies cover maternity care. Personal health insurance policies have been available in the market for the past few years that cover maternity care as well.

In the past, maternity care was denied coverage because the insurance covers unforeseen medical expenses and does not cover maternity leave. Insurance companies changed this position as part of their strategy to expand policy sales.

Almost all new trends in the insurance industry are initiated by private insurance companies. Maternity insurance policies were also first marketed by private insurance companies. Now, public sector general insurance companies are also launching similar policies in the market. It is important to understand the terms and conditions of these policies before embarking on such personal policies as they cover the maternity hospital expenses only.

Policies covering maternity hospital expenses limit such expenses. Maternity care coverage offered by most policies is only 10 per cent to 20 per cent of the policy amount. For example, in a policy of Rs 1 lakh, the coverage for a normal delivery is only Rs.10,000 to Rs.20,000. This limit may be slightly higher in group insurance policies.

In most of these insurance products, maternity care is covered only after a certain period after the policy is taken out. The waiting period is four to six years. In the case of group insurance policies, the waiting period is only up to nine months.

If the policies are taken for the sole purpose of covering maternity hospital expenses, the real benefit will often not accrue to the consumers. If the premium paid during the waiting period is effectively invested, the hospital expenses can only be recovered. This amount can be deposited in a mutual fund or post office time deposit. Also, take into account the fact that the claim amount is allowed only up to a certain limit of the cost of maternity care.

Since a health insurance policy is a cover for various types of medical expenses, a policy should be taken only with such a view. Only those who do not actually have group insurance coverage should consider taking out such policies. Those with adequate group insurance coverage do not need such policies.