Insurers up maternity game with wider coverage, faster access

Women’s changing needs, ranging from education, career advancement, to delayed childbirth, are prompting insurers to offer more competitive and attractive maternity plans with wider coverage. Several major insurers have reduced the waiting period for maternity coverage from 2-3 years to 9-12 months, allowing earlier coverage and facilitating easier access to financial support during pregnancy. Meanwhile, newer plans offer extensive coverage, including pre and post-natal care, C-sections, newborn care, and even complications arising from pregnancy. Some plans even cover assisted reproductive treatments.

“Post-Covid, the inclusion of an OPD feature in health insurance has emerged as a game changer, covering more than just hospitalisation expenses. Similarly, maternity insurance is set to become a game-changer as more consumers are looking for comprehensive insurance plans from insurance companies that cover them holistically,” said Siddharth Singhal, Business Head - Health Insurance at insurance aggregator Policybazaar.com.

“Earlier, maternity insurance used to focus mainly on covering expenses related to childbirth, such as hospital stays, delivery charges, and medical procedures. However, this approach often overlooked other important aspects of maternal healthcare,” he said.

Several health insurance plans are available for a couple residing in Delhi, both aged 32 years, with a sum insured of Rs 10 lakh. These plans offer different premiums, maternity benefits, and coverage for newborn babies. For instance, Niva Bupa’s Aspire plan has a premium of Rs 19,370 and covers maternity-related complications up to Rs 12,000 after a waiting period of 9 months. Meanwhile, Care Health Insurance’s Joy Tomorrow plan, with a premium of Rs 29,132, covers maternity expenses up to Rs 50,000 after a waiting period of 24 months, and provides additional coverage for newborns without an extra premium.

“The newly launched maternity insurance plans provide more comprehensive coverage that includes already served waiting period will be passed on to spouse, covers expenses of pregnancy, prenatal and postnatal consultations, assisted reproductive treatments and infertility treatments, surrogacy and delivery for surrogate mothers covered, charges for adopting a child and vaccination expenses of a newborn,” said Singhal.

Similarly, other plans like Star Health and Allied Insurance, Manipal Cigna Health Insurance, Aditya Birla Health Insurance, and Zuno Health Insurance offer various benefits and coverage options tailored to different needs.

“Given the positive response to these comprehensive plans, the trend is likely to continue, with health insurance providers recognizing the importance of offering all-inclusive coverage that caters to the varied needs and aspirations of individuals and families,” said Singhal.

Many intending parents nowadays are looking for plans that also cover surrogacy expenses. The Surrogacy (Regulation) Act, 2021, in India prohibits any financial compensation to the surrogate mother beyond reimbursement of medical expenses and basic insurance. Since insurance plans typically don't cover expenses related to commercial transactions, they wouldn't offer coverage for surrogacy in this scenario in a normal maternity plan. But many policies in altruistic surrogacy are able to provide coverage to the surrogate mother.

“Surrogacy till now was not covered in any of the maternity plans. The newly launched Aspire covers for surrogacy expenses too. Roughly 40% of people who opt for maternity opted for a plan with surrogacy. Cost is not known yet since the plan was launched last month only,” said Singhal. “We see more and more insurers providing wholesome maternity benefits including day one coverage for newborn, surrogacy, child adoption etc,” he said.

The government is also aiming to increase the health insurance coverage for women. Union Finance Minister Nirmala Sitharaman while presenting the Interim Budget 2024-25 in Parliament this month, proposed that ASHA workers, Anganwadi workers and helpers to be covered under government flagship health insurance scheme Ayushman Bharat, that offers free health insurance coverage of up to Rs 5 lakh per year to India's low-income population for secondary and tertiary care in hospitals.

 “The extension of health coverage under the Ayushman Bharat scheme to ASHA, Anganwadi workers, and helpers is commendable, especially for enhancing insurance penetration among women and to propel India towards 'Insurance for All' by 2047. Consolidating existing schemes for maternal and child healthcare into one comprehensive program promises smoother implementation,” said Prasun Sikdar, MD & CEO, ManipalCigna Health Insurance.