Waiting Period in Maternity Health Insurance

What do we mean by a waiting period in health insurance that covers maternity costs? While people usually look for maternity insurance without waiting periods, there is usually a waiting period for maternity insurance that you should factor in, before opting for these plans.

What is Maternity Health Insurance?

Before learning what is waiting period in health insurance, you should know more about maternity health insurance overall. Maternity insurance plans offer coverage for costs linked to maternity. As per several reports, the average age when women give birth has increased to 32 years from 33 years in the country. There is a perception that women who give birth to their first children in the early 30s are likely to have more complicated pregnancy procedures. The ratio of cesarean procedures to regular deliveries has already touched 65:35 in India’s metro cities as per studies. 

Many women are thus choosing health insurance policies which offer coverage for maternity costs too. These plans have longer waiting periods and higher premiums. Maternity-linked expenditure is covered through various riders in the health insurance plan (additional premiums are chargeable for such coverage). In some scenarios, maternity coverage is under the OPD-linked expenditure category. Group policies also cover maternity insurance in some other scenarios. 

Key Features and Advantages of Maternity Health Insurance

Here are some points worth noting in this regard: 

• Most maternity health insurance plans come with 3-6 year waiting periods for claiming benefits. Group insurance policies with maternity coverage have 9-month waiting periods (sub limits not exceeding Rs. 50,000). 
• Coverage varies as per the insurer but extends to pre and post hospitalization costs (30 and 60 days respectively) along with hospitalization costs, nursing costs, anesthetist costs, delivery costs and vaccination of infants. Coverage is also provided for ambulance costs, post and pre-natal expenditure, baby coverage and emergencies (some insurers offer separate coverage up to Rs. 50,000). 
• These plans usually come with slightly higher premiums since they are high-risk products with 100% claim ratios than many other policy types. Premiums are dependent upon the industry type, age profile, risk aspects, employee count (group policies only) and the location of the company (group policies). 

Maternity Insurance Waiting Period

You should naturally check for the lowest waiting period for maternity insurance. Pregnancy and childbirth represent two of the most beautiful experiences in the life of any woman. Taking skyrocketing healthcare and treatment costs into account, purchasing maternity coverage has become crucial for every household. 

The waiting period is the duration, upon completion of which, suitable coverage is provided to the insured person. Any claim raised by the holder of the policy will be rejected within this period and no financial coverage will be given for maternity-linked costs as well. Waiting periods for maternity insurance policies start on the date of their respective policies but keep varying across insurance providers/policies. 

Types of Waiting Period in Maternity Health Insurance: 

• Maternity Cover: These plans usually come with coverage availability after a duration of 9 months to 6 years as the waiting period (varies across insurance companies). 
• Initial Waiting: All health insurance policies with this coverage will have initial waiting periods of a month or 30 days in most cases. No claims will be accepted by the insurer in this period, excepting medical costs of treatment for accident-led injuries. 
• Pre-Existing Ailments: All maternity insurance policies have waiting periods between 2 and 4 years. In this duration, the insurance company will not offer coverage for pre-existing diseases. 
• Specific Ailments: Specific procedures and ailments have coverage under maternity health insurance after the completion of a waiting period. This is usually two years. These ailments will be mentioned in policy documents. 

Functioning Of Waiting Periods in Maternity Health Coverage

Whenever any woman purchases maternity health insurance coverage, the waiting period that is applicable begins with the starting date of the policy. This policy has to be renewed annually without any lapses. With the waiting period getting over, the maternity coverage will commence and the insured person will have eligibility to raise claims thereafter. Hence, you should purchase maternity health insurance well in advance and not before or during the pregnancy procedure.

It should be bought by those women who are planning to conceive and start their families in the near future. The waiting period of the plan will naturally pass by the time an insured woman enters the pregnancy phase. It is only possible if the insured woman avails of this coverage at an early stage. 

Some Other Aspects of Maternity Health Insurance

• Most maternity insurance policies come with waiting periods. 
• You will find it difficult to find any maternity insurance coverage without a waiting period. 
• Regular health insurance policies with this coverage also have waiting periods. 
• Women should thus purchase maternity insurance coverage well in advance. 
• Some plans offer options for lowering waiting periods as well. They have specific riders like PED waiting period reductions which help in lowering applicable waiting periods under health insurance policies with maternity coverage. 
• Yet, these riders only apply upon payment of an extra premium and may/may not come with a maternity coverage plan. 

The Conclusion

Maternity health insurance coverage is one of the best possible investments that women should make in advance, especially if they are planning to start a family in the future. Yet, these plans will always have waiting periods and you should check them with care before finalizing your purchase. You can also consider lowering your waiting period by purchasing a rider for reducing the same.