Author: Rupanjali Mitra Basu

Our health insurance policy is fraught with a mix of complex jargons, jargons that are technical. A common man finds it hard to understand such jargons and does the inevitable – ignores it. How many times have we looked at the policy wordings of the health insurance plan we are intending to buy or have bought? Almost never, isn’t it? And this is the reason that at the time of claim we face a hard time understanding the policy conditions and getting the claim settled. Take the case of Mr. Singh for instance.

Mr. Singh, my neighbor, had a decent health insurance policy for himself and his family. However, he did not know the difference between a Day Care Treatment and an OPD expense and considered both the same. It was when he availed a Day Care Procedure without being hospitalized and got his claim rejected did he realize his folly. He understood that both the concepts were different. He learned his lesson by paying the bills from his own pockets. What about you? Do you know the difference between Day Care Treatments/procedures and Outpatient expenses? No? Let me illuminate you:

What are Day Care Treatments or Procedures?

Health insurance plans pay a hospitalization claim only if hospitalization is affected for a minimum period of 24 hours. But, there are treatments and procedures which, though require hospitalization, are for a short duration because of technologically developed procedures. If such procedures would not have been available, the patient would have required a longer hospital stay. These technologically advanced treatments which do not necessitate a hospital stay of 24 hours are called Day Care Treatments. A health insurance plan covers such treatments under the category of Day Care Treatments or Procedures.

What are OPD expenses?

OPD stands for Outpatient Department and relate to those expenses which are incurred on doctor consultations, pathological tests and investigations, etc. Basically, outpatient expenses encompass all medical expenses which are incurred without being hospitalized. Such expenses usually occur when you visit a doctor’s clinic and avail treatments.

Similarities between the two

The only similarity between a Day Care Treatment and an OPD expense is the short duration of medical treatment. Under both these categories, the patient receives a short treatment for his medical ailment.

Difference

Both these terms – Day Care Treatments and OPD expenses – are not only literally different, they are technically different too. Let us understand how:

• Hospitalization

Under a Day Care Treatment, hospitalization is compulsory. It is only the time period of such hospitalization which differentiates a Day Care Treatment from an in-patient hospitalization. Day Care Treatments include such treatments and procedures which have become quicker only because of technological advancement. Otherwise such treatments would have required a longer hospital stay making them an in-patient hospitalization.

OPD expenses on the other hand never require hospitalization. These expenses are incurred on doctor consultations which are availed in a doctor’s clinic. Any subsequent investigations and medical tests are also included under the scope of OPD expenses.

• Scope of coverage

Day Care Treatments are covered by all health insurance plans. However, the list of Day Care Treatments which a plan covers differs between different health plans.

OPD expenses are usually excluded from the scope of coverage of a health plan unless otherwise expressed. Some plans, though, provide inbuilt coverage for OPD expenses while some charge an additional premium for including the OPD coverage feature. Overall, OPD expense is not a universal coverage feature of a health plan.

• Level of coverage

Barring a few treatments (like cataract, for example) there are no sub-limits on Day Care Treatments. These treatments are covered for up to the Sum Assured level chosen by the insured.

OPD expenses are always covered fractionally. Their coverage is either expressed as a percentage of the Sum Assured or a maximum absolute amount. This amount is much lower than the sub-limits on certain Day Care Treatments.

Now, I hope, that you are clear on the difference between two important and yet ignored health insurance concepts of Day Care Treatments and OPD expenses. Here is a small list of some common treatments which qualify as Day Care Treatments:

• Cataract
• Nasal sinus aspiration
• Removal of a foreign body from the nose
• Tympanoplasty
• Tonsillectomy
• Surgical treatments of anal fistulas
• Cystoscopical removal of stones
• Chemotherapy for cancer
• Hemodialysis
• Radiotherapy for cancer treatments

Mr. Singh learned his lesson and never made the mistake of considering both Day Care Treatments and OPD expenses to be similar. You have been forewarned and should learn the difference yourself too if you want to avail a successful claim settlement.

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Health insurance is a technical product. It requires policyholders to understand the basic terms and conditions of their policy to make a successful claim. Due to a lack of awareness of its technical nature most of us get stumped when making a successful claim on the health insurance provider. More so if the treatment is taken at home because we believe that our health plan would pay only when we face hospitalization. Is the belief correct? Can’t we raise a claim for a treatment taken at home? We can.

Yes, you heard me right. There is a concept in our health insurance plan called ‘Domiciliary Hospitalization’ which permits treatments availed at our homes. Do you know about it?

What is Domiciliary Hospitalization?

Treatments taken at home for a disease or injury either because of non-availability of hospital beds or because the patient is not in a condition to be moved to a hospital are called domiciliary hospitalization.

This was the basic definition of domiciliary hospitalization but the concept doesn’t end here. There are certain terms and conditions which should be fulfilled for a treatment to be categorized as domiciliary hospitalization. Let us see what such terms and conditions are:

Terms and Conditions for Domiciliary Hospitalization

• The treatment would be allowed at the policyholder’s home only when:

1. There is a lack of accommodation at a hospital, or
2. The patient’s condition does not permit him to be moved to a hospital

• The treatment should be required for such a medical condition which, in normal circumstances, would require treatment at a hospital
• The medical treatment availed at home should be for a period of more than 3 days.

Treatments fulfilling all the above conditions would only qualify under the concept of domiciliary hospitalization.

Common exclusions for Domiciliary Hospitalization

There are some exclusions which are not covered under the purview of Domiciliary Hospitalization even when the above three conditions are met. Such exclusions are as follows:

• While pre hospitalization might be covered under some plans, post hospitalization expenses incurred for such treatment would be excluded from the cover.
• There are some treatments for which domiciliary hospitalization availed would not be covered. Such treatments include the following:
• Bronchitis
• Asthma
• Diabetes Mellitus and Insipidus
• Chronic Nephritis
• Diarrhea, Dysentery and Gastroenteritis
• Hypertension
• Epilepsy
• Cough, cold and Influenza
• Pyrexia of unknown origin for a period of less than 10 days
• Psychiatric or Psychosomatic Disorders
• Arthritis, Gout or Rheumatism
• Tonsillitis and Upper Respiratory Tract Infection, Laryngitis or Pharyngitis

Points of importance

A domiciliary hospitalization entails other points too. Here are some important points to remember in addition to the conditions and the exclusions of a domiciliary hospitalization:

• Not every health insurance plan covers domiciliary hospitalization. Even in plans where the coverage is available, it might either be inbuilt or provided as an optional cover. In case of an optional cover an additional premium is required to opt for the cover.
• Some plans cover domiciliary hospitalization up to the Sum Assured while in some plans the coverage is restricted. Such a restriction might either be in absolute terms or depicted as a percentage of the Sum Assured.

So, by now you must have had a clear understanding of what domiciliary hospitalization actually is. The next time when you read the term in your plan’s features you would know exactly what your policy would cover and what not, isn’t it?

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As part of routine annual health checkup from his company, Vikas went to a well-known hospital for the same. He was quite surprised to know that his blood pressure or BP was high. He was diagnosed with hypertension. Hypertension indicates a high risk factor for cardiovascular or heart ailments. Vikas was worried as he did not have any individual health insurance plan. This led him to investigate health plans which cover critical illnesses related to the heart.

Research shows that in India over 320 lakh people are cardiac patients in 2015. Medical Inflation is almost 20% per annum. It can thus make a large hole in one’s pocket.

Vikas comes across a Cardiac Care Plan and wonders if he should opt for that! To understand a Cardiac Special Plan, you need to know who can opt for the same.

Who can opt for Cardiac Special Health Plans?

Star Health has a cardiac special health plan called Cardiac Care Plan. Star Health Cardiac Care Plan has been especially designed for people who have undergone heart surgeries for the first time or had an angiogram. Heart surgeries include PTCA (Stenting) through Angioplasty or CABG (By Pass Surgery).

Therefore, the basic question is answered here. Vikas has been diagnosed with hypertension. He, however, has not undergone any of the heart related surgeries. Thus, he needs to apply for a regular health plan immediately. Along with basic lifestyle changes to keep the high BP under control. If the medications start, it becomes difficult to get the regular health plan issued, even with additionalpremium.

Now, you may have an ischemic heart or other heart related disease in the family. Even then, you need to apply for a regular health insurance plan. This should however be done after making the necessary declarations. Heart related ailments would then be considered as a “pre-existing” illness and might have a waiting period. Cardiac Care Health Plans can be bought ONLY if you have undergone any heart related surgeries. Not otherwise.

Uniqueness of Star Health Cardiac Care Plan.

Eligibility.

It can be taken by anyone till 65 years of age and can be renewed lifelong. This policy can be taken by anyone who has undergone Angioplasty or Bypass surgery. However it needs to be within 6 months to 3 years prior to applying for such plan.

Small Waiting Period.

This plan has 2 variants, Gold and Silver. The benefits can be summarized as under.

In both Silver and Gold Plan, all Hospitalization and Accidental expenses are covered from day 1. Even out patient expenses upto the specified limit are covered. Pre-existing non-cardiac ailments are covered after 4 years of continuous renewal. This is similar to many plans in the industry. The Gold variant covers medical management treatment as well where surgery is not mandatory.

The uniqueness of this plan is the small waiting period of only 3 months from commencement for all Cardiac Related Pre-Existing Ailments. Thus, all heart related treatments are covered from the 91^st day onwards. As long as the treatment requires at least 24 hours of hospitalization.

Other Exclusions.

• Dental treatments, other than any damage due to an accident.
• Any ailment or costs related to hearing/visual impairment, spectacles, contact lenses, wheelchair, etc.
• Pregnancy and other maternity expenses.
• There is a 2 year waiting period for treatment of certain illnesses. The illnesses under this category would be cataract, tonsillitis, piles, fistula, gall bladder, etc.
• Unconventional treatment.

Is the Star Health Cardiac Care Plan very expensive?

Let us take an example of a 40-year old man with heart surgery. If he opts for a coverage of Rs 4 lacs in the Silver Variant, he needs to pay a premium of Rs 25,300.

If he did not have any heart surgery, he would require to take a regular health plan. Star Health Medi Classic Policy would cost him Rs 5992 only. Star Health Comprehensive Insurance Plan would cost him Rs 9286 for a comprehensive coverage of Rs 5 Lacs.

So, yes this plan is quite expensive. That is the cost you need to pay if you have had a heart surgery and yet do not have any health plan!

Moral of the story is take your health insurance coverage ASAP. It should be taken much before you are even diagnosed with any serious ailment. Else be prepared to pay more premium!

Read more about how to lower your insurance premiums

Read more about Dejargonizing health insurance plans

A health insurance policy is a very important requirement in today’s age. Modern day lifestyle has made an average individual more prone to illnesses. Coupled with this, the rate of medical inflation has increased tremendously to almost 20% according to HDFC ERGO. Here is the graph showing the increase in hospitalization costs as surveyed by the National Sample Survey Office in 2014:

Both these reasons mandate a health insurance policy for your whole family, an important requirement. Insurers have designed family floater health insurance plans to fulfill this requirement. These plans cover all the family members under a single umbrella and are also affordable. Even your parents can be covered under such plans. But, is covering your parents under the same floater plan prudent?

Before advising you on the right course of action, let’s understand the concept of family floater plans.

What are family floater plans?

Family floater plans cover family members in one plan under a single Sum Assured. The members covered include self, spouse, dependent children and dependent parents. Some health plans also cover parents-in-law. These plans are cheaper than individual health plans for each family member.

Read more about family floater plans

Should parents be involved in a floater plan?

Though family floater plans allow the inclusion of parents, it is not prudent. There are several reasons why parents should not be included in a floater health plan. Such reasons include the following:

1. Entry age restrictions. Floater plans have a restriction on the maximum entry age. Usually the age of the eldest member is considered and is limited to 65 years. If your parents are above this maximum age limit, they cannot avail a floater plan. Individual senior citizen plans, on the other hand, are designed for individuals above 65 years of age. Thus, they fit better for your parents’ cover.
2. Higher rates of premiums. Under a family floater plan, premium is calculated using the age of the eldest member. If you include your parents, the premium rate would depend on their age and would be high.
3. Disadvantage of frequent claims. When you do not make any claim in your health plan, you are entitled to a No Claim Bonus (NCB) in the subsequent year. This NCB is cumulative in nature and accumulates for every consecutive claim-free year. If your parents share your floater cover, being aged, they might require frequent medical assistance. As such, the probability of making a claim in your plan increases and you lose out on the accumulation of NCB.
4. Pre-existing waiting period. Every health insurance plan has a waiting period for pre-existing illnesses. The waiting period ranges from 2-4 years depending on the plan chosen. Since your parents might be suffering from such illnesses, their illnesses would be excluded from the scope of your plan. Consequently, despite having a health plan, you would have to bear the medical costs of such pre-existing illnesses.

What should you do?

From the above discussions, it is clear that parents should not be covered under your floater health plan. However, they should not be left out from the scope of a health plan either. You should buy a separate floater plan for your parents. Below are the arguments in favor of such separate plans:

1. Customized coverage. Senior citizen plans are designed especially for older individuals. As such, they provide an exhaustive coverage for ailments found commonly in the older population. Under these plans, your parents can enjoy all-inclusive coverage for their ailments which were excluded from your regular floater plan.
2. Lower waiting period. If your parents are more than 60 years of age, then you should opt for Senior Citizen Plans for them without a second though since they might have pre-existing ailments. Plans for Senior Citizens generaly cover pre-existing illnesses after a smaller waiting period compared to regular health plans. Thus, you would be spared the expenses of such ailments.
   However, for parents less than 60 years of age you need to avail regular health plans as they may not qualify for senior citizen plans.
3. Savings in premiums. Premiums for your floater plans would come down when you segregate your parents’ coverage. For example:

Case 1. Mr. A, aged 35 years buys Apollo Munich Easy Health Plan covering his family – parents (60 and 58 years), himself (35 years), wife (33 years) and two kids (4 and 2 years). He chooses the Sum Assured of Rs.5 lakhs and the premium required comes to Rs.84, 386 for a 1-year policy.

Case 2. He buys a separate family floater for his family (self + wife + kids) and another one for his parents. He pays Rs.23, 781 for his floater cover and Rs.48, 237 for his parents’ floater cover bringing the total outgo of Rs.72, 018. This is significantly lower than the earlier figure.

All in all, though you might be tempted to include your parents in your floater plan itself, you should avoid doing so. Covering your parents in a separate health plan makes more sense. We, at Turtlemint, believe in this and provide a separate health plan for your parents at the outset. If you wish to buy a health plan online for your family visit us at www.turtlemint.com. We would fulfill your health plan requirement and also suggest a separate plan for your parents.

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Read more about Dejargonizing health insurance terms

To those who are new to health insurance, terms like “deductible,” “copay,” and “premium” can be overwhelming. Having at least a basic understanding of what these terms mean can help in selecting a policy and actually using the policy for health care, however. This article will give a quick explanation to help make the new insurance process smoother.

Benefit

A benefit is any money provided by the insurance company to cover costs of services. As such, a beneficiary is anyone covered under the plan. A benefit period is an amount of time during which services are being continually offered that should be covered – at least in part – by the insurance company.

Hospitalisation

A standard health insurance covers for in-patient treatment that is overnight stay in a hospital.  This is known as Hospitalisation which could be due to an illness or accident.

Copayment

A copayment is a part of the payment that must be made by the policy holder out of his pocket based on the policy terms and conditions for certain services like room charges, specific disease treatment etc.

Understand copayment much better with the help of the below video

Deductible

The deductible is the amount of money that must be paid by the insurance policy holder before the insurance company will start covering medical costs.

Network Hospitals

Network hospital is a terminology that is generally used to let policy holders know which Hospitals or specialists to go to. When a hospital is indicated to be in the insurance company’s network then it will be eligible for cashless treatment.

Premium

A premium is an amount paid every year to keep your health insurance policy active. Failure to pay the premium amount every year will result in a lapsed policy. Some insurance companies may allow a grace period before the coverage lapses but this may involve certain terms and conditions which might put the claims on hold during this period.

Many of us take steps to take care of our health; however when it comes health insurance we get hassled with the new terms. Here we have tried to simplify some of these important terms.  For more information about the policy benefits and terms please visit our site www.turtlemint.com/health-insurance  or if you are based out of India you can contact your local health insurance provider and check the various health insurance policies available in the country of your residence.

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~~Hope you have not done the same mistake as her. ~~

Diabetes is one of the most common diseases globally and specially in India. About 44 lakh people in India between ages 20 and 79 are not even aware that they are Diabetes affected. Quite contrary to the belief, rural Indians are more affected with diabetes than urban Indians. Now, the diabetes count in India is close to 62 million. By 2030 India is expected to cross the 100 million mark of diabetes-affected people! In fact, nearly 52% of Indians have a tendency of high blood sugar. They are not even aware of the health precautions and the possible preventions and insurance.

Cause for Diabetes.

Diabetes is a metabolic disorder where the blood sugar levels get high. Blood sugar levels in the body are controlled by insulin produced by the pancreas .When there is an inadequate production of insulin it is called Type 1 Diabetes. This generally happens at a young age and needs regular insulin injections.

When body becomes insulin resistant or insulin is not working the way it should then the glucose does not reach the cells. It then remains in the blood leading to high blood sugar levels, causing diabetes. This is Type 2 Diabetes and can be treated with medication and lifestyle changes.

Diabetes is also a hereditary disease.90% of diabetes affected Indians  have Type 2 Diabetes. This type of diabetes is more common with the middle-aged and older people.

The rising expenditure on Health Care for Diabetes.

Due to the rising epidemic of Type 2 diabetes, the Indian Government has also started various health programmes. However, in 2010, only 19% of the entire population was covered under the Government scheme of health care.

The World Bank data of 2014 says that 89.2% of India’s expenses on health care are out-of-pocket. Thus it is not covered by insurance. About 70% of Indians spend their entire lifetime’s income only on medical treatment due to the rising medical expenditure.

Costs involved in taking care of a diabetic is very high. A lower middle-class family in India spends more than 20% to of the family’s annual household income in taking care of the diabetic in the family. Taking care would mean treatment, medicines and other expenditure. If the family has a diabetic child, it spends about 35% of the income in the treatment of the diabetic, besides the stress involved.

The average monthly expenses for diabetic ranges from Rs 3000 to Rs 8000 per month. This includes diagnostic charges for regular tests, doctor fees and cost of insulin dosage. The average cost for an insulin dependent diabetic is  about Rs 6000 per month.  If insulin is not required, the average monthly costs are around Rs 3000.

Precautions.

As revealed from ASSOCHAM findings, diabetes among men has increased by 25 per cent while up to 42%  among women in India.The Government is also quite alarmed and is taking very serious health care steps as the World Health Organization has predicted a figure as high as 80.9 million diabetics in India by 2030! It, however, focuses towards the lower strata of the society.

Thus, for regular citizens like you and me, the burden of additional health care for the diabetic is entirely upon us. We need to take health precautions, medications and insurance for our own benefit.

Shilpa, a friend of mine, diabetic for the last 5 years inspired me to write this article. She had been diagnosed with fasting blood sugar of 143 mg/DL and post-prandial blood sugar of 220 mg/DL about 5 years ago. This is a case of Type 2 Diabetes wherein she could have controlled the same with medicines and healthy living. However, she did not really take care of herself at all. And, now she needs to take insulin dosages every day, twice daily! And yes, she has no insurance.

Scare, but yes if you look around there are quite a few who have similar stories to narrate. I would strongly suggest each of you to start exercising today. Focus on healthy living. Eat more fruits and vegetables in your diet and less of proteins and carbohydrates. Lower your alcohol and introduce at least 20-minute walk in your daily life. It would spare you the horror of undergoing what Shilpa has been for the last 5 years.

Insurance Plans for the Diabetic.

Here are some of the health insurance plans that have been especially designed for the diabetic.

** Pre-diabetes – IFG is impaired fasting glucose i.e 100 to 125 mg/dL in Fasting Blood Sugar Test and IGT  is impaired glucose tolerance i.e  140 to 199 mg/dL in Post-meal Blood Sugar test.Star Health Diabetes Safe Plan is a comprehensive health insurance plan while Apollo Munich Energy Health Plan is a disease-specific plan for diabetics.

However, ICICI Prudential Diabetes Care is a critical illness plan for the diabetics wherein on diagnosis of any of the listed 7 critical illnesses, the policy pays the entire sum assured and the policy terminates.

The premiums for the above mentioned plans are listed below for a 45 year old opting for a Rs 3 Lacs cover.

• Star Health Diabetes Safe Plan A has a premium of Rs 11,590.
• Apollo Munich Energy Silver Plan has a premium of Rs 11,707 without co-pay and Rs 9,493 with 20% co-pay while
• The Critical illness plan from ICICI Prudential, Diabetes Care Active has a premium of Rs 14,319.

So, you only spend on a premium of Rs 12,000 to Rs 14,000 per annum. Alongside you get income tax benefit U/S 80D till Rs 25,000 per annum of premium payment. You also get a minimum of Rs 3 lacs coverage every year. This also includes wellness programmes like an annual medical check-up. The annual medical check-up includes blood sugar test along with

• Blood pressure check-up.
• Regular diet charts.
• Regular exercise charts.
• Lipid profile test.
• ECG
• Routine urine test.
• Serum creatinine.

As well as doctor’s consultation.

I have suggested Shilpa not to look beyond and think anymore, but just choose the best health plan which she feels like and then take it as soon as possible. Alongside, I have suggested her to start yoga and 20 minutes of brisk walking with low oil diet if she really cares for herself and her family. And, if you happen to be like Shilpa, need I say more?

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Motherhood is a beautiful experience in every woman’s life. It makes a woman feel complete. Juggling between career and life, motherhood often gets delayed. Thus complications during childbirth have also become quite prevalent. This is because of the surrounding stress, lifestyle and delayed pregnancy.

Motherhood comes with a lot of responsibility as well as expenses. In fact these days, couples plan their families based on their financial conditions rather than emotionally. Expenses do not end after the child is born. The total expenses could cost you a fortune if you are not prepared. Thus, raising a child needs good financial backup. In this case, a health insurance with maternity coverage can solve the problem.

What is maternity insurance?

Health insurance covers the cost of insured individual’s medical expenses. But, maternity coverage is a very important health benefit for women. It pays for all expenses related to normal pregnancy, labour and delivery. Some of this maternity plans support new-born baby care and other related expenses too. It, however, does not cover artificial insemination and other related costs.

Read more about why you should buy maternity insurance plan

Does it make sense to buy a Health Plan with Maternity Benefits?

Childbirth in a good hospital has become quite expensive today. A normal delivery costs around Rs 20,000 to Rs 50,000, without much complication. However, a caesarean delivery is way more expensive. It can range anything between Rs 35,000 to Rs 1 lakh.

Thus, it is not always possible to bear a huge amount during delivery. And you still wish to get the best services for your family and child. Having maternity coverage will reduce your financial stress during pregnancy. Alongside you would not have to compromise on your childcare as well.

Some corporates also provide group health plans with maternity coverage for employees and their spouses. If your company offers one, you are saved. Else, buying an individual health plan makes sense

Here are few reasons why an individual health plan is a better option over a group health cover:

• In case, you change your job. The coverage would be lost along with the maternity coverage.
• Coverage under group health policy might be limited in terms of value.
• Group plan might not include pre and postnatal expenses related to childbirth. An individual plan covers it all.

Key things to consider while buying a Maternity Insurance

A health plan with maternity benefit includes almost all expenses related to pregnancy.

• Pre and post hospitalization.
  Pre hospitalization consists of check-ups before hospitalization to medicines. Post hospitalization would take care of childcare after delivery. The 30-60 days before hospitalization and 60-90 days after discharge is considered under this.
• Delivery charges and in patient hospitalization.
  The hospitalization charges for delivery are covered in this insurance. Some policies have certain sub-limits pertaining to delivery. Sub limits for normal deliveries are Rs 15,000- Rs 25,000. And that for caesareans are Rs 25,000-Rs 50,000.
• Pre and postnatal expenses.
  This covers for childcare expenses which included doctor’s consultation as well as medicines. Even check-up and incubation costs are also covered.
• Vaccination cover.
  Some health plan cover the Government mandatory vaccination expenses of the new born also. Usually it is provides for the first year vaccinations only but some plans extend it as well to 12 years.
• New Born Coverage.

Some health plans provide new-born health cover including all special care necessary and expenses related to defects, if any from the time the child is born.

When is the best time to buy maternity coverage?

Many think about when is the right time to opt for maternity coverage and the answer is very predictable- as early as possible. Though delaying is a common thing, there are various reasons why one should not delay to opt for maternity coverage.

Here are the top 3 reasons for opting for Maternity Coverage ASAP.

Applying for a maternity coverage plan at the last minute can be a big mistake. Here are the glitches of availing maternity coverage at the last minute.

1. Waiting period and pre-existing clause.This is a specified period of time after which you can get cover for maternity expenses. Most insurance companies do not provide for maternity coverage in the initial years. The first 2-6 years are usually excluded from this coverage. This is called the waiting period for maternity. Corporate policies also sometimes have a waiting period of 9 months to 2 years.

In addition, you cannot avail a new maternity coverage plan if you are already pregnant. In such case, pregnancy would be considered as a pre-existing condition and hence no maternity coverage shall be provided.

Hence, it has to be availed at least 2 years before you are planning to conceive a child.

2. Rise in premiums with age and time.Premium of this coverage would increase with your advancing age. So if you delay to avail this insurance, you are likely to pay higher premiums to fulfil your needs.Also, with the marriage age being pushed further today, more women above 35 and even 40 are delaying motherhood. In addition, even expenses related to motherhood are increasing day by day. Therefore, if you delay, you might not be able to opt for a cheaper maternity plan as the waiting period for the same is usually longer. Thus, you would end up opting for a plan with a higher premium to avail the timely benefit.
3. Ease in availing the Policy. If you have time, it is always better in terms of availing any kind of insurance. If the maternity coverage is not taken early in life, maternity benefit might not be available at a higher age due to the complications involved with ageing! You might also have to avail the same in a hurry and thus not able to do complete research. So the earlier you buy, the better it is!

Popular Plans with Maternity Coverage

There are some popular plans, which offer good features on maternity coverage. They are

• Apollo Munich Easy Health Premium Plan
• Religare Joy Plan
• HDFC Health Suraksha Gold Plan
• Star Wedding Gift Plan and
• Max Bupa Heartbeat Plan

Here is a comparative analysis between Apollo Easy Health plan and Religare Joy Plan.

Expert advice

If you wish to buy a Maternity Insurance Plan, now is the right time. Alternatively, if you got married recently and planning to have a child in next few years, having a maternity coverage can be helpful. However, if you are planning a baby immediately, then you need to consider the premiums before buying, since plans with lower waiting periods are relatively quite expensive.

Also, having a maternity coverage can be helpful if you plan your next child a few years later. However, if you are not planning any more children, then this additional benefit is not required. Or, if your group insurance provides enough coverage for the entire benefit that you may need, then this additional maternity benefit may not be required.

Thus, the best solution is to opt for a comprehensive health insurance plan like Apollo Munich Easy Health or Max Bupa Heartbeat, which has all other benefits like lifelong renewability and has Maternity Coverage too at a competitive rate. You can continue this health insurance plan for the rest of your life and can include your family as well. However, a purely maternity driven plan like Religare Joy is helpful only for immediate Maternity benefit and hence, can be discontinued afterwards, since the premium is very high as compared to the rest of the industry.

So don’t waste your time as time is money. Old saying but true as it can help you save quite a lot. Get the best insurance plans in India online at Turtlemint.

Read also An anatomy of an health insurance plan

Read more about Dejargonizing health insurance terms