About Maternity Health Insurance
Motherhood is indeed the most beautiful feeling but the role comes with a number of additional responsibilities and expenses. From top-notch medical attention to proper medication, this phase needs a lot in addition to care and love. A maternity and pregnancy insurance plan is a good way to handle these additional medical expenses. Maternity insurance policies are designed to help the policyholder cover birth, pre-natal and post-natal expenses. This type of plan ensures the wellness of the mother as well as the baby. In a nutshell, this health insurance is an easy way of financial planning. HDFC ERGO Maternity Health Insurance provides two maternity insurance options that offer required cover to the policyholder and their loved ones.
Types of HDFC ERGO Maternity Health Insurance Plans
HDFC ERGO provides two maternity health insurance plans with maternity cover as mentioned below::
- Health Suraksha Gold Insurance Plan
- my:healthMedisure Classic
Health Suraksha Gold Insurance Plan
This plan is designed to cater to the diversified maternity medical needs. This maternity plan provides comprehensive coverage at the most reasonable cost. Choosing this plan gives the policyholder and their family complete financial protection to safeguard them from the spiralling medical expenses throughout the pregnancy phase. Anyone can buy this plan as there is no specified entry age for this plan.
my:health Medisure Classic
This plan is designed to help customers meet their medical necessities for a hassle-free pregnancy phase. This plan provides a larger coverage to safeguard the expected and unexpected maternity expenses. This health plan for maternity offers protective cover for the mother and newborn and also reduces the sudden financial burden that may arise due to inflating medical expenses. The minimum entry age for this plan is 91 days. In addition to this, pre-policy check will also be required for applicants below 50 years of age.
Features of HDFC ERGO Maternity Plans
These plans offer a number of unique features and benefits to this policyholder and their family members. Features and benefits of these plans have been listed one-by-one here:
Features of these plans have been given below:
| Plan | Health Suraksha Gold Insurance | my:health Medisure Classic |
| Product Benefits | The health insurance plan provides various coverage options. For individual and family floater plans, the sum assured/ insured – Rs. 3, 4, 5, 7.5 and 10 lakh | The plan offers the sum insured options – Rs. 2, 3, 4 and 5 lakh |
| In-Patient Treatment | This plan covers the expenses incurred due to accident or illness. Medical expenses covered are room rent, nursing, boarding expenses, ICU, anaesthesia, oxygen, blood, medical practitioner, operation theatre charges, medicines, surgical appliance, cost of prosthetic, diagnostic procedures and drugs and consumables. | Treatment expenses of any illness, injury or disease are covered under this plan. In-patient treatment expenses include – surgeon fees, nurses, anaesthetist, specialists, diagnostic tests, medicines, operation theatre, oxygen, blood, internal appliances such as pacemaker, etc. |
| Pre and Post Hospitalisation | 60 days of pre-hospitalisation and 90 days of post-hospitalisation expenses are covered. | 30 days of pre-hospitalisation and 60 days of post-hospitalisation expenses are covered. |
| Day Care Procedures | Medical expenses for 144 (listed) day care procedures are covered or reimbursable by the insured. | Medical expenses of both existing and upcoming day care treatments are covered. |
| Domiciliary Treatment | Any treatment taken at home is domiciliary treatment. Expenses of such treatments are also covered. | Such treatments are also covered if appropriate medical facilities or bed is not available for continuous 3 days in the hospitals. |
| Emergency Ambulance | Up to Rs. 2,000 for sum insured amount Rs. 3, 4 and 5 lakh and up to Rs. 3,500 for Rs. 7.50 and Rs. 10 lakh is provided as emergency ambulance expenses. | NA
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| Organ Donor | Any expense incurred due to organ transplant can also be reimbursed. | NA |
| Alternate Treatment | The plan also covers the alternate treatment such as Ayurvedic, Yoga and Unani, Siddha and Homeopathy. | Expenses of the non-cosmetic Ayurvedic treatments up to Rs. 25,000 per annum are covered. However, prior approval from the insurance company is needed to avail the benefit. |
| Newborn Baby | Medical expense of the newborn are also covered for 90 days after the birth. | Benefits up to the limit of sum insured chosen are provided to the newborn as well the mother |
| Cumulative Bonus | 5% of the basic sum insured is provided as a cumulative bonus for every claim-free year. However, it is a subject to a maximum 50% of the basic SI. | NA |
Benefits of HDFC ERGO Maternity Insurance Plans
The benefits offered by these plans have been given here:
- Hospitalisation Expenses:All expenses related to the newborn birth are covered. The insurance company offers Rs. 15,000 and Rs. 20,000 or up to 10% of the sum assured (whichever is lower) for normal delivery. For Caesarean, Rs. Rs. 25,000 and Rs. 40,000 or up to 20% of the sum insured (whichever is lower) is provided to the insured.
- Pre-Natal and Post-Natal Expenses: Under maternity benefits, all sort of pre-pregnancy expenses such as doctor visit, diagnosis, medicines, etc. are covered. These plans also cover post-pregnancy expenses for the mother as well as for the newborn to ensure their wellness.
- Vaccination Expenses:To provide newborn with enhanced immunity against diseases, they need certain vaccination time to time. Maternity plans by HDFC ERGO cover vaccination expenses as well to ensure they are healthy.
- Income Tax Benefits:Both the plans offer certain tax benefits to the policyholders on the amounts they pay as premiums. The benefits are provided under section 80D of the Income Tax Act, 1961. Since the benefits depend on the prevailing tax laws, they might change with the amendment in the laws. Section 80C benefits are not included.
Both plan haves are apt for maternity and pregnancy insurance and help cover the vast medical and other pregnancy-related expenses. Look at the table below to know the coverage provided by both the plans:
| Maternity Benefit Type | Health Suraksha Gold Insurance | my:healthMedisure Classic |
| Hospitalisation Expenses | Yes | Yes |
| Pre and Post Natal Expenses | Yes | Yes |
| Newborn Cover | Yes | Yes |
| Immunisation or Vaccination Expenses | No | Yes |
| Coverage for Normal Delivery | Rs. 15,000 | Rs. 20,000 or 10% of sum insured |
| Coverage for Caesarean Delivery | Rs. 25,000 | Rs. 40,000 or 20% of sum insured |
| Waiting Period for Pre-Existing Illnesses | 4 years | 4 years |
Exclusions of HDFC ERGO Maternity Plans
In addition to a number of benefits and unique features, these plans come with certain exclusions as mentioned below:
| Health Suraksha Gold Insurance | my:healthMedisure Classic |
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How to Make Claims for HDFC ERGO Maternity Plans?
Claiming process of the maternity plans offered HDFC ERGO maternity plan is quite easy. Here are the steps to follow:
- Get admitted in one of the HDFC ERGO network hospitals
- Show valid ID proof and health card to avail the cashless treatment facility
- Hospital will contact the insurer to request pre-authorisation
- At the time of discharge, the insured will have to show their medical documents to the insurer. They will scrutinise the documents received and convey their stand on the requested claim
- Hospital will send the final bills to the insurer for authorisation. HDFC ERGO will verify the same and give final authorisation in the event of successfully approved transaction to the hospital.
FAQs
Q1. What are the different plans under HDFC ERGO maternity plans?
There are two plans proposed by HDFC ERGO wherein individuals can purchase maternity plans, they are:
- Health Suraksha Gold
- My: Health Medisure Classic
Q2. What is covered under AYUSH benefits?
Unani, Sidha and Homeopathy are covered under AYUSH benefits.
Q3. What are pre-hospitalization and post-hospitalization period under HDFC ERGO Maternity plans?
Under HDFC ERGO Health Suraksha Gold, pre-hospitalization and post-hospitalization period is 60 days and 90 days respectively and for HDFC ERGO My: Health Medisure Classic Insurance, pre-hospitalization and post-hospitalization period is 30 days and 60 days respectively.
Q4. Is new born baby covered under the maternity insurance plan?
Yes, new born baby is covered under the the maternity insurance plan to meet the unexpected expenses during the post-birth of baby.