How To Claim Maternity Insurance: Step-by-Step Guide

Posted on: Nov 30, 2023 | 3 mins | Written by: HDFC ERGO Team

How To Claim Maternity Insurance: Step-by-Step Guide

Maternity insurance takes care of a range of maternity-related expenses of the policyholder. The health plan covers pre-natal, childbirth and post-natal expenses and makes things easier for new parents. Maternity insurance can be taken as a standalone policy or as an add-on cover with health insurance. Keeping the ever-increasing healthcare costs in mind, having adequate maternity insurance can help expectant mothers avail of quality healthcare without worrying about the bills.

If you’re wondering, "How to claim maternity insurance?" let’s look at it in detail.

Before filing a maternity claim, you must notify the insurance company. You must inform your insurance provider at least 72 hours earlier if it is a planned hospitalisation. In an emergency, notify the insurer within 24 hours of hospitalisation.

What is Maternity Health Insurance?

Maternity insurance is a financial benefit for pregnant women to cover the costs they incur during their pregnancy. The policy covers the costs and treatments associated with pregnancy, baby delivery, and post-natal care.

The common inclusions of this policy are:

• Consultation charges

• Medical tests

• Hospitalisation

• Delivery costs (both vaginal and C-section deliveries are covered)

• Expenses related to pre-natal and post-natal care

• Treatment and medicines for the newborn baby

• Medical costs incurred for complications in the pregnancy and delivery

• Newborn’s vaccines

• Costs related to storing stem cells

• Medical termination of pregnancy or abortion costs

Steps To File a Reimbursement Claim

Here is how to claim maternity insurance benefits:

• Take the reimbursement claim form from the TPA desk at the hospital.

• Once you get discharged from the hospital, settle all the bills from your pocket. Remember to collect the discharge summary and all your bills and receipts from the hospital.

• Fill out the claim form correctly; submit it to the insurance company with the original bills and receipts from the hospital.

• The insurer will review your claim. If everything looks fine, they will reimburse the claim amount to your bank account.

Steps To File A Cashless Claim

• Visit any network hospital of the insurance provider. Remember to carry your cashless card with you.

• Take the pre-authorisation form from the hospital’s TPA desk. You can also take this form from your insurance provider.

• Fill out the form and submit it at the TPA desk along with your ID proof and health e-card or cashless card.

• If the documentation is proper, the insurance provider will settle the hospital bills on your behalf.

When you are filing a claim, make sure you submit all bills and receipts to the insurance provider to avoid claim rejection. Also, you can file a claim only if the waiting period of your maternity insurance policy is over. Since the policy comes with a waiting period, it is wise to take this health plan at an early age to enjoy its benefits.

health insurance plans

It is always wise to choose health insurance plans that meet your medical needs. You can also avail of a family health insurance plan to cover the healthcare expenses of family members.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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