Motherhood is one of the most precious experiences a woman can have. However, not planning it in advance or not being ready for it can make this feeling difficult to enjoy. Pregnancy is an expensive affair, therefore, it is essential to be prepared for it beforehand, both emotionally and financially. If you are wondering how you can manage all the expenses related to pregnancy, then this article is for you.
Many Insurance companies provide maternity health insurance policies so that you can fully enjoy the most beautiful phase of your life. A maternity insurance policy covers all expenses related to the pregnancy and birth of a child.
Continue reading to know more about Maternity expenses and how you can claim them.
What is maternity expense?
Maternity expense is a type of insurance policy that provides coverage for any expenses incurred during the delivery of a child. It includes treatment for the mother and child till the time of discharge from the hospital. Many companies provide maternity expenses for their female employees, along with health insurance policies. In some cases, maternity expenses can be offered as a rider to female workers by their employers. One can buy a maternity health insurance policy either as a rider or as a dedicated standalone health insurance plan.
Benefits covered under maternity expenses shall include:
- Medical treatment expenses related to childbirth (including complicated deliveries and cesarean sections) incurred during hospitalization.
- Expenses towards lawful medical (or medically necessary) termination of pregnancy during the policy period (limited to two deliveries).
- Pre and postnatal medical expenses related to delivery or termination of pregnancy.
- Mandatory vaccinations of the newborn baby up to 3 months.
- Pre and post-hospitalization expenses and Stem cell preservation.
To be able to get Maternity benefits, one must have a maternity insurance plan that they are signed up for. A maternity insurance policy helps women to be ready for the financial requirements of growing a baby.
Some of the top health insurance plans in India with maternity coverage are:
- Bajaj Allianz Health Guard Policy
- Aditya Birla Activ Health Platinum Enhanced Plan
- Cholamandalam Healthline Plan
- Bharti AXA Smart Super Health Insurance Policy
- Care Joy Maternity Insurance Plan
How to claim maternity expenses?
If you are about to have a baby and want your claim settlement process to be expedited, follow the below-mentioned steps.
- Soon after getting hospitalized, the first thing you need to do is inform your insurance company.
- After informing the insurer, the next step is to fill out a claim settlement form with all the accurate details and submit the form to the respective insurer.
- Once you have submitted the claim form, you would also need to give in other documents such as identity proofs, address proof, the policy certificate, etc.
- The next step is to furnish all medical bills to the insurer so that they can calculate the reimbursement amount.
- Lastly, the insurance company will send an agent to the hospital to examine and verify the details provided. Upon successful verification, the reimbursement amount will be released within 2-3 weeks.
Note: Please keep in mind, if you have chosen a network hospital of your insurance company, the claim will be settled through a cashless mode. However, if you have visited a non-partner hospital, then you will have to initially incur all the expenses, and later (after document submission and verification) the claim will get settled by the insurance company.
Documents Required to Claim Maternity Expenses
To file a maternity insurance claim, the following is the list of documents which is required:
- Admission Advice
- Accurately filled out a maternity claim form
- Insurance Policy certificates
- Discharge summary
- KYC documents
- Fitness certificate
- Consultation bill (if any)
- Original copy of hospital bill
How to claim maternity expenses in Accenture India?
Accenture India provides cover for maternity expenses up to Rs. 60,000. To claim maternity expenses, the employee needs to send a settlement/claim form along with other relevant documents to the India Finance Center (courier them to the TPA). There is no need to give in claim documents to anyone in the company. The employee must mention their SAP ID and the number of documents sent for verification on the envelope. After successful verification, the claim amount will be settled.
How to claim maternity expenses in Infosys?
There are two ways one can claim maternity expenses in Infosys. One is through Third Party Administrator, in which the TPA will take care of your expenses if hospitalized in a panel network hospital of the insurance company. However, if you chose a non-panel hospital then you need to bear all the expenses first and fill an offline claim later to get reimbursed. Once your claim request gets approved, you will get the reimbursement in 30 days in your account. Infosys have also designed ‘PregaCare’, a program to extend their support towards expecting mothers in which various session related to childbirth is provided to women.
How to claim maternity expenses in TCS?
Employees at TCS are eligible for maternity expenses coverage up to Rs. 75,000. In order to claim the expenses, one must inform their company HR in advance. Also, employees are required to visit www.ultimatix.net to file their claims. After the successful submission of the claim form online, an employee can take a printout and drop them along with all the required documents in TCS HIS drop box.
To raise a maternity reimbursement claim in HCL, an employee must inform their Third Party Administrator (TPA) office in writing within 48 hours of admission to the hospital. Claim form, along with other mandatory documents must be submitted to the Company / TPA within 15 days of discharge from the Hospital to settle all the expenses.
Employees working at Medibuddy can apply for maternity reimbursement claims through an online portal. The steps to raise claims are as follows:
Login to t.medibuddy and select reimbursement, followed by appropriate claim and hospitalization.
Fill out all the mandatory details and upload the scanned documents.
Upload your address and identity proof along with the claim documents.
Submit/courier documents to the address mentioned in the contact matrix.
Maternity Expenses — Practical Cost & Coverage Guide
Planning a delivery involves hospital charges, doctor fees, room rent, medicine/consumables and newborn care. If you have health insurance or are covered under ESI/CGHS/corporate policy, many costs can be cashless or reimbursed (as per policy terms).
Typical Maternity Expense Heads
| Head | What it Includes | Coverage Notes |
|---|---|---|
| Room Rent & Nursing | Ward/Private room rent, nursing charges | Many policies have a room rent cap (e.g., 1% of SI/day). Upgrades may cause proportionate deduction. |
| Doctor & OT Charges | Gynecologist fee, anesthetist, OT charges | Covered if maternity benefit is included; sub-limits can apply. |
| Normal Delivery | Delivery, basic meds, consumables | Often covered up to a fixed sub-limit under maternity rider. |
| C-Section (Cesarean) | Surgeon, OT, extra monitoring | Usually a higher sub-limit vs normal delivery. |
| Pre- & Post-Natal | Consultations, scans, tests, postnatal medicines | Check pre/post-hospitalization day limits (e.g., 30/60 days). |
| Newborn Care | Nursery, vaccinations, NICU (if required) | Some plans cover baby from Day 1; others require addition at renewal. |
Note: Coverage depends on your policy sum insured (SI), sub-limits, waiting period and co-pay clauses.
Key Policy Terms that Impact Maternity Claims
- Waiting Period: Many policies have a 9–48 months waiting period for maternity benefits.
- Sub-Limits: Separate caps for Normal vs C-Section (e.g., ₹35k vs ₹60k — just examples).
- Room Rent Cap: If you choose a higher room than eligible, proportionate deductions may apply.
- Pre/Post-Hospitalization: Bills allowed only within defined day-limits.
- Newborn Cover: Check if baby is covered from birth or needs addition to the policy.
- Exclusions: Non-payables (consumables, personal items), fertility treatments unless specifically covered.
How to Use Cashless for Maternity (Network Hospital)
- Confirm Network: Choose a network hospital for planned delivery (call insurance desk).
- Pre-Auth: Hospital sends pre-authorization with EDD/admission plan to insurer/TPA.
- Approval: You receive an authorization number; coverage is as per sub-limits and policy terms.
- Discharge: Insurer pays approved items to hospital; you pay non-payables/excess (if any).
Reimbursement (If Cashless Not Used)
- Collect Documents: Discharge summary, itemised bills, doctor notes, test reports, pharmacy bills.
- Submit Claim: Fill claim form, attach KYC (Aadhaar/PAN), cancelled cheque, and all originals.
- Timelines: Submit within the policy’s claim window (e.g., 15–30 days).
- Emails/SMS: Track queries from insurer and respond with missing docs promptly.
Documents Checklist (Maternity Claim)
- Policy copy/e-card, ID proof
- Admission note, discharge summary
- Itemised hospital bill + receipts
- Doctor prescriptions & investigation reports
- OT notes (for C-Section)
- Baby’s birth record (for newborn cover)
- Bank details/cancelled cheque (for reimbursement)
Common Reasons for Deduction/Denial
- Waiting period not completed for maternity benefit
- Exceeded sub-limit or room rent cap
- Non-payables (consumables/toiletries/attendant meals)
- Out-of-network hospital for cashless
- Late or incomplete documents in reimbursement
Illustrative Payout Example
| Scenario | Amount | Note |
|---|---|---|
| Total Hospital Bill (C-Section) | ₹90,000 | Itemised with OT, doctor, meds, room |
| Maternity Sub-Limit | ₹60,000 | As per policy |
| Room Cap Impact (if higher room) | −₹5,000 | Proportionate deduction (illustrative) |
| Non-Payables | −₹3,000 | Consumables/personal items |
| Payable by Insurer | ₹52,000 | Within sub-limit and terms |
| Payable by Patient | ₹38,000 | Excess + non-payables |
Purely illustrative; actual payout varies by policy terms and hospital charges.
Govt & Corporate Coverage Notes
- ESI: Eligible insured persons can avail maternity benefits as per ESIC rules (leave + medical).
- CGHS/State Schemes: Check empanelled hospitals and package rates before admission.
- Corporate Policies: HR group policies may have higher sub-limits and day-1 newborn cover.
Maternity Expenses — FAQs
Is maternity covered in all health insurance plans?
No. It’s available in select plans/riders with a waiting period and sub-limits. Check your policy wordings.
Does insurance cover prenatal scans and tests?
Often under pre-hospitalization if within allowed day-limit; confirm in your policy schedule.
Is baby covered from birth?
Varies by plan. Some cover from Day 1; others require addition at renewal or within a set window after birth.
Can I get cashless for delivery?
Yes, at a network hospital with successful pre-authorization. Non-network hospitals are usually reimbursement-only.
Disclaimer: Information is generic and for awareness only. Always rely on your policy wording, insurer/TPA guidance and hospital finance desk.