Planning to start a family? Here's why employer's group health cover is not enough for maternity needs

What maternity features should one look for in a family health plan? This was a query posed by a 31-year-old man who was planning to start a family with his 29-year-old wife within a year and is currently relying on my employer's group health cover.

Prioritising financial planning over family planning is a thoughtful decision, Sarbvir Singh, joint group chief executive of PB Fintech, told Mint. “The good news is that maternity health insurance has become more practical for young couples than it was a few years ago.”

Traditionally, Singh noted, maternity benefits came with waiting periods of two to four years, which meant many couples either missed out on coverage or had to plan well in advance, “something that was often impractical”.

However, he said, this has changed significantly today. “There are now plans that offer maternity cover with a waiting period of as little as three months.”

This, Singh said, allows couples to get covered well before pregnancy and better align insurance with their family plans, as maternity is a planned life event, unlike most other health claims.

When evaluating plans, Sarbvir Singh suggested not to look at the waiting period alone. “Check the maternity benefit limit, as most plans have a defined payout rather than allowing the entire sum insured for delivery expenses.”

Depending on the plan, he said, maternity benefits can range from ₹ 50,000 to ₹ 2 lakh.

He also suggested that individuals must look for coverage for normal and C-section deliveries, pre- and post-natal care, newborn cover from Day 1, vaccinations and congenital conditions, wherever applicable.

“Maternity should be one part of your overall health cover, not the sole focus,” he told the 31-year-old.

“Since you're both in your early 30s, this is a good time to build a comprehensive family floater with at least ₹ 50 lakh cover, or a higher cover supplemented by a super top-up, to protect against both childbirth and future healthcare costs.”

Noting that an employer's group health cover is a valuable protective layer, Singh said, “It should not be your only source of protection”. He highlighted that group policies are tied to employment and that their benefits can change if you switch jobs.

An individual health insurance policy ensures continuity of coverage irrespective of your employer, Singh said, noting that it also gives an individual access to maternity benefits that are increasingly designed around the realities of modern family planning.

For couples like the 31-year-old, Singh suggested the newer generation of maternity plans, which offer a much more practical way to plan for parenthood.

“They allow you to align your insurance with life plans, while ensuring that both your growing family's immediate and long-term healthcare needs are well protected,” he added.