What am I entitled to?
During pregnancy and after childbirth, women with health insurance are entitled to medical assistance and the assistance of a midwife. The insurance also covers pharmaceutical costs and hospitalization and meals in the clinic.
Do I have to pay the ticket for medical visits?
The ticket for medical examinations is not foreseen for social security visits during pregnancy, not even for consultancy directly related to the results of an exam. The ticket is only available if the consultation or examinations are particularly thorough or if the patient requests it. Since April 2007, there is no longer even a ticket for hospitalization before and after childbirth, provided that the hospitalization is for childbirth.
When do I have to pay for extras?
Extra payments are required for some health insurance services. You will find detailed information at your health insurance company. It is always worth asking, as health insurance funds subsidize certain standard preventive measures. For example, some company and supplementary health insurance funds offer a prevention package aimed at avoiding premature birth.
Here are the most common services.
Health insurance service
from the fourth to the eighth week of pregnancy: examination, detection of pregnancy, registration of blood tests in the pregnancy booklet, rubella test, syphilis test, hemoglobin detection, chlamydia sampling. Not covered by the health insurance:certificate for the employer (it is sufficient to present the pregnancy booklet), screening for toxoplasmosis, screening for cytomegaly, tests for listeria.
XNUMXth to XNUMXth week of pregnancy: check-up and first ultrasound. Not covered by the health insurance:screening for early diagnosis of Down syndrome, PAPP-A.
14th to 16th week of pregnancy:check-up visit, possibly hemoglobin detection. Not covered by the health insurance:non-mandatory ultrasound, tri-test with biometry, toxoplasmosis test.
18th to 22th week of pregnancy: check-up and second ultrasound, tocogram, evt. hemoglobin detection.
22th to 24th week of pregnancy: follow-up visit, antibody test, tocogram, evt. hemoglobin detection. Not covered by the health insurance:optional ultrasound, Doppler ultrasound for gestational detection, toxoplasmosis testing.
26th to 28th week of pregnancy: check-up visit, cardiotocography, possibly hemoglobin detection. Not covered by the health insurance:non-mandatory ultrasound, blood insulin test.
30th to 32th week of pregnancy: check-up with ultrasound, cardiotocography, evt. hemoglobin detection.
32th to 35th week of pregnancy: check-up with ultrasound, possibly detection of hemoglobin, examination for hepatitis B antigen, cardiotocography. Not covered by the health insurance:non-mandatory ultrasound, tests for toxoplasmosis.
40th week of pregnancy: check-up visit.
Do I still have my state insurance?
A woman is always insured during pregnancy, maternity (six weeks before to eight weeks after giving birth) and remains insured until the end of parental leave, even if she does not work during maternity leave. And even if she extends parental leave by one year.
Do I have to pay contributions during maternity leave?
Contributions to the sickness fund must be paid for the entire duration of maternity leave with. Indeed, it is the health insurance that will pay you the maternity allowance, which is up to all taxpayers. The allowance can be claimed with a certificate indicating the expected date of delivery, which the doctor issues no earlier than one week before the start of maternity leave.
Do I have to pay contributions during parental leave?
During your leave you do not need to pay any contributions as long as you are entitled to the allowance. When the leave ends, it is necessary to start paying contributions again. However, most health insurance funds waive the obligation to pay contributions if the woman could insure herself with her husband's family fund and if she still has a steady job.
Otherwise, i.e. if the woman is not married or no longer has a job, the sickness fund will ask for contributions. The same is true for married women who have their own insurance and cannot insure themselves with their husband's family fund. Also in this case, once the indemnity period has ended, it is necessary to start paying the contributions again. The same goes for women who are still receiving child-raising subsidies because their children were born before December 31st.
What are the costs of private health insurance?
The clauses of private health insurances provide for the medical treatment necessary during pregnancy so, depending on the insurance, the costs for all necessary treatments and analyzes will often be incurred, as is the case for state health insurance funds.
Do I have to pay contributions during maternity and parental leave?
Those with private insurance usually have to continue to pay contributions even during maternity and parental leave, and there is no exemption as in state sickness funds.
What should I pay attention to when taking out private insurance?
Those who intend to start a family, already at the time of the composition of the insurance package should pay attention to the assistance provided in the event of pregnancy and childbirth. This way you will know in advance which services you can use during pregnancy, such as the assistance of a midwife.
To deepen the topic:
Maternity and work during the months of leave: how do I behave with the company?
I'm pregnant, how do I tell the boss?
Advance maternity, how to ask for it
Maternity and work: mothers' rights
- first year
- weeks 1-13