Baby on the way? For parents-to-be, holding a positive pregnancy test in their hands marks the start of an exciting but also challenging time. During this time of great anticipation, there are many open questions. One of them being: How does insurance actually work in this situation – what do we pay, what does the health insurer pay?
During a pregnancy, a regular visit to the gynecologist or midwife is a matter of course. Precautionary checks are aimed at early recognition of possible diseases or risks associated with the expectant mother and the unborn baby. The first routine examination usually takes place during the second or third month of pregnancy, and from then on, approximately every six weeks.
The benefits under basic insurance are regulated by law and are the same for all providers. Pregnancy complications until the end of the 12th week of pregnancy are considered as illness. If treatment is necessary, the expectant mother must pay the excess and the deductible. As of the 13th week of pregnancy until eight weeks after birth, the cost contribution (German only) is waived. This means that you pay neither the excess nor the deductible. You can benefit from the following before, during, and after the birth:
Depending on the service catalog, supplementary insurance pays other contributions, for example doctor-prescribed vitamin products during pregnancy and breastfeeding, birth preparation and postnatal exercise classes, or for the additional costs of a family room or birthing pool. Some supplementary insurances also pay for breastfeeding if a midwife confirms in writing that the mother breastfeeds exclusively.
With supplementary hospital insurance, mothers enjoy greater privacy in a one-bed or two-bed room. If desired, the physician can also be chosen freely or your own gynecologist can accompany the birth. However, supplementary insurance often includes a qualifying period (waiting period). At AXA, there is a waiting period of one year from the beginning of “Hospital Flex”, “Hospital Private”, or “Hospital Semi-Private”. If your pregnancy begins within the waiting period, the supplementary insurance does not pay maternity benefits.
After giving birth, you have three months’ time to conclude health insurance for your baby. You child is covered from day one, retroactively and regardless of its health. Every health insurer must cover the baby unconditionally. You are therefore not required to insure your child with your own health insurance company, but rather you have free choice from among the approved health insurers. As basic insurance benefits are stipulated by law, but the premiums vary greatly, it is worthwhile to compare premiums. To do so, use our independent comparison platform. Of course, you can also register your baby with your health insurer of choice even before the birth – then you will have your mind free and it will be enough to submit the first name and date of birth after your baby is born.
If your baby is to be accepted without a health check, you must register the child for a supplementary insurance before the birth. Some health insurers have additional conditions for prenatal acceptance without a risk check: For example, at least one parent must already have a basic or supplementary insurance policy with the same insurer. Even after the birth, you can apply for your baby to be accepted to a supplementary insurance at any time. However, in this case you will always have to fill out a health questionnaire. This means: If your child is not completely healthy, the supplementary insurance may reject the application for your child or insist on a restriction or benefit exclusion. The Swiss supplementary insurance market is very complex because health insurers offer numerous products with entirely different benefits. This makes comparisons difficult.
To sum up, then: The basic insurance covers all the necessary services with regard to pregnancy and birth. In Switzerland, mother and child are thus generally well protected and cared for. It is a good idea to take out supplementary insurance for the mother if she wishes for more comfort and privacy and/or would like to benefit from additional contributions. However, pre-birth registration of a child for supplementary insurance is definitely recommended if you have a lot to gain and little to lose: If, after the birth, it should turn out that the baby has health problems, the contract is already concluded and the insurer cannot rescind it. On the other hand, if the child is completely healthy, the parents can easily terminate or switch the supplementary insurance after the minimum contractual term – usually one year – if they discover a more suitable product in the meantime. Tip: Make a note in your calendar right away so that you don’t miss the three-month notice period.