Insurance Guidebook: Tips and information for the mother-to-be and her child

Insurance Guidebook
Tips and information for the mother-to-be and her child

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Tips for the mother
• For benefits for motherhood* in the basic insurance neither
a deductible rate nor retention has to be paid. Often it is not
obvious to the health insurance company which expenses are
linked to motherhood. It is best the care provider states on
the invoice that motherhood is the case.
• Especially with hospital supplementary insurances, a quali-
fying period in the case of motherhood applies. This means
that in the case of motherhood full coverage in a semi-private
or private ward is only applied after a certain time period.
This time period varies depending on the provider. Generally,
this supplementary insurance has to be taken out at least
365 days before the claim for benefits.
• Furthermore, it has to be checked whether existing supple-
mentary insurances include benefits in the case of
motherhood.
* includes pregnancy and delivery as well as the time after
birth (childbed and lactation period)

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Tips for the child
• For children, the basic deductible rate is CHF 0. Higher
deductible rates for children are not worthwhile as parents
with small children often go to the doctor.
• Parents and child do not have to take out insurances with the
same health insurance company. Family offers sound good –
but if you compare the health insurance companies, you can
save considerably more.

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Basic insurance for the mother
Benefits before birth
• 7 check-ups
• 2 ultrasonic check-ups
(11th – 14th and 20th – 23rd week of pregnancy)
• Contribution of CHF 100 for birth preparation course
Benefits at birth
• Full coverage in the general ward of a hospital or in a birth
centre according to the hospital list of the canton of residence
or for a home birth
Benefits after birth
• Care at home by a midwife up to 10 days after birth
• 3 breastfeeding consultations with a midwife
or a breastfeeding consultant
• 1 check-up 6 – 10 weeks after delivery
High-risk pregnancy
In the case of a high-risk pregnancy (e.g. multiple pregnancy,
existing illnesses such as diabetes), the benefits mentioned
above and additional measures after medical assessment are
covered by the basic insurance.

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Supplementary insurances for the mother
Semi-private or private ward
These hospital supplementary insurances enable a free choice
of doctor, a stay in a 1 or 2 bed room and cover the costs of
delivery in a private clinic or outside the canton of residence.
Depending on the type of supplementary insurance, the costs
for delivery and a stay at a birth centre which is not on the can-
tonal hospital list are covered.
General ward whole of Switzerland
For the coverage of delivery costs outside the canton of resi-
dence in the general ward of a hospital, the hospital supple-
mentary insurance “general ward whole of Switzerland” is
sufficient.
Outpatient supplementary insurances
Depending on the type of insurance offered, outpatient sup-
plementary insurances also pay contributions for alternative
medicine, recovery courses or a household help.

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Basic insurance for the child
Registration
Insurance for the child can already be taken out before birth.
3 months after birth, at the latest, the child has to be regis-
tered with a health insurance company. Expenses are taken
over retroactively from the beginning of the insurance
(date of birth).
Benefits
The benefits of basic insurance are the same with all health
insurance companies and cover all medically necessary points
(including preventive medical check-ups and vaccinations).
Accident insurance
Accident coverage is compulsory for children and has to be
taken out as well with the insurance company.

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Supplementary insurances for the child
Semi-private or private ward
Swiss childrens‘ clinics do not have private wards. In rare cases
a 1 or 2 bedroom is available, however, occupancy is not guar-
anteed. A semi-private or private hospital supplementary insur-
ance guarantees only a free choice of doctor or treatment of the
child by the head of department, apart from the extension of
the coverage onto the whole of Switzerland. This supplemen-
tary insurance can generally only be taken out after the birth of
the child.
General ward whole of Switzerland
This hospital supplementary insurance is then recommended
if the parents wish to choose a children’s clinic. This supple-
mentary insurance can already be taken out before the birth of
the child.
Outpatient supplementary insurances
A supplementary insurance for tooth position corrections is
very much recommended. Half of all children sooner or later
need an expensive tooth position correction. Depending on the
insurance company, such insurance has to be taken out at birth
or at the latest before the first visit to the dentist. In the case
of other outpatient supplementary insurances it is worthwhile
taking a look at the individual needs.

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