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Maternity – pregnancy and birth

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Maternité, assurance prénatale et naissance

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The main maternity treatment is covered by the basic LAMal insurance but not all medical care is covered. What treatments are not covered? What insurance to take for the newborn? Where to give birth (in the cantonal hospital or in a private clinic) and what are the administrative procedures to follow? As a future mother, you have to make many decisions to prepare for the birth of your child.

Here are the 6 points to properly prepare for your childbirth.

 

1 - Understand the coverage of the basic LAMal insurance

The LAMal covers the main maternity benefits. To avoid any surprise, you should understand what is covered inl the basic LAMal insurance cover and what is missing.

Maternity, main services LAMal

  • Preventive examinations: amniocentesis and analysis of the placenta (in case of high risk)
  • Check-ups during and after pregnancy, prescribed by a doctor and carried out by a doctor or a midwife
  • Possibility to give birth at home birth, in a hospital or in a birth house
  • Contribution to the cost of childbirth preparation courses
  • Advice on breastfeeding
  • Services provided by midwives before, during and after childbirth
 

Midwives, LAMal services

Before childbirth, midwives can perform the following services reimbursed at 100% by the LAMal base:
  • Control examinations
  • Prescription of an ultrasonic examination (ultrasound)
  • Prepartum exam using cardiotocography (examining the baby's heartbeat)
  • Contribution to the cost of childbirth preparation courses limited to 150 CHF for an individual or group course
  • Contribution to the cost of breastfeeding advices limited to 3 sessions
After the birth (post-partum):
  • Home visits by midwives limited to 56 days after birth unless prescribed by a doctor
  • Check-ups between the sixth and the tenth postpartum week
  • In the event of premature birth, multiple birth, first child or cesarean section, home visits limited to 16 visits, with a maximum of five home visits twice on the same day (additional home visits require a medical prescription)
  • In other cases, during the 10 days following the birth, in addition to home visits, a maximum of five home visits twice on the same day (additional home visits require a medical prescription)
It is by going through the details of each coverage that you will realize the limits of the basic LAMal cover

 

2 - Understand the coverage of the complementary health insurance long before being pregnant

If you want to give birth in a private clinic, to have the choice of medical staff, to have access to additional medical examinations than those covered by the basic LAMal insurance (e.g ultrasounds) or to benefit from “comfort” services during your childbirth then the basic LAMal insurance is insufficient and you will need additional complementary insurances. It is worth noting that these additional insurances are not effective right away. There is a waiting period. This is the reason why you have to subscribe in advance, as soon as you think about having kids. Please refer to the article on complementary insurances for additional information on this subject.

 

Contact our experts
 

 

3 - Insure your baby with prenatal insurance before birth

The mother's basic LAMal insurance covers the medical costs directly linked to childbirth, any minor complications and the costs of hospital stay for the newborn. It is worth noting that however, if the child is sick, it is his/her own insurance that covers the costs and not the mother’s insurance.< To avoid unpleasant surprises, the easiest way is to take out prenatal insurance for your baby before the birth of your baby. This prenatal insurance is made up of :
  • a LAMal base ; and
  • any additional complementary insurance of your choice, without answering a health questionnaire for your baby and therefore systematically accepted by the insurance company. The billing starts upon the birth of the child.
  After birth, should you want to subscribe to a complimentary insurance, you will need to answer a health questionnaire for your baby and therefore, depending on the responses to the health questionnaire, the insurance company may refuse to insure the baby. During pregnancy, prenatal insurance will not cost me more and will always be accepted by the insurance company as answering the health questionnaire is not required.

 

Together we protect your baby
 

 

4 - Check the compatibility of the mother's and baby's insurances

If the mother has the complementary insurance “Private or semi-Private”, then the baby must have a prenatal insurance with a complimentary insurance“Private or semi-Private” as well (one needs to be careful as the “baby package” offer rarely has this option). Otherwise, if my baby needs specific birth medical treatments, the clinic can:
  • bill parents for fees; or
  • refuse support; or
  • request that the child is moved to the canton hospital and treated in the common ward
  The article prenatal insurance will give you details about the coverage and the timelines.

 

Contact our experts

 

5 - Pregnancy : who to inform and when

 

Notify your employer

Once your pregnancy is confirmed,you must notify your employer in order to benefit from the maternity leave - the maternity allowance is set per the rules of your canton and your employer, generally corresponding to 80% of your starting salary. Although there is no regulation for the notification deadline, you should  notify your employer before the end of the 3rd month of pregnancy.

Notify your health insurance company

You should also inform your health insurance company of your pregnancy ASAP because all maternity-related medical costs are reimbursed without deductible or co-payment. In addition, from the thirteenth week of pregnancy and up to eight weeks after childbirth , all medical costs in the event of illness - whether or not related to the pregnancy - are also reimbursed without deductible or co-payment with the exception of dental care and medical costs which are preventive measures. In case you forget to notify your health insurance company, the maternity will take care of it by asking for a guarantee of hospitalization to the health insurance company that will confirm the type of insurance you have:
  • additional insurance “Semi Private or Private”, allowing you to be hospitalized in a semi-private or a private ward with the choice of the private clinicl and the obstetrician. You must check the date of subscription to this supplement because the waiting period on maternity is one year.
  • compulsory LAMal base, leading to hospitalisation in a common ward; this means that you have to do your pregnancy follow-up, give birth in a cantonal hospital and have no choice of doctor.
The mother's insurance covers the costs related to pregnancy, childbirth and the birth of the child. It does not cover the care of the child after birth.

 

6 - Where to give birth?

Several options are available to give birth in Switzerland.

In a private clinic

Giving birth in a private clinic means benefiting from the best of Swiss quality applied to medicine. Indeed, private clinics combine the best in care, technology, services and comfort. Thus, you have the choice of the medical team, the approach used. This is however expensive and to access this and be reimbursed requires having previously subscribed (for at least one year) to additional insurance in a semi-private or private ward.

In the cantonal hospital

To give birth in the cantonal hospital, complementary health insurance is not necessary. At the cantonal hospital, you have access to standard care provided for by the LAMal law. You do not have the choice of the medical team that takes care of you. If you have semi-private or private complementary health insurance, you are installed in another part of the hospital. you have the choice of the medical team and my room is individual (private) or shared (semi-private) with only one other mother.

In a Birth House

Moms who want to give birth naturally choose the Birth Center. Empathy, a warm environment, alternative medicine are priorities. Epidural anesthesia is not possible there. In the same way as for a childbirth at the cantonal hospital, the basic health insurance LAMal covers the costs of the birth at the Birthing Center.

At home

This traditional childbirth is performed with the help of a midwife who provides the necessary equipment. The midwife prepares for childbirth, accompanies labor and after birth. The costs are covered by the compulsory LAMal insurance. Following this article, you can find the details of the possibilities for giving birth in the article Where to give birth?

 

Preparing your maternity

Now that you have read the 6 points to prepare well for your childbirth, please continue continue reading through the following articles:

 

Together we protect your baby
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