Your rights in health insurance

A pregnant woman's rights in health insurance :

First of all, a lot of things have changed about the pregnany rights in basic health insurance (LAMal). Health insurance gives you a lot more coverage now.

You have to know that you are considered as a pregnant woman, and your yearly franchise disappears. It does not matter if this franchise was of 300 or 2'500 francs, you can consider that you have a franchise of 0 francs while you're pregnant and even after.

Not so long ago (1st March 2014), complications were still being considered as diseases and the franchise applied to them. This inegality is now corrected, and currently, starting from the 13th week of your pregnancy until the 8th week after delivery, a pregnant or recently having given birth woman, will be reimbursed by her health insurance for every consultation, analysis and medicaments submitted to the basic health insurance, whether they concern the pregnancy or just a flu.

But careful, even if the law corrected this inegality, a lot of insurance companies don't apply the update correctly and our specialists have to fight quite often to cancel some of our clients' bills, by claiming this right. Stay watchfull, and contact us if you think you've been a victim to a mistake.

Scans and gynecologist visits

Routine visits at your gynecologist are reimbursed as well, but attention, they are regulated. The same goes for scans.

7 routine exams (2 scans included, one between the 11th and 14th week of pregnancy and the second one between the 20th and 23th week ; in case of a risky pregnancy, supplementary exams are taken into charge ) and the post-birth exam (between the 6th and 10th week after childbirth).

In a lot of cases, the need to be accompanied, advised and consulted is superiour to these minimal consultations and we advise you to subscribe a good complementary insurance equally for the mother, in order to benefit from better coverage and more scans and exams. This way you can keep track of your baby's day by day development. Be careful about the deficiency delays that are applied by the insurance companies. These delays can vary from 1 day to a year before the pregnancy. Our pre-birth specialist are at your disposal in order to inform you about these delays and find you a solution adapted to your needs.

Childbirth preparation reimbursed

There exist more and more childbirth preparation classes, however a very few are reimbursed by the basic health insurance. The LAMal participates up to 150.- for a collective childbirth class given by a midwife. The same amount is distributed for a counseling session with a midwife over the delivery, the planification and the organisation of the post-birth period at home, as well as over the nursing preparations.

150.- is good, but it's not much. Once again, great participations of complementary health insurances can cover a better and bigger choice of these classes. We have explained in detail, in our Advice rubric, all the classes and accompaniments we recommend.

Pre-birth tests and analysis

In order to diagnose a case of the Down, Edward, and Patau Syndroms (21 - 18 - 13 trisomy), it was necessary to infiltrate a needle into the amniotic liquids and to take a sample for analysis. This practic was, of course, of high risk. A non-invasive (NIPT) test, much safer, much efficient, and operating with only a blood sample, was up to now only reimbursed by the complementary insurances. Fortunately, nowadays, the NIPT test is reimbursed by the basic health insurance ; you can protect your future child and make the test without hesitation.

We note globally, that the needs of a pregnant woman are protected by the basic health insurance but for those who want to fully benefit from these moments and adapted coverages, it's essential to chose a good complementary for the mother, so she can benefit from all these coverages.

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