What is covered by your health insurance

insurance card
This question can be so confusing and so different from one to another insurance companie. The best advice is to carefully read your insurance plan ,if one exists, and to make sure you know what you sign up for.

A german state insurance or public insurance

The insurance most germans have (Gesetzliche Krankenkasse) All of these companies agree to one portfolio but on top most of them advertise with special benefits for their insured. For an example, will one insurance cover the partners costs at a birth preparation class others do cover a pregnancy yoga class.

What do all cover:

Midwifes

  • by german law you are entitled to midwifery care. Meaning as soon you even think you are pregnant you can contact a midwife.
  • during your antenatal time there is no restriction on how often you can see her, there is a restriction on antenatal check ups but for all the questions and complications that arise there is not.
  • if your midwife offers acupuncture, k taping, shiatsu and so on she will have to clarify the extra costs with you.
  • your insurance covers the costs of your birth, not all cover the costs of the “on call fee” (Rufbereitschaftspauschale) you will pay if you have signed on to a home birth midwife, birthing house birth or if you have found a Beleghebamme.

And of course they will cover all the costs during your hospital stay.

  • After your baby is born the insurance covers the midwifes visits. (Wochenbettbesuche)  The insurance will cover every day visits, the first 10 days. Furthermore the first 12 weeks up to 16 visits or phone calls/text messages.
  • On top you are entitled to 14 hours of birth preparation classes and 10 hours of postnatal exercises in a group led by a midwife

Gynacologists

  • your antenatal care is covered and 3 ultrasounds will be covered by your insurance. You will quickly notice if your gynie sticks to this rule or she/he will offer you more Ultrasounds. They are entitled to charge you for this service.
  • necessary blood samples, can be taken by midwife or doctor, are included too. Additional blood tests ( Toxoplasmosis) and or vaginal swabs ( Group B-strep.), have to be payed out of your pocket.

 

Private insurance

Most private insurances cover all the costs the puplic insurances do. Of course it depends on your personal health care plan. This plan might be very generous or very mean. Contact your insurance to make sure and PLEASE have all they say in writing. I witnessed a few cases over the years where there where mistakes in what the insurance would cover and in the end they didn’t. How disappointing and expensive.

International insurance

At first go and check your health care plan and make sure you tell your medical caregiver.

Why?

With an international insurance you are automatically seen as a private insured person. Meaning the doctors and midwifes can claim double the amount a public insured person pays. ( If you get to see the head of the department of a hospital, they even are allowed to charge you up to 3 times the amount).

Please check, if your international insurance, covers the cost of your pregnancy, covers the midwife, covers the doctor.They might only cover a certain amount of visits some state in their healthcare plan that they will cover all costs equivalenty to the german state plan.

For an example I met people where the insurance only covered a hospital birth and sometimes I come across international insurances that only cover 10 midwife visits after birth.

 

My “golden rule” over the years has been, if you don’t sign you do not pay extra. Was that true for you? Which costs did surprise you? I’m keen to hear.

Lots of love & Go leor de ghrá,

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