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digitsclimb 15.12.2012 18:21

Insurance Coverage for Pregnancy and Birth
 
Hi,

I am a bit confused. My wife has the basic insurance here in Switzerland (I understand they are all the same coverage). We are going to have a baby in April and have been going to the doctor.

What is not clear to me is if the pre-natal visits and hospital stay for the birth is included in the "selbsbehalt". It is clearly listed in the insurance information that we get 8 visits and that the inpatient care is covered. But does that mean its covered but we have to pay the first 2000 CHF (the selbstbehalt amount).

Its really very confusing. I've even had this conversation with the insurance broker and decided not to lower the selbstbehalt because he led me to believe all the birth related stuff is just "covered". But now I've heard conflicting things. The bills are actually not even sent to us but to the insurance directly. And they have not billed us....yet.

Thanks

UktoSwiss 15.12.2012 19:23

Re: Insurance Coverage for Pregnancy and Birth
 
Your insurance broker is right; whatever the excess pregnancy-related costs are entirely paid by the insurance, with no contribution from yourself. Unless there are complications, where things can become...complicated.

Notice that your insurer can make "mistakes" (never in your favour...). Always check that you are paying for things you shouldn't.

digitsclimb 15.12.2012 21:38

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by UktoSwiss (Post 1746371)
Your insurance broker is right; whatever the excess pregnancy-related costs are entirely paid by the insurance, with no contribution from yourself. Unless there are complications, where things can become...complicated.

Notice that your insurer can make "mistakes" (never in your favour...). Always check that you are paying for things you shouldn't.

Thank you. Very helpful

Pernilleskokken 15.12.2012 21:51

Re: Insurance Coverage for Pregnancy and Birth
 
Please read this post about medication and non-normal pregnancy costs.

MissScotland 27.12.2012 16:41

Re: Insurance Coverage for Pregnancy and Birth
 
Hi there - I am in exactly the same position as your wife. I have only basic care health insurance with a chf 2,500 excess. I have had a nightmare with my insurance company getting them to actually answer my basic questions about 'now that I am pregnant what should I do to ensure that I do'. All they could talk about was my unpaid bill.....and so it went on. After a complete hormonal tantrum which included tears I was eventually put through (after more than 4 calls and 8 transfers) to my hero. He confirmed that basic insurance covers me for:

5 Gynae Visits
2 Ultrasound Scans
Giving birth

and that none of this is billed or included as part of the excess. Because of former complications and my age I have been advised to get a Gynae to validate me as a 'high risk' which apparently covers me for a little more - I think one more scan and 8 visits.

The fact that my husband also pays insurance and is clearly essential in the mix counts for nothing.

I have heard however, horror stories about complications such as needing a c-section, so I have been advised to fully discuss this at the outset with the Gynae.

I hope this helps but if anyone can talk me through basis insurance and what this means for me in more detail I would be eternally grateful. Also any help as to how I go about upgrading? I seem to have so many problems getting this type of information clearly and concisely over the phone. x Thanks

JanieCH 04.01.2013 15:48

Re: Insurance Coverage for Pregnancy and Birth
 
I am also pregnant (due in June) and had a long talk with a friend of mine who is a "baby planner" (don't ask....). This is my second (my first was born in Canada) so I had a good idea of what questions to ask. My friend told me that the following things are covered, 100%, no deductible:

- 7 visits with a gynecologist
- 2 ultrasounds (12 & 22 weeks) though she said some insurance providers will reimburse a third
- all of the standard tests and blood work (I just had a whole bunch done, but I couldn't even tell you what they were) -- the genetic defect tests are NOT covered
- 100 CHF for prenatal classes
- 3 breastfeeding consultations
- vaginal delivery (if you have to visit the hospital in the weeks / days before the deliver, if you are overdue for example, this counts as part of the delivery costs)
- 1 post-partum visit with your gynecologist
- daily visits from a midwife for the first 10 days post-partum

Basically, if you have a normal pregnancy with no complications, everything will be covered. I didn't even ask what would happen in the case of a "complication", but at any rate if that were to happen we would do what was necessary for the health of the baby and myself and deal with the costs later, so no need to worry about it prematurely.

I hope that helps. Good luck to all of the pregnant ladies!

Kat_eurodiva 04.01.2013 16:16

Re: Insurance Coverage for Pregnancy and Birth
 
just don't make the mistake I did when you go to the hospital to pre-register (during one of their "Futur Eltern" nights, for example) thinking you have halbprivat insurance when you really only have allgemein. That was a costly little mistake, to the tune of 3500 chf. :eek: :msnmad: :msnshock:
but, that was the only thing i paid for. i was overdue and had all the homeopathic help (nettle oil, herbal tea) which i was supposed to pay extra for but didn't actually end up seeing on the bill. (thank you SanSan). also the extra charge for my husband staying in the room w/ me on my 2nd pre-delivery night - labor was SLOW never made it on the bill.
this was at the Kantonsspital in Zug. lovely team of midwives there.

Carlos R 04.01.2013 16:23

Re: Insurance Coverage for Pregnancy and Birth
 
Don't forget that different insurers might offer different packages.

@ any and all women going through birth in CH for the first time, good luck, but remember to pre-register your child with their insurance company well ahead of the day. Ideally before it reaches "viable" age.

This means that on or soon after the birth you need to complete a little form with date or birth and birth details and send to the insurer. But insurance will have been set up before hand (this does not cost you anything extra).

This way if there are any complications with the birth - and sorry, this does happen - your child will be fully covered with no exclusions.

Also, while I think about it, if you are having a planned c-section, try to get early in the month - health insurance, and thus fees, covers the whole month, irrespective of if born on the 1st or the 31st. What a cheapskate I am. :D

little_isabella 04.01.2013 16:32

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by Carlos R (Post 1758587)

Also, while I think about it, if you are having a planned c-section, try to get early in the month - health insurance, and thus fees, covers the whole month, irrespective of if born on the 1st or the 31st. What a cheapskate I am. :D

Not necessarily cheap but maybe not fully informed.

http://www.webmd.com/baby/news/20110...term-pregnancy

Ladies, please don't schedule a c-section earlier unless you're advised to for medical reasons.

Carlos R 04.01.2013 17:10

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by little_isabella (Post 1758596)
Not necessarily cheap but maybe not fully informed.

http://www.webmd.com/baby/news/20110...term-pregnancy

Ladies, please don't schedule a c-section earlier unless you're advised to for medical reasons.

:confused:

You completely missed a lighthearted jest. Nevermind.

When picking a date for a c-section (if one is needed) the Dr will usually discuss the available dates - this is usually a range of 2-3 days about 1-max 2 weeks ahead of the "planned" due date. No earlier and no later.

In some instances this could cover the dates over the end of a month and into the next. That's all.

Misinformed indeed. Have you had a c-section in CH? In which case you would know what I am talking about, based on the 3 we've had, and not including the 1st emergency one :rolleyes:

3Wishes 04.01.2013 17:28

Re: Insurance Coverage for Pregnancy and Birth
 
Carlos, I don't get it. How does being baby being born on the 1st or the 31st impact what insurance will or won't pay?? If my insurance premium is for the year? :confused:

Carlos R 04.01.2013 17:40

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by 3Wishes (Post 1758658)
Carlos, I don't get it. How does being baby being born on the 1st or the 31st impact what insurance will or won't pay?? If my insurance premium is for the year? :confused:

Child's insurance starts from the month is it born (in the first year).

e.g. if born on 28th August, you will pay all of August through to end of year, i.e. 5 months, then annually. Same amount as if born on 1st August (and no, they don't get free CH citizenship). If born on 30th March, you pay all of March (i.e. from 1st) through to end of year, i.e. 10 months. There is no pro rata for the first month.

Really, it was a throwaway remark. It does little to premiums when they are so low anyway. The important bit is to register your unborn baby with the insurance company, ideally towards the end of the second trimester. It means it is done nice and early and won't get forgotten in the final push to the line, if you'll allow the pun.

CH_Me 04.01.2013 17:46

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by Carlos R (Post 1758668)
Child's insurance starts from the month is it born (in the first year).

e.g. if born on 28th August, you will pay all of August through to end of year, i.e. 5 months, then annually. Same amount as if born on 1st August (and no, they don't get free CH citizenship). If born on 30th March, you pay all of March (i.e. from 1st) through to end of year, i.e. 10 months. There is no pro rata for the first month.

Our insurer offered the month of birth free. Mine had to be born at the end of the month :msnsad:

Guest 04.01.2013 17:49

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by JanieCH (Post 1758554)
I am also pregnant (due in June) and had a long talk with a friend of mine who is a "baby planner" (don't ask....). This is my second (my first was born in Canada) so I had a good idea of what questions to ask. My friend told me that the following things are covered, 100%, no deductible:

- 7 visits with a gynecologist
- 2 ultrasounds (12 & 22 weeks) though she said some insurance providers will reimburse a third
- all of the standard tests and blood work (I just had a whole bunch done, but I couldn't even tell you what they were) -- the genetic defect tests are NOT covered
- 100 CHF for prenatal classes
- 3 breastfeeding consultations
- vaginal delivery (if you have to visit the hospital in the weeks / days before the deliver, if you are overdue for example, this counts as part of the delivery costs)
- 1 post-partum visit with your gynecologist
- daily visits from a midwife for the first 10 days post-partum

Basically, if you have a normal pregnancy with no complications, everything will be covered. I didn't even ask what would happen in the case of a "complication", but at any rate if that were to happen we would do what was necessary for the health of the baby and myself and deal with the costs later, so no need to worry about it prematurely.

I hope that helps. Good luck to all of the pregnant ladies!

That was very detailed and highly informative. Thanks Janie, much appreciated.

Are you or anyone here able to estimate the total costs for all the above treatment you've mentioned, which doesn't eat into your deductible?

The reason for asking is that we are with UK Axa Prestige cover and the total they will pay out for normal pregnancy is 10k GBP and all complications (including c section) are covered up to 2M GBP.

Carlos R 04.01.2013 17:50

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by MarieZug (Post 1758675)
Our insurer offered the month of birth free. Mine had to be born at the end of the month :msnsad:

Haha. We are with Assura - cheapest of the cheap. No discounts for us. :D

little_isabella 04.01.2013 18:02

Re: Insurance Coverage for Pregnancy and Birth
 
1 Attachment(s)
Quote:

Our insurer offered the month of birth free. Mine had to be born at the end of the month :msnsad:
Second to that as ours did too.

Quote:

Misinformed indeed. Have you had a c-section in CH? In which case you would know what I am talking about, based on the 3 we've had, and not including the 1st emergency one :rolleyes:
There's no need to be so defensive! ;p One doesn't need to have a c-section to post the link I shared nor does it even matter where in the world it is. I was genuinely concerned that you thought scheduling a c-section earlier in the month rather than later had no potentially negative consequences (and that others reading might think so too). The two weeks earlier maximum date you suggest is challenged in the study. A doctor may indeed okay it as many around the world do, but new research suggests it's best not to plan it earlier (unless there's a medical reason to do so).

Quote:

Are you or anyone here able to estimate the total costs for all the above treatment you've mentioned, which doesn't eat into your deductible?
I believe mine was around the ten grand mark and that was for an uncomplicated pregnancy. I also checked out of the hospital the morning after the night I delivered.

Edit: I'll try to pull up my old bills and update this post with a more precise number. I have copies of all the bills, including the midwife and hospital ones. Everything was covered except for some on-call cost pertaining to the midwife and also a birth registration fee from the hospital. I've attached a copy of information in English on basic insurance, which includes pregnancy. Hope it helps! =)

Guest 04.01.2013 18:09

Re: Insurance Coverage for Pregnancy and Birth
 
I believe mine was around the ten grand mark and that was for an uncomplicated pregnancy. I also checked out of the hospital the morning after the night I delivered.[/QUOTE]

Ten grand in chuffs or GBP? Did you go for the 1st, 2nd or 3rd class?

When I asked the question about the class of treatment, the nurses couldn't give me a good concise comparable breakdown and apparently majority go for the 3rd class and it's not much different to the first two classes.

little_isabella 04.01.2013 18:15

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Ten grand in chuffs or GBP? Did you go for the 1st, 2nd or 3rd class?

When I asked the question about the class of treatment, the nurses couldn't give me a good concise comparable breakdown and apparently majority go for the 3rd class and it's not much different to the first two classes.
It's CHF. Just basic insurance and I had a scan with each ob/gyn visit, which were all covered. In my case, checking out the next morning meant I never had to share a room as I just left the delivery room. I felt much more comfortable recuperating at home, but I definitely understand how some women choose to stay (and how others must do so for medical reasons) longer.

JanieCH 04.01.2013 20:27

Re: Insurance Coverage for Pregnancy and Birth
 
Quote:

Originally Posted by cotw99 (Post 1758680)
That was very detailed and highly informative. Thanks Janie, much appreciated.

Are you or anyone here able to estimate the total costs for all the above treatment you've mentioned, which doesn't eat into your deductible?

The reason for asking is that we are with UK Axa Prestige cover and the total they will pay out for normal pregnancy is 10k GBP and all complications (including c section) are covered up to 2M GBP.

I am less than 4 months in have had two gyneco visits, one ultrasound and a bunch of blood tests and it's already cost about 1000 CHF (I'm still awaiting reimbursement....).

tryingtolikech 22.03.2013 13:51

Swisscare Re: Insurance Coverage for Pregnancy
 
I am getting exceptional service (and coverage) from Swisscare!

So, I am also pregnant and have insurance with Swisscare (as a student).

I recently submitted my receipts for up to now for 2013 (all of them from Unispital Zurich).

They are reimbursing everything, except for Elevit Pronatal (prenatal vitamins, they are considered a nutrition supplement, cost is negligible, about CHF20 per month).

Some other medication (extra magnesium and iron) is covered, but I have not reached my franchise of CHF300 yet, so I still have to pay.

Important: One of the visits was not planned (I went to the emergency room after an emergency). They also fully covered this one (even though I suppose it should be considered a "complication").

All in all, Swisscare is amazing considering how low-cost it is. The only disadvantage is that you have to pay first and get reimbursed later, which might be a problem for someone's cash flow.


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