Consultations with the family doctor, gynecologist and midwife, obligatory examinations, hospitalization expenses, perineal rehabilitation… If some of these expenses are partially or fully covered by the health insurance (100% coverage of the base), the amount of remains dependent can remain significant, particularly in the case of overruns: the Conclusion of an adapted supplementary health insurance is strongly recommended to optimize the coverage.
However, when announcing a pregnancy, many ideas jostle and the choice of supplementary health insurance is not always in the foreground. However, choosing the right contract is essential to benefit from optimal access to care and maintenance benefit from attractive reimbursements. To help you choose health contract, APRIL gives you his expert advice in complementary health.
Pregnancy: What costs are reimbursed by health insurance?
From the beginning of pregnancy compulsory exams are for pregnant women covered by health insurance up to 100% of the conventional tariff.
Case of Ultrasound:
Ultrasound is only reimbursed at 70%* up to the end of the 5th month of pregnancy, and then at 100%* from the 6th month of pregnancy (*reimbursement basis Assurance Maladie).
From 6th Months, the entire health care of the mother-to-be is taken over by the social insurance (100% of the reimbursement basis), regardless of whether they are related to the pregnancy of the insured person or not.
Note that this support is only possible if you have done so have reported your pregnancy to the health insurance company before the end of the 3rd month. This declaration is made via a form, online or in paper form, which will be sent to you at the end of the 1. prenatal examination performed by a doctor or midwife.
Despite long-term care and close support from the health insurance company during your pregnancy, Some costs are at your own expense and can take a toll on your budget, which is already strained by the approach of a baby.
This is the case with Fee Overruns and comfort services (single room, alternative medicine, etc.) that are not reimbursed by social security; depending on the guarantees taken out, they can be covered by supplementary health insurance
Complementary health care during maternity: the criteria to consider when making your choice
As a rule, the insurance companies offer pregnant women their classic contracts including basic guarantees such as co-payment management, deductible management, comfort care, etc. up to the subscribed levels.
However, be careful that Reimbursement Rates and Caps practiced and the additional guarantees are very different from insurer to insurer, from contract to contract or from guarantee level to guarantee level. Consult the table of benefits in your policy to learn more about the types of benefits covered and the level of coverage you may receive.
Some supplementary health insurance companies offer additional guarantees such as packages amniocentesis Where from in vitro fertilizationwhich may turn out to be interesting, or even a birth package, also called maternity package. This is a fixed amount that is paid at the birth of the child; it varies on average 100 to 250 € according to the contracts and allows to cover part of the expenses caused by the arrival of the baby.
Do you already have complementary health insurance? The birth of a baby is a good reason for this Readjust your coverage level. If you are happy with your current insurer, contact them to purchase a higher level of coverage or add additional coverage.
Does your supplementary health insurance no longer suit you? Since December 1, 2020, the right to termination during the year allows policyholders to change their supplemental health insurance contract at any time, free of charge or without penalty, after one contract year. A life event like an upcoming birth can also be an opportunity to cancel your current health insurance plan subscribe to a more complete and advantageous offer.