Being pregnant and applying for German health insurance

john g. Active member

62POSTS

12 years ago

This is a surprising and welcome development. If you are pregnant and qualify for German public health insurance/gesetzliche Krankenversicherung, you have never had a problem with the maternity costs - it麓s covered.
A major problem has always been for pregnant women who cannot get into public insurance for whatever legal reason and who must apply for private health insurance.
They have usually been turned down straight away or have been asked to pay a high surcharge or have been refused cover if they are already more than a few weeks pregnant.

As a result of the new Unisex Laws for insurance since the beginning of this year, it seems change is afoot. There are now a couple of German private insurers who no longer even ask the question " are you pregnant?" in their application form and will insure you even if you are 6 or 7 or 8 months麓 pregnant at NO extra charge.
This is hopefully good news for some of you.

See also

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hadi88 Active member

49POSTS

12 years ago

hi john g,
how much cost for this insurance?and if any one come from non EU-country then whats problem occurred?
regards:
hadi88

john g. Active member

62POSTS

12 years ago

Hello Hadi! Private German insurance is at the moment mostly only available for EU citizens with no visa/residence restrictions either as self-employed/freeelance or for employees earning over 52,200 euros a year.
It depends what you would be doing here...
At your age, I can only guess between 250-300 euros a month but , again , that depends what else you would want in the cover.
I hope that helps.
Best wishes
John

maryboh Member

1POSTS

12 years ago

Hi John g,
is there any chance you can advice which are the few German private insurers that will cover a pregnant woman. So far I couldn't find any and I will move to Germany in 1 month and will be already 7 months pregnant.
kind regards
Maryboh

beppi Germany/Singapore Expert

15644POSTS

12 years ago

If you take up residency in Germany, you must be health-insured (pregnant or not).
Depending on many complicated factors (you rarely have a choice), you must either join the public system or the private one.
The public insurance (if you qualify to join it) costs a percentage of your income (usually between 聙350 and 聙700/month - half of which is paid by your company if you are employed) and they cannot reject you or add surcharges for prior illnesses or pregnancy.
The private insurers (if you qualify to join them) cost a monthly fee depending on your age and health status. They can add surcharges or reject you, but have to accept you into the "Basistarif" (which costs approx. 聙700/month - half of which is paid by your company if you are employed, and also covers pregnancy and prior illnesses). Since they dislike the "Basistarif" (which was imposed on them by law and incurs losses), they w铆ll not tell you this and do anything in their power to prevent you from joining - stand firm and insist if you intend to go this way!

2 members reacted to this post

john g. Active member

62POSTS

12 years ago

Hello Maryloh! Beppi is correct - you must be health insured if you come to live here. What is not clear is WHY you are coming here. As Beppi points out, it麓s no problem if you麓re going to be an employee - it麓s public insurance without rejections and almost half paid for by the employer.
The problem is if you麓re NOT going to be an employee or the spouse of a publicly insured person ( with whom you could be co-insured free of charge).
Hanse Merkur and Signal Iduna are two private companies that I麓m aware of who no longer aks questions about pregnancy on their application forms BUT they won麓t take non-EU citizens coming straight from the US.
Again, as Beppi states, there is otherwise the possibility of the so-called Basistarif - BUT they (private insurance companies ) would use the argument you may not have a long term visa in place or not earn well enough not to be a financial risk..
So the question is: why and in which circumstances are you coming here?

juliabone Member

3POSTS

12 years ago

I dont have insurance, in in Germany from last month, 8 months pregnant. Somebody can help me....i need to get a insurance

juliabone Member

3POSTS

12 years ago

Why nobody don't replay me?

john g. Active member

62POSTS

12 years ago

Just seen this. Nobody knows your situation, juliabone. Why are you here? Why aren麓t you insured? Have you got a European Health Card from Rumania? Why wait so long for help? If you have a European Health Card from your home country, visit a public insurance office tomorrow in Jesteburg eg DAK, Techniker or go to an insurance agent..look for someone there or google " Versicherungsagenten in Jesteburg".

juliabone Member

3POSTS

12 years ago

#10

I'm very happy to see that you replay for me. My situation it's very complicated. But i need help more then never. My husband he is from srilanka. We married in cyprus in 2011, from there i had a european card, but this expired in december 2013. From cyprus we went to romania and from there we found a job to come in germany,but hired in romania and ditashed in germany. This happend last year, then i got pregnant. Because of very very bad situation we was forced to go in november 2013 to srilanka, we came back in germany last month, because i want to born my baby in europ. Sure, your question is now why we came to germany. Because in romania my husband he can't get a job, then me i will dont get any benefits, so no chance to live. My husband working now the same hired in romania and ditashed to here. Thats why he dont have a insurance in germany what it covers me, he can use that only for medical controls. My baby will come in few weeks, i need to get a insurance. Please help, nobody to do something for us. Thank you

Your Europe Citizens Guest

0POSTS

12 years ago

#11

Here you can find more information regarding health insurance within the EU:
europa.eu/youreurope/citizens/health/index_en.htm

Klaibernicki Member

1POSTS

8 years ago

#12

I would like to know more about pregnant women and health insurrance in Germany. I would like to know if I can ask further questions聽 through here please, thank you

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#13

You are welcome to ask any question you have about living in Germany. Please check first if the topic has already been discussed on the forum (the search function helps finding it).
German health insurance covers all necessary medical examinations and treatment of pregnant women and baby (some small co-payments might apply).

sreekala edannur New member

7POSTS

8 years ago

#14

Dear John
I am sreekala, an Indian, right now an alexander von Humboldt fellowship holder in berlin, germany. I am covered by International science insurance but they do not cover pregnancy. there was a special charge to cover maternity, but considering my age, 43, I did not opt it. I am paying 60 per month a total of 180 euros for my whole family. Now i doubt I am carrying, not yet consulted a doctor, and I am worried. I checked other options like Mawista science they also will not cover after conceiving. Changing the insurance, humboldt foundation says will bring unforeseeable consequences. I dont know what. Going back to India will spoil my research. John please advice, what to do

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#15

sreekala edannur: Given that this post thread is from 2013 and the original poster "John" was not active on the forum for two years, you might not get a reply from him.
I am surprized you are allowed to reside in Germany with such an insurance that does not seem to fulfill the requirements. But if that is the case, you need to either get another insurance or go to a place where you are covered (i.e. India).
International insurances, or the German private scheme, are probably impossible, because they usually excluse pre-existing conditions (which an existing pregnancy obviously is).
You should try to join the German public insurance scheme, which knows no such exclusions. Inquire at a public insurer of your choice and - if they don't accept you - try another one until you find one that does!

sreekala edannur New member

7POSTS

8 years ago

#16

Dear Beppy,
Sorry I have not noticed the year and I am thankful to you for spending time for me. I will immediately start looking for one. Thanks a lot again. Please let me know any other. what is DAK, ok i check in net
Sreekala

john g. Active member

62POSTS

8 years ago

#17

Funnily enough, I can actually see these last posts! The lady is privately insured so cannot switch to public insurance.
There are no international insurances which cover an existing pregnancy if not already a client and non-pregnant clients are faced with a waiting time of 8-11 months.
It is possible for an already pregnant woman to get fully comprehensive private health insurance in the German system assuming:
She is otherwise healthy
Has a residence permit with at least 24 months to run
She is financially viable

However, the costs are much higher than what she is paying at the moment and this could be a huge stumbling block!
John

sreekala edannur New member

7POSTS

8 years ago

#18

Dear John
Thank you for the reply. I have not expected this much of complications!
it seems almost nothing is possible and I have to go back. My residence permit is upto feb 2019 only. and I am a fellowship holder. it seems there is no way. I am with International science health care plan. will there be a way out with them? like paying a surcharge or something?
I will write to them.

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#19

I stand corrected about John's absense. Thanks for replying!

Sreekala: I assumje you are covered by IHC's plan IHSCP () or FlexMed ().
According to what I see online, both are covering pregnancy (unless it existed before coming to Germany).

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#20

Sorry, I just saw that the application form for ISHCP has a checkbox option for "additional pregnancy cover", which I presume is what you didn't take.
Then unfortunately what John said above is true.
You could only try talking to the insurance and hoping that they will include it retroactively out of goodwill.

sreekala edannur New member

7POSTS

8 years ago

#21

Thank you for this .

Sreekala

john g. Active member

62POSTS

8 years ago

#22

I am afraid there is no chance of any insurance acting retrospectively re your pregnancy馃槥

And again , I am afraid you will not be able to get even expensive German insurance given your visa doesn't have long to run....

Fellowship holders often have the problem anyway that they do not receive a salary within the German employee system and thus are not " versicherungspflichtig " in the sense that they must or are able to get into the " proper " German system eg public insurance, if they have come from a country outside Europe.

It would have been different if you had come - even as an Indian citizen - to Germany from a country with a public health system you had been in eg UK, France etc.

I wish there were an affordable and legally posdible solution for you but there isn't.

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#23

John's post above gave me one more idea you might try:
If you or your husband get a job with regular pay above EUR451/month, you'd have to join the German public health insurance and everything would be covered.
I don't know, though, whether your visa allows that or whether you can find a job. Often the universities have part-time assistantship positions - ask about it there!

john g. Active member

62POSTS

8 years ago

#24

Good point!!

sreekala edannur New member

7POSTS

8 years ago

#25

God i feel defeated

sreekala edannur New member

7POSTS

8 years ago

#26

Thanks a lot for the help. I
Cannot do any job. But my husband is free at home and he can get some job. He is now in b1 level German. But we 3 are niw covered by private insurance.聽 What to do with that.
Sreekala

sreekala edannur New member

7POSTS

8 years ago

#27

And one query. How long should be the contract?

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#28

As long as your husband has a >EUR450 job, he is compulsorily member of the public scheme (up to around EUR5000/month, above which he must remain in the private scheme) - at least for as long as he has the job (under certain circumstances and after certain waiting times also longer). And I believe you can then be covered under his insurance as dependent free of charge - as long as you have no own income. (In case you get a scholarship, I don't know if this is counted as income ...)
Another option you may explore is the private insurance's "Basistarif". It has basically the same coverage (incl. pre-existing conditions and pregnancy) as the public scheme and costs around EUR350/month. It was forced upon the private insurers by law (meaning they must offer it), but is loss-making and therefore they will do anything they can to deny you entry - including claiming you cannot join (which is probably untrue in your case).
Or you pay the cost of a normal birth from your own pocket. It would be around EUR10000 if there are no complications. (And if there are complications, your current insurance might pick them up again - ask!)

Unfortunately the German health insurance regulations are so extremely complicated that even insurance staff often do not understand them and admit or reject people wrongly (that's why I initially said try a few insurers and don't give up when rejected). As a consumer, you are basically on your own. I am not aware of any organisation advising on these matters (without having commercial interests in pushing you one side or the other), telling you your rights or helping you defend them.

john g. Active member

62POSTS

8 years ago

#29

Check the real price of the Basistarif!!! PER PERSON!
Even to get into is really tough, especially for a foreigner...virtually impossible..you would need the help of a Versicherungsberater ( a kind of insurance lawyer charging fees...).
I don麓t mean the run of the mill insurance salesperson running around calling himself a Versicherungsberater (eg those working for pyramid companies ) but a proper specialised profession.

Another problem: even if husband gets a job and into public insurance - there may be an issue with backpayments PLUS the wife would only qualify as a non-paying family member if her monthly income (profit ) from any source worldwide is under 435 euros a聽 month.

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#30

Well, I was clutching at straws here. Since even insurance personnel do not understand and follow these regulations in full, it may still be worth trying. (The alternative, giving up and aborting her stay in Germany, still remains, so there's nothing to lose!)

john g. wrote:
you would need the help of a Versicherungsberater ( a kind of insurance lawyer charging fees...).

I did not know of the existence of such a profession. Could you tell us any contact details? (In case you don't want to post it here in public, you may send Sreekala a PM - and me too, please, for future reference!)

john g. Active member

62POSTS

8 years ago

#31

beppi wrote:
Well, I was clutching at straws here. Since even insurance personnel do not understand and follow these regulations in full, it may still be worth trying. (The alternative, giving up and aborting her stay in Germany, still remains, so there's nothing to lose!)

john g. wrote:
you would need the help of a Versicherungsberater ( a kind of insurance lawyer charging fees...).

I did not know of the existence of such a profession. Could you tell us any contact details? (In case you don't want to post it here in public, you may send Sreekala a PM - and me too, please, for future reference!)

Hope the link works!!!
I麓m NOT a Versicherungsberater, by the way, so not posting for business.

And depending where you live:

AndreaRuthes Member

1POSTS

8 years ago

#32

Which private insurances cover pre existing pregnancy in Germany?

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#33

There is an 8 month waiting period before pregnancy and birth are covered by German private health insurers. The only existing exception is the "Basistarif", which by law offers the same coverage as public insurers (incl. pregnancy coverage from the first day) and costs at least 鈧�750/month (of which your employer might pay up to half). But the insurers will do anything in their power to prevent you from joining it.
Choose the publich scheme, if you can!

john g. Active member

62POSTS

8 years ago

#34

I know two private German insurers- there may be more- who accept pregnant women without any waiting time as long as they have a general medical check up first and have no serious side effects and, if non-EU citizens, have a minimum 24 month residence permit still to run.
Whether public or private insurance is the way to go depends on many factors, though.

john g. Active member

62POSTS

8 years ago

#35

Hi Beppi! Why would someone try to get the private Basistarif if they are an employee? Normal public insurance would be the normal thing to do with the employer chipping in.

beppi Germany/Singapore Expert

15644POSTS

8 years ago

#36

john g. wrote:
Hi Beppi! Why would someone try to get the private Basistarif if they are an employee? Normal public insurance would be the normal thing to do with the employer chipping in.

Yes, I agree: Public insurance is preferable in almost all cases.
But there are people who are not allowed to join it (I assumed this might be the case with the above poster), and if they are pregnant the Basistarif might be worth considering. I didn't know, though, that there are private insurers who accept pregnant ladies without the standard waiting period, in which case these are even better.

ozdorf Member

1POSTS

7 years ago

#37

Good day john_g ,

Apologies for digging up this thread, just wanted to run a few things by you - and I have read the forums at length.

My situation:

EU Citizen living in Sydney, relocating to Germany as an employee with a salary above 55000 EUR/year threshold. No German.

The wife is 2 month pregnant (Australian).

Our options to get insured in the current condition are:

* Public health insurance (co payed by the employer)
* Hanse Merkur and Signal Iduna private insurance companies on sensible tariff
* Any private insurance company on Basis Tariff

Could you please confirm if I am missing anything?
Thank you!

Cheers,
OzDorf

john g. Active member

62POSTS

7 years ago

#38

ozdorf wrote:
Good day john_g ,

Apologies for digging up this thread, just wanted to run a few things by you - and I have read the forums at length.

My situation:

EU Citizen living in Sydney, relocating to Germany as an employee with a salary above 55000 EUR/year threshold. No German.

The wife is 2 month pregnant (Australian).

Our options to get insured in the current condition are:

* Public health insurance (co payed by the employer)
* Hanse Merkur and Signal Iduna private insurance companies on sensible tariff
* Any private insurance company on Basis Tariff

Could you please confirm if I am missing anything?
Thank you!

Cheers,
OzDorf

Good day, Ozdorf!
Public insurance covers you, your wife and child-to-be and is the best option for you if your wife is not going to be working
Yes, Signal and HanseMerkur would cover her subject to a medical check up AND if she possesses a minimum 24 month visa. BUT private insurance would mean all two and later three of you each having your own private health insurance contract - expensive.,

Basistarif: absolutely useless - expensive and not even welcomed by many general doctors and definitely NOT required in your case but for the uninsurable!
It makes most sens to take out public insurance - based on income but with the employer more or less sharing the costs
Cheers
John

Kristianamez11 Member

1POSTS

7 years ago

#39

Hello everyone,
If someone could give me any advice,
My wife and I just moved to Germany, she is here for Phd studies.
She was pregnant 5 weeks when she got the insurance from her schoolarship.
My question is , according to our calculations the baby will come 8 months and half from the day she was insured.
Insurance company: Continentale.
Does the insurance cover her or I should pay for everything?

beppi Germany/Singapore Expert

15644POSTS

7 years ago

#40

You have to check the insurance conditions (a.k.a. fineprint) of Continentale. Every insurer have their own rules.
If Continantale does not cover pregnancy and child birth in your current plan, you can try to change to one that does - or move to the public insurance scheme (which always covers it).