If the pregnancy and birth progress without complications, Sanitas covers the following benefits:
Check-ups: Sanitas covers the cost of 7 check-ups and 2 ultrasound scans before the birth. In the event of a high-risk pregnancy, invasive and non-invasive tests and ultrasounds are performed and the costs covered as deemed clinically necessary (see below).
Antenatal courses: Sanitas pays CHF 150 towards individual or group antenatal courses given by a midwife.
Hospital list: If the hospital or maternity facility of your choice is not on the list, please check whether Sanitas will cover the costs.
Delivery in hospital: Under basic insurance Sanitas pays all costs of the birth and after-birth care on a general ward, provided that the hospital of your choice is on the list of hospitals. A cost share (deductible and copayment) is not applied.
Home birth: The costs for a midwife are covered; the deductible and copayment are not applied.
Birth at a maternity facility: For home births or births at a hospital or maternity facility, basic insurance pays benefits according to the contractual provisions and tariff rules agreed with midwives, doctors and hospitals.
Cost share: From the 13th week of pregnancy up to 8 weeks after the birth, the cost share under mandatory basic health insurance is waived, with the exception of the following treatments:
Child sickness: If the newborn falls ill, the child’s health insurance pays and a cost share (deductible and copayment) is applied.
After-birth care: In case of an outpatient birth or home birth, home care provided by a midwife is covered. A medical prescription is needed from the 11th day after birth.
Breastfeeding advice: Sanitas covers the cost of three breastfeeding sessions with a midwife or trained breastfeeding consultant.
Check-up: The cost of the gynaecological check-up carried out between the 6th and 10th week after the birth of your baby.
Excluded from cover: Drugs, medical aids (e.g. compression socks) and equipment (e.g. milk pump) are subject to the deductible and copayment.
Insurance for your baby: If your child is born healthy, the costs of the birth are covered by the mother’s insurance. If your child is born with complications, the child’s insurance pays.
Therefore, it’s a good idea to take out health insurance for your child before the birth, particularly supplementary insurance.
Non-invasive prenatal screening: Blood is taken from the mother to screen for chromosomal abnormalities in the child. Costs are covered provided that a first-trimester test has been performed, with results indicating a risk of 1:1000 or higher for trisomy 21, 18 or 13.
First-trimester test: During this test, the risk of trisomy 21, 18 or 13 is calculated by measuring the nuchal translucency using ultrasound (12th to 14th week), determining the PAPP-A and free ß-hCG in the mother’s blood and taking into account additional maternal and foetal factors.
Amniocentesis, chorionic villus sampling, cordocentesis: These invasive tests are covered under basic insurance under the following conditions: