What basic insurance covers
Under the KVG and the KLV benefits ordinance, basic insurance pays for practically everything that is medically necessary: 7 antenatal check-ups (blood work, urine, blood pressure, weight, the baby's heartbeat), 2 ultrasounds (a first-trimester scan with nuchal translucency measurement and the organ screening), as many additional checks as medically needed in a high-risk pregnancy, CHF 150 towards a midwife-led birth-preparation course, the birth itself in the general ward of a listed hospital, in a birth centre on the cantonal hospital list or at home with an independent midwife, medically indicated Caesarean sections, 10 to 16 midwife aftercare visits within 56 days, 3 lactation consultations with an IBCLC-certified adviser, and medication without deductible from week 13. Source: FOPH, KLV.
No deductible or out-of-pocket share from week 13
In weeks 1 to 12, pregnancy-specific services are already exempt from cost sharing, but general treatments still count towards your deductible and out-of-pocket share. From week 13 until 8 weeks after the birth, everything is free of both, including treatments that have nothing to do with the pregnancy, and regardless of which deductible you chose. Tip: where possible, schedule plannable treatments from week 13 onwards, then you pay neither deductible nor out-of-pocket share.
The seven check-ups at a glance
Weeks 6–8: first check-up, blood tests and blood group. Weeks 11–13: first-trimester screening with the first ultrasound and nuchal translucency measurement. Weeks 16–18: check-up, the baby's heartbeat, blood tests. Weeks 20–22: the big organ-screening ultrasound. Weeks 24–28: glucose test for gestational diabetes and blood-pressure check. Weeks 30–34: the baby's position and birth planning. Weeks 36–40: final checks with CTG, weekly if needed. All seven check-ups and both ultrasounds follow the SGGG standard and are covered by basic insurance.
Prenatal tests: what is paid
Nuchal translucency measurement and the first-trimester test are covered routinely. The NIPT (non-invasive prenatal test) is only paid when the first-trimester test shows a risk above 1:1000; without that indication it costs CHF 510 to 750 out of pocket, and extended NIPT panels add around CHF 350. Amniocentesis and chorionic villus sampling are covered when medically indicated.
Where to give birth: three covered options
Hospital (CHF 8'000–12'000): 3 to 5 days, full facilities including neonatology, ideal for high-risk pregnancies; fully covered in the general ward of a listed hospital in your canton of residence. Birth centre (CHF 5'000–8'000): 1 to 3 days, midwife-led with a family atmosphere, for complication-free pregnancies; the centre must be on the cantonal hospital list. Home birth (CHF 3'000–5'000): with an independent midwife, for complication-free pregnancies close to a hospital. Outpatient births, where you go home 4 to 6 hours after delivery with midwife care at home, are also fully covered.
Midwife aftercare and breastfeeding support
Basic insurance pays a maximum of 10 home visits after a normal birth and up to 16 after a Caesarean, for first-time mothers or after a multiple birth, all within 56 days of delivery. In the first 10 days, up to 5 additional second daily visits are possible if medically necessary. It also pays for 3 lactation consultations with an IBCLC-certified adviser.
What is NOT covered
Semi-private or private wards (twin or single room) require hospital supplementary insurance. Family rooms cost CHF 150 to 300 a night unless the insurer deems the room medically necessary. An elective Caesarean is usually paid in practice but not legally guaranteed. NIPT without a risk indication costs CHF 510 to 750, extended variants around CHF 350 more. Only CHF 150 of a midwife-led birth-preparation course is covered. Postnatal exercise classes and pregnancy yoga are not covered by basic insurance, though some supplementary plans contribute a prevention benefit. Support stockings and breast-pump rental are only partly covered with a medical indication and prescription.
Supplementary insurance: sign up before pregnancy
Semi-private and private hospital plans apply waiting periods of 12 to 24 months to maternity benefits, so anyone who signs up during pregnancy has no claim to those benefits for that birth. Take out hospital, and also dental, supplementary insurance before starting a family. The differences: basic insurance means a shared ward (4+ beds) and the duty doctor in a hospital of your canton of residence; semi-private means a twin room and free choice of doctor anywhere in Switzerland; private means a single room and the chief physician, with a family room usually included in semi-private and private plans.
Register your baby before birth
Register your baby with an insurer between the 5th and 8th month of pregnancy. The child is then accepted into supplementary insurance without any health assessment, even with congenital conditions, and is covered from the first minute; you simply send the name and date of birth after delivery. Without prenatal registration you have only 3 months after the birth to arrange all supplementary cover. Insurer practice differs: CSS and Sanitas accept prenatal semi-private or private registration if a parent holds the same plan, Groupe Mutuel accepts it without conditions, Concordia, Helsana and KPT only accept registration after birth, and SWICA reserves the right to exclude congenital conditions retroactively.
Switching insurer while pregnant
Basic insurance: yes. Insurers must accept every applicant, pregnancy can never be a reason for rejection, all KVG benefits are fixed by law, and you have a special termination right when premiums rise; the ordinary deadline is 30 November for a switch on 1 January. Supplementary insurance: no. The health assessment means pregnancy almost always leads to rejection or exclusions, and waiting periods of 12 to 24 months apply to maternity benefits. Never cancel an existing supplementary plan before a new one is confirmed in writing.
Maternity and parental allowance
The loss-of-earnings scheme (EO), run through the AHV compensation office, pays mothers 14 weeks of maternity leave at 80% of average pay, capped at CHF 220 per day, with an extension possible if the newborn has to stay longer in hospital; apply through your employer. The other parent receives 2 weeks of paid leave at 80% of pay, capped at CHF 3'080 in total, to be taken within 6 months of the birth, also applied for through the employer. Since 2024 the former paternity leave is officially called the other parent's leave.
The five most expensive mistakes
1. Trying to buy supplementary insurance during pregnancy: waiting periods of 12 to 24 months make it pointless, always sign before family planning. 2. Forgetting the prenatal registration: you risk rejection of the baby's supplementary insurance, especially with congenital conditions. 3. Cancelling a supplementary plan while pregnant: a new insurer will almost always reject or exclude you. 4. Having plannable treatments, such as dental work or operations, before week 13 instead of after, when cost sharing is waived completely. 5. Booking a midwife too late: good midwives are booked out early, so make contact in the first trimester, postnatal care matters most.
