Maternity benefits & private insurance: Who is entitled?

What about maternity benefits for patients with private insurance? Under what conditions is money paid? How much is the maternity benefit and how long is it paid? We have all the answers to the most important questions about maternity benefits and private health insurance for you.

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Maternity pay explained simply

If you are employed and expecting a baby, you are subject to maternity protection periods before and after giving birth: As a rule, you do not have to work for six weeks before and eight weeks after the birth and can concentrate 100% on the birth and the first time as a mother.

To ensure that you are financially secure during this phase, you will receive maternity pay and an allowance from your employer.

Who receives maternity benefit and from whom?

Mothers with public health insurance: Maternity benefit is paid by the public health insurance funds. Upon application, your public health insurance will pay you a maternity allowance of a maximum of 13 euros per calendar day for salaried employees.

Privately insured mothers: If you are insured with a private health insurance company, you can apply for maternity benefits from the Federal Social Security Office. You will then receive a one-time payment of 210 euros.

At a glance:

  • Employees with public health insurance receive maternity benefits from their health insurer when they go on maternity leave. For privately insured women, there is a different regulation about maternity benefits: Privately insured employees receive maternity benefits upon application from the Federal Social Security Office.
  • If you are a self-employed person and a member of a private health insurance company, you will not receive maternity benefits. In this case, however, you can take out private daily sickness allowance insurance in good time to receive daily sickness allowance during the statutory maternity periods and thus compensate for the loss of earnings.

Maternity benefit: All the information for moms-to-be

The anticipation is enormous: a baby is on the way and your world is suddenly turned upside down! Now there is so much to do: Finding a midwife, setting up the nursery, shopping for baby clothes ... But the feelings of happiness are often accompanied by questions and doubts. Is the little-one healthy? How will the start of family life go? Will the balancing act between child and career work? And then, of course, there's the financial aspects.

To ease one of the worries of young families, at least in the short term, there is maternity benefit. This is a so-called income replacement benefit that mothers are entitled to shortly before and after the birth of their baby. But not all moms receive maternity pay - which naturally raises questions. We help expectant mothers and answer the most important questions: In which period is the maternity benefit paid? How much is it, who is entitled to it and what role does private health insurance play in maternity pay?

Maternity protection: These deadlines apply

Maternity benefits, such as maternity allowance, are intended to provide you with income while you take care of your health and that of your baby as a pregnant woman or new mother. Maternity benefits are paid during the maternity protection period, which usually starts six weeks before the expected date of birth and ends eight weeks after the birth.

If you are expecting multiples, the child is born prematurely or with a disability, the statutory protection period is extended to twelve weeks after the birth. During this time, you do not have to work, and the maternity benefit compensates for your loss of income.

How much is the maternity benefit in the public health insurance?

However, not all mothers receive maternity benefits. Whether you are eligible and how much maternity benefit you receive depends on various factors such as your work situation and your health insurance.

If you are an employee and have compulsory health insurance six weeks before your due date, you are entitled to maternity benefit. The same applies to employees with voluntary public health insurance. Your public health insurance fund will then pay you maternity benefits of up to 13 euros per day. Your employer will top up this amount so that your previous net salary will still be in your account during the maternity protection period. But what about maternity benefits for privately insured patients?

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Private health insurance benefits: What are privately insured mothers entitled to?

For members of a private health insurance, the receipt of maternity benefits is regulated a little differently. The private health insurance company itself does not pay maternity benefits; instead, privately insured employees receive a one-time transfer of up to 210 euros from the Federal Social Security Office.

For salaried employees:

For privately insured employees, the employer also contributes to the maternity benefit through subsidies. The employer's allowance for privately insured (expectant) mothers is calculated as if they were covered by public health insurance.

This means that during the maternity protection period, the employer will pay you your normal net salary minus the public health insurance benefit of up to 13 euros per day.

Check out the rates for private health insurance for employees now!

For the self-employed:

If you are privately insured as a self-employed person, you are not entitled to maternity benefits. However, you can take out private daily sickness allowance insurance to receive the agreed daily sickness allowance during maternity leave.

Please note: The insurance contract for your daily sickness allowance insurance must have been concluded at least nine months previously for the daily sickness allowance to be paid out. If you are planning a pregnancy as a privately insured entrepreneur, you should keep this deadline in mind and, if necessary, take out the private daily sickness allowance insurance in good time. The daily sickness benefit will then cover your actual loss of earnings.

Check out the rates for private health insurance for self-employed now!

For civil servants:

Are you privately insured as a civil servant? Then you do not receive maternity benefits. However, this is not necessary, because you will receive your normal salary including allowances during maternity leave.

How to apply for maternity benefit

For employees with public health insurance, contact your public health insurance to apply for maternity benefits. If you do not have public health insurance yourself, but have family insurance through your partner, you will not receive maternity benefits. 

There is an exception if you have family insurance and have a marginal job, such as a mini-job. In this case, you can apply for a one-time payment of 210 euros from the Federal Social Security Office. On top of this, you would receive an employer's allowance if you earned more than 390 euros net as a mini-jobber before your maternity leave.

Private health insurance: Things to know about maternity protection and parental leave

There is one important thing to remember if you are privately insured as an employee: During maternity leave, your employer does not pay any subsidies for private health insurance. This also applies during parental leave if you do not work.

If you go to work during or after parental leave, you may slip below the compulsory insurance limit - because as a mom you may not want to or be able to work as much as you did before the birth.

If your income is less than €69,300 per year or €5,775.00, you will generally have to take out public health insurance. However, under certain circumstances, it is possible to be exempted from compulsory insurance and thus remain a member of private health insurance. It is best to contact your private health insurance provider.

Marie-Theres Rüttiger
HIER SCHREIBT Marie-Theres Rüttiger

Marie-Theres is online editor for health and insurance topics at ottonova. She designs the editorial plan, researches and writes mainly about (e-)health and innovation that make life better.

ottonova sales experts
HIER SCHREIBT ottonova sales experts

Our ottonova team of experts has over 40 years of experience in private health insurance and answers questions about it every day. What are old-age provisions and for whom does private health insurance make sense? What is the actuarial interest rate and which tariff is right for you? They know!

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