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.
Table of contents
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.
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.
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.
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. instead, privately insured employees receive a one-time transfer of up to 210 euros from the Federal Social Security Office.
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.
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 €73,800 per year or €6,150.00, 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.
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.
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.
The application process for maternity benefit depends on your type of health insurance and employment status. Here's a breakdown of how to apply.
For Employees with Public Health Insurance:
Contact your public health insurance fund directly to apply for maternity benefits.
For Employees with Private Health Insurance:
You can apply for maternity benefits directly to the Federal Social Security Office (Bundesversicherungsamt).
For Self-Employed Individuals with Private Daily Sickness Allowance Insurance:
Inform your private insurance provider about your pregnancy and the expected date of birth well in advance. Your doctor or midwife can provide the necessary confirmation.
Special Case: Family Insurance (without own public health insurance):
Generally, if you are covered by family insurance through your partner and do not have your own public health insurance, you are not eligible for maternity benefits.
Exception for Mini-Job Employees with Family Insurance:
If you are covered by family insurance but have a marginal job (mini-job), you may be eligible for a one-time payment of 210 euros from the Federal Social Security Office. Additionally, if you earned more than 390 euros net per month as a mini-jobber before your maternity leave, you would also receive an employer's allowance.
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!
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.
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