Pregnancy

Pregnant – a new situation

«Now I know: I'm pregnant. The pregnancy test was positive. What does that mean for me? Am I at all ready for a child? What does it mean for me and my life that I'm expecting?»

Neue Situation

Maybe you planned this baby. Then you'll already have asked yourself these questions some time ago. But it could be that you didn't plan to get pregnant. Then you'll be asking yourself: am I ready for this child?

Talking about it can give you peace of mind

In this case, you should first come to terms with the situation yourself. You'll of course discuss it with your partner as well. Is he also ready for a child? For the thought of starting a family? And what does it mean for him? It helps to talk to people you trust. Your mother? Your friend? Or do you have a particularly close relationship with your father? Talking to people who have your best interests at heart will help you reach the right decision.

All-round support from your midwife or gynaecologist

Now that you know you're pregnant, you can look for a midwife. She will advise and support you during your pregnancy and look after you later during labour, in the immediate postnatal period and while you're breastfeeding. You can of course choose to be looked after by your gynaecologist.

Statutory maternity protection

If you work, you should inform your employer within a reasonable period. Don't put this off for too long. The Maternity Protection Act stipulates that an employee may not be discriminated against in the event of pregnancy. Your contract of employment may not be terminated during the pregnancy and for a period of 16 weeks after the birth of your baby.

If your baby was not planned and you have got into serious difficulties as a result of the pregnancy, the charitable relief organisation Swiss Aid for Mother and Child is there to help you. It will provide you with advice if you are in financial difficulties, if there are problems with the acknowledgement of paternity or if you have other worries.

What can Helsana do for you?

Choose a midwife you can trust early on. You don't have to worry about the costs as your basic insurance covers the costs for the services of a midwife, without any effect on your deductible or copayment. For example, your midwife may carry out up to six check-ups during the pregnancy without you incurring any costs. She also looks after you together with your gynaecologist in the event of a high-risk pregnancy.

Midwife services are in high demand. So try and find one as quickly as possible. Perhaps someone you know can give you a recommendation. The Swiss midwives association will also be happy to help you.

If you have concluded PRIMEO supplementary insurance, Helsana will pay part of the charges for the midwife advice line. You'll also receive the costs of online consultations from the University Hospital Zurich.

Choice of doctor

Basic insurance
Free choice of doctor in canton of residence.

If you have selected an alternative insurance model, the following applies instead:

  • BeneFit PLUS Family Doctor option: You always contact your selected family doctor (or group practice). If necessary, your family doctor or group practice will refer you to a specialist or hospital.
  • BeneFit PLUS Telemedicine option: You always contact the doctors of the Medgate Centre for Telemedicine. If necessary, the Medgate doctor will refer you to a doctor, specialist or hospital for a physical consultation.
  • PREMED-24: You always contact Medgate by telephone first to receive non-binding health advice. If necessary, you can then consult a doctor of your choice in your canton of residence.

You can freely choose a doctor to treat you within your canton of residence from case to case and consult him or her directly, if necessary.


PRIMEO
Free choice of doctor at recognised institutions

If you have selected an alternative insurance model, please note the following:

  • BeneFit PLUS Family Doctor option: Please contact your family doctor or group practice first.
  • BeneFit PLUS Telemedicine option: Please contact the Medgate Telemedicine Centre first.
  • PREMED-24: Please contact Medgate's telephone medical advice service first.

You have an unrestricted choice of doctor in the hospital for outpatient procedures or operations (e.g. eye cataract, bunion, tendonitis, tennis elbow, knee arthroscopy, etc.) or for an outpatient birth. For example, you can even choose to be operated on by the head physician.

Conditions:

  • The outpatient surgery is performed at an institution recognised by us.
  • The selected doctor is on the list of specialists (senior physician, head physician, professor) at the hospital in question.

Product information:
PRIMEO
HOSPITAL PLUS
Unrestricted choice of doctor anywhere in Switzerland

You have an unrestricted choice of doctor in any hospital in Switzerland. For example, you can even choose to be operated on by the head physician.


Product information:
HOSPITAL PLUS
HOSPITAL COMFORT
Unrestricted choice of doctor anywhere in Switzerland

You have an unrestricted choice of doctor in any hospital in Switzerland. For example, you can even choose to be operated on by the head physician.


Product information:
HOSPITAL COMFORT
HOSPITAL FLEX
Unrestricted choice of doctor anywhere in Switzerland (semi-private & private)

You have an unrestricted choice of doctor in any hospital in Switzerland if you stay in a semi-private or private ward. For example, you can even choose to be operated on by the head physician.


Product information:
HOSPITAL FLEX

Choice of hospital

Basic insurance
Listed hospitals

You are free to choose among all the hospitals in Switzerland that are included on the cantonal hospital lists (“listed hospitals”), but receive no more than the costs specified by the tariff of your canton of residence.


OMNIA
Free choice of hospital anywhere in Switzerland

You are free to choose the hospital you want anywhere in Switzerland.

Please note that some hospitals do not have a (recognised) general ward; in such cases, you may incur costs for which you alone will be responsible.


Product information:
OMNIA
HOSPITAL ECO
Unrestricted choice of hospital anywhere in Switzerland

You are free to choose the hospital you want anywhere in Switzerland.

Please note that some hospitals do not have a (recognised) general ward; in such cases, you may incur costs for which you alone will be responsible.


Product information:
HOSPITAL ECO
HOSPITAL PLUS
Unrestricted choice of hospital anywhere in Switzerland

You are free to choose the hospital you want anywhere in Switzerland.

Please note that some hospitals do not have a (recognised) semi-private ward; in such cases, you may incur costs for which you alone will be responsible.


Product information:
HOSPITAL PLUS
HOSPITAL COMFORT
Unrestricted choice of hospital anywhere in Switzerland

You are free to choose the hospital you want anywhere in Switzerland.

Please note that some hospitals do not have a (recognised) private ward; in such cases, you may incur costs for which you alone will be responsible.


Product information:
HOSPITAL COMFORT
HOSPITAL FLEX
Unrestricted choice of hospital anywhere in Switzerland

You are free to choose the hospital you want anywhere in Switzerland.

Please note that some hospitals do not have a (recognised) general, half-privat and privat ward; in such cases, you may incur costs for which you alone will be responsible.


Product information:
HOSPITAL FLEX

Semi-private ward

HOSPITAL PLUS
Two-bed room, free choice of doctor

You can claim the costs of accommodation and medical treatment in a two-bed room in the semi-private ward of any hospital in Switzerland. There, you can enjoy a peaceful environment and privacy as well as a free choice of doctor at the hospital.

Please note that certain hospitals do not have a (recognised) semi-private ward, in which case you may incur costs which you will have to bear yourself.


Product information:
HOSPITAL PLUS
HOSPITAL FLEX
Two-bed room, free choice of doctor

You decide in each case what ward you would like to be admitted to and be treated in.

In a semi-private ward, you enjoy a peaceful environment and privacy in a two-bed room and have a free choice of doctors at the hospital. Depending on which option you select, you bear part of the costs yourself:

  • HOSPITAL FLEX 1: You pay 35% of the costs up to CHF 3,000 per calendar year.
  • HOSPITAL FLEX 2: You pay 20% of the costs up to CHF 2,000 per calendar year.

Product information:
HOSPITAL FLEX

Private ward

HOSPITAL COMFORT
One-bed room, free choice of doctor

You receive the costs of the stay and medical treatment in a one-bed room in the private ward of any hospital in Switzerland. There you can enjoy peace and privacy as well as a free choice of doctor.

Please note that some hospitals do not have a (recognised) private ward; in such cases, you may incur costs for which you alone will be responsible.


Product information:
HOSPITAL COMFORT
HOSPITAL FLEX
One-bed room, free choice of doctor

You decide in each case what type of ward you would like to be admitted to and be treated in.

In a private ward you enjoy peace and privacy in a one-bed room and have a free choice of doctor. Depending on which option you select, you pay for part of the costs yourself:

  • HOSPITAL FLEX 1: You pay 50% of the costs up to CHF 9,000 per calendar year.
  • HOSPITAL FLEX 2: You pay 35% of the costs up to CHF 4,000 per calendar year.

Product information:
HOSPITAL FLEX

Medical hotlines & online services

PRIMEO
Up to CHF 300.-

You receive up to CHF 300 per calendar year towards medical advice provided via a chargeable hotline or online service, such as the children's hotline at the children's hospital or the online medical consulting service offered by University Hospital Zurich.

Conditions:

  • You can show that you incurred these expenses by sending us the relevant phone bill or invoice from the online service.
  • The advice came from a service provider approved by us.

Product information:
PRIMEO

Pregnancy

Basic insurance
Examinations and consultations
Check-ups and ultrasound examinations
  • For a regular pregnancy, you are entitled to seven check-ups carried out by a doctor or six examinations by a midwife.
  • We will also reimburse you for two ultrasound examinations carried out by a doctor.
  • For a high-risk pregnancy, you will receive the costs of all necessary check-ups and ultrasound examinations.
Breastfeeding guidance
  • You receive 3 sessions of breastfeeding guidance from a midwife or specially trained nursing staff. In case of multiple births, you receive up to 2 additional guidance sessions.
  • Breastfeeding guidance replaces the breastfeeding allowance. This was abolished with the 1996 revision of the Health Insurance Act.

SANA
75% up to CHF 500.–

CHF 500 is the total amount payable to cover all preventative treatment measures.

In addition to the pregnancy-related benefits included in the basic insurance, you will 75% of the costs of additional ultrasound examinations up to CHF 500 per calendar year .


Product information:
SANA
COMPLETA
90% up to CHF 750.–

CHF 750 is the total amount payable to cover all preventative treatment measures.

In addition to the pregnancy-related benefits included in the basic insurance, you will 90% of the costs of additional ultrasound examinations up to a maximum of CHF 750 per calendar year .


Product information:
COMPLETA

Birth preparation

Basic insurance
CHF 150.–

You can claim CHF 150 per calendar year for ante-natal courses provided by an accredited midwife.


SANA
75% up to CHF 500

CHF 500 is the total amount payable to cover all health-related measures in connection with the pregnancy, such as ante-natal courses, and pregnancy and post-natal exercise classes.

You can claim 75% of the costs up to CHF 500 per calendar year for ante-natal courses.

Conditions:

  • The course is approved by us.
  • The course is provided by an accredited midwife.

Product information:
SANA
COMPLETA
75% up to CHF 500

CHF 500 is the total amount payable to cover all health-related measures in connection with the pregnancy, such as ante-natal courses, and pregnancy and post-natal exercise classes.

You can claim 75% of the costs up to CHF 500 per calendar year for ante-natal courses.

Conditions:

  • The course is approved by us.
  • The course is provided by an accredited midwife.

Product information:
COMPLETA

Pregnancy exercise

SANA
75% up to CHF 500.–

The sum of CHF 500 is to be used in its entirety for health-related measures in connection with the pregnancy, such as birth preparation courses and antenatal and postnatal gymnastics.

You receive 75% of the costs of pregnancy exercise up to CHF 500 per calendar year.

Conditions:

  • The course is recognised by us.
  • The course is carried out by a recognised midwife, by a recognised course instructor or in a hospital.

Product information:
SANA
COMPLETA
75% up to CHF 500.–

The sum of CHF 500 is to be used in its entirety for health-related measures in connection with the pregnancy, such as birth preparation courses and antenatal and postnatal gymnastics.

You receive 75% of the costs of pregnancy exercise up to CHF 500 per calendar year.

Conditions:

  • The course is recognised by us.
  • The course is carried out by a recognised midwife, by a recognised course instructor or in a hospital.

Product information:
COMPLETA

Fitness offers

SANA
75% up to CHF 200

Choose a method and a provider that is recognised by us. Both are of high quality.

You will receive 75% of costs up to CHF 200 per calendar year for health-promoting fitness offers such as weight training at a fitness centre (fitness centre membership), fitness courses, aquafitness, etc.

Conditions:

  • The course is recognised by us.
  • The course instructor is recognised by us.
  • The fitness centre is recognised by us.

Product information:
SANA
COMPLETA
75% up to CHF 200

Choose a method and a provider that is recognised by us. Both are of high quality.

You will receive 75% of costs up to CHF 200 per calendar year for health-promoting fitness offers such as weight training at a fitness centre (fitness centre membership), fitness courses, aquafitness, etc.

Conditions:

  • The course is recognised by us.
  • The course instructor is recognised by us.
  • The fitness centre is recognised by us.

Product information:
COMPLETA

Medical aids and equipment

Basic insurance
According to list

You receive the costs of medically prescribed aids and apparatus, such as crutches, blood-sugar measuring devices, inhalation/respiration therapy equipment and compression stockings, up to the maximum amount specified by law.

This is on condition that the medical aids are listed in the aids and equipment list and that you obtain them from an authorised provider.


TOP
90% up to CHF 1,000 / Fixed amount

You receive 90% of the costs of medically prescribed aids and equipment that improve restricted body functions, such as blood pressure monitors and orthopaedic shoe inserts, up to CHF 1,000 per year.

This is on condition that the aids and equipment are recognised by us.

For reusable aids, you receive costs up to the fixed amount. You can find these in the list of reusable aids and equipment.


Product information:
TOP
COMPLETA
90% up to CHF 1,500 / Fixed amount

You receive 90% of the costs of medically prescribed aids and equipment that improve restricted body functions, such as blood pressure monitors and orthopaedic shoe inserts, up to CHF 1,500 per year.

This is on condition that the aids and equipment are recognised by us.

For reusable aids, you receive costs up to the fixed amount. You can find these in the list of reusable aids and equipment.


Product information:
COMPLETA
PRIMEO
Excess amount

Applies if you also receive a contribution from basic insurance.

You do not receive any contributions for excesses of other social insurance institutions such as AHV or disability insurance.

If the benefits you receive for medical aids from your basic insurance are not enough to cover the entire cost, you receive up to CHF 5,000 per year towards the uncovered part of the cost.


Product information:
PRIMEO
OMNIA
90% up to CHF 1,000 / Fixed amount

You receive 90% of the costs of medically prescribed aids and equipment that improve restricted body functions, such as blood pressure monitors and orthopaedic shoe inserts, up to CHF 1,000 per year.

This is on condition that the aids and equipment are recognised by us.

For reusable aids, you receive costs up to the fixed amount. You can find these in the list of reusable aids and equipment.


Product information:
OMNIA

Spitex

Basic insurance
Cost contribution

With home care, the care specialist determines your expected need for care with the direct time requirement. The specialist completes a relevant statement of requirements. We pay for the duration of care required based on the corresponding amount in francs specified by law.

You receive a contribution to the costs for Spitex at home (home nursing care), if prescribed by a doctor.

This is subject to the condition that the chosen Spitex organisation or healthcare professional is qualified and recognised.


Household help

OMNIA
CHF 30 per day

Following an acute inpatient hospital stay, you will receive CHF 30 per day for up to 30 days per calendar year for medically prescribed household help.


Product information:
OMNIA
HOSPITAL ECO
CHF 30 per day

Following an acute inpatient hospital stay, you will receive CHF 30 per day for up to 30 days per calendar year for medically prescribed household help.


Product information:
HOSPITAL ECO
HOSPITAL PLUS
CHF 60 per day

Following an acute inpatient hospital stay, you will receive CHF 60 per day for up to 30 days per calendar year for medically prescribed household help.


Product information:
HOSPITAL PLUS
HOSPITAL COMFORT
CHF 90 per day

Following an acute inpatient hospital stay, you will receive CHF 90 per day for up to 30 days per calendar year for medically prescribed household help.


Product information:
HOSPITAL COMFORT
HOSPITAL FLEX
CHF 50 per day

Following an acute inpatient hospital stay, you will receive CHF 50 per day for up to 30 days per calendar year for medically prescribed household help.

This cover is available provided you have also chosen the optional FLEX supplementary module.


Product information:
HOSPITAL FLEX