Why rethink your cover during pregnancy
A child profoundly changes how you use healthcare. Monitoring appointments, ultrasounds, birth preparation and delivery all generate services under the compulsory health insurance (LAMal/KVG). Planning ahead means checking that your chosen deductible still matches these foreseeable costs, rather than sticking with a decision made years earlier in a different stage of life.
Pregnancy is one of the few events where care needs are largely predictable in advance. This visibility lets you weigh a low versus a high deductible calmly and check whether a supplementary (LCA/VVG) policy is worthwhile. The goal is not to stack up contracts, but to align each guarantee with a concrete reality: nine months of monitoring followed by the birth itself.
Maternity: covered without co-payment
The LAMal provides that specific maternity benefits are covered without any cost-sharing. In practice, from the start of pregnancy and for maternity-related services, the insured woman pays neither deductible nor co-payment on these legally defined services: pregnancy check-ups, delivery, breastfeeding advice and a set number of consultations fall under this special regime.
This exemption changes the optimisation logic. For purely maternity-related services, a high deductible generates no saving on cost-sharing, since no cost-sharing is due. You therefore need to reason separately: on one side the exempt maternity services, on the other the "ordinary" care (illness, accident outside employer cover) which remains subject to the usual deductible and co-payment.
What the exemption covers
The exemption applies to maternity services defined by the ordinance: check-ups during and after pregnancy, delivery at home, in hospital or in a birthing centre, midwife services and breastfeeding advice. For these items the patient pays no co-payment. Check the exact scope of the services concerned with your insurer, as related care may follow different rules.
Basic deductible: should you adjust it?
The annual deductible for adults falls within the legal range of 300 to 2,500 francs. A low deductible means a higher premium but reduced cost-sharing from the first treatments; a high deductible does the opposite. Because part of pregnancy care is exempt from cost-sharing, the trade-off should focus on the non-maternity care you anticipate: monitoring of a condition, medication, dental care outside LAMal that remains payable by you.
Changing the deductible generally takes effect for the following calendar year, with a request sent to the insurer within the deadlines. If a pregnancy is confirmed during the year, the useful adjustment often concerns the year of the birth. Compare the extra premium of a low deductible against the cost-sharing you would avoid on ordinary care, always reasoning from your real situation and never from invented amounts.
Supplementary (LCA) cover: comfort and enrolment deadlines
Supplementary policies (LCA/VVG) can cover comfort benefits around the birth: semi-private or private ward, free choice of facility or doctor, certain services not reimbursed by the basic plan. Unlike basic insurance, supplementary cover has no obligation to admit: the insurer may ask health questions and apply reservations. A pregnancy already declared often reduces the chance of taking out new maternity supplementary cover.
Hence the importance of planning ahead: maternity benefits under an LCA policy are ideally arranged before pregnancy begins, often several months in advance, because of the waiting periods set out in the contracts. If you already hold supplementary cover, re-read the terms: hospital cover, midwife services beyond the legal base, preparation courses. The aim is to avoid both under-cover and over-insurance relative to your real expectations.
Deadlines and cancellation rights to observe
For basic insurance, the key rule is the 30 November deadline: a cancellation validly notified for that date takes effect on the following 1 January, with the usual one-month notice period. If your insurer announces a premium increase, an extraordinary right of cancellation lets you switch even outside the ordinary calendar, provided you respect the stated deadline. Choosing an alternative model (family doctor, telemedicine, care network) can also lower the premium without touching the benefits catalogue.
Plan these steps around your expected delivery date. The aim: not to lose cover during a sensitive period and to make full use of the maternity co-payment exemption. Supplementary LCA cover follows its own contractual deadlines, often distinct from 30 November; read your general terms and send every cancellation in writing, keeping proof of dispatch, to secure each change.
Frequently asked questions
Is maternity really covered with no deductible or co-payment?
Yes. The LAMal provides that the legally defined specific maternity services are covered without any cost-sharing: neither deductible nor co-payment for this care. This applies in particular to pregnancy check-ups, delivery and midwife services. Check the exact scope of the services concerned with your insurer.
Should I lower my deductible because I am pregnant?
Not automatically. Since maternity care is exempt from cost-sharing, a low deductible brings no advantage on that care. The trade-off concerns the non-maternity care you anticipate. Compare the extra premium of a low deductible against the cost-sharing avoided on your ordinary care, based on your real situation.
Can I take out maternity supplementary cover once pregnant?
It is often difficult. Supplementary LCA cover has no obligation to admit: the insurer may ask health questions, apply reservations or decline. A pregnancy already declared sharply reduces the chances of obtaining maternity cover. Ideally these benefits are taken out before pregnancy begins, allowing for the contractual waiting periods.