What PKV Covers During Pregnancy
German private health insurance covers pregnancy and childbirth as a standard medical condition. Unlike some international insurance systems, there is no exclusion for "pre-existing pregnancy" once you are enrolled in a German PKV tariff. The following are covered under standard PKV tariffs:
- Prenatal care: All midwife appointments (Hebammenbetreuung), Mutterschaftsvorsorgeuntersuchungen (scheduled prenatal check-ups), and ultrasounds
- Additional diagnostics: NIPT (Non-Invasive Prenatal Testing), amniocentesis, chorionic villus sampling — covered under most comprehensive tariffs, though some require a separate add-on
- Childbirth: Hospital delivery covered at your tariff's hospital tier level. PKV holders in a private room with senior consultant (Chefarzt) benefit extends to delivery
- Postnatal care: Midwife home visits in the weeks after birth, paediatric initial check-ups (U2 etc.)
- Complications: Any medically necessary intervention, emergency C-section, NICU care for newborns
Tip: Check your tariff's wording on "Entbindungsleistungen" (delivery services) and "Vorsorgeuntersuchungen" (preventive care). Higher-tier tariffs typically cover additional screening options such as NIPT and 3D ultrasound that standard tariffs do not.
Adding Your Newborn to PKV
One of the most important things to understand as a PKV holder expecting a child is how your newborn gets insured. Unlike GKV (where children are automatically co-insured under Familienversicherung), every person under PKV needs their own individual policy — including your baby.
The good news: a newborn can be added to a PKV policy without a health declaration, provided the application is submitted within two months of birth. This is a significant advantage — it means pre-existing birth conditions or complications discovered at birth do not result in exclusions or surcharges, as long as you act within the window.
After two months, the standard health declaration and underwriting process applies. A premature birth or birth with complications discovered after two months may lead to risk surcharges if you miss the window.
Practical checklist for PKV holders expecting a child:
- Contact your PKV insurer before birth to confirm the application process and required forms
- Have the newborn application ready to submit within 2 months of birth
- Budget for an additional PKV premium per child (typically €80–€200/month depending on the insurer and tariff)
- If both parents have PKV, compare whose tariff offers the best value for the child — premiums vary significantly by insurer
Income During Maternity Leave: PKV vs GKV
This is a critical area where PKV and GKV differ substantially:
Under GKV: Employed mothers receive Mutterschaftsgeld (maternity allowance) from the GKV fund — up to €13/day — during the statutory protection periods (6 weeks before and 8 weeks after birth). The employer tops this up to your full net salary. This is a significant financial benefit built into GKV membership.
Under PKV: PKV does not pay Mutterschaftsgeld. Instead:
- Employed PKV holders receive a lump-sum Mutterschaftsgeld of €210 from the Bundesversicherungsamt (Federal Insurance Office) — a one-off payment significantly lower than GKV's daily allowance. Their employer is still legally required to top up their salary during the protection periods
- Self-employed PKV holders have no automatic maternity income support. This is where Krankentagegeld (sick pay insurance) becomes critical. Some insurers now offer specific Mutterschaft-Krankentagegeld add-ons covering the maternity protection periods
Action point for self-employed PKV holders: Discuss Mutterschaft-Krankentagegeld options with your broker before becoming pregnant, as many policies have waiting periods. Adding this after pregnancy begins may not be possible.
PKV vs GKV for Expectant Mothers
PKV: Strengths for Pregnancy
- Private room and senior consultant for delivery
- Broader prenatal diagnostics covered
- More flexibility in choice of midwife and specialist
- Newborn insured without health declaration (within 2 months)
GKV: Strengths for Pregnancy
- Full Mutterschaftsgeld income replacement
- Free family insurance for all children
- No per-child premium costs
- Simpler administrative process for newborn coverage
Key Things to Check in Your PKV Tariff
| Tariff Element | What to Look For |
|---|---|
| NIPT / prenatal screening | Covered without additional premium? Some tariffs require an Ergänzungstarif |
| Hebamme (midwife) | Free-choice midwife vs. approved midwife list? Home birth coverage? |
| Hospital delivery | Confirm private room and Chefarzt applies to the maternity ward specifically |
| Postnatal midwife | Number of home visits covered — standard is up to 16 post-birth visits |
| Newborn application window | Confirm 2-month window and required documentation with your specific insurer |
| Mutterschaft-Krankentagegeld | Available? Waiting period? Daily benefit linked to your Krankentagegeld amount? |
Compare PKV Tariffs for Your Situation
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