Pregnancy, childbirth, maternity care and your health insurance

Welcoming a new baby brings tons of joy, but it also involves a lot of practical planning. This can raise questions about your health insurance. In this article you will find all the information you need about insurance in relation to your pregnancy, childbirth and maternity care. Does it make sense to take out additional insurance, or is the basic insurance enough? Can you take out additional insurance when you are already pregnant? 

What does the basic insurance cover?  

Before you get pregnant

• Preconception care: consultations with the midwife or general practitioner with information about becoming pregnant in a healthy way. No deductible applies to this. 
• Fertility testing: if you are referred by your primary care physician to a specialist for further testing, this will be reimbursed. However, the deductible may be charged for this.
• Fertility Treatments: Basic insurance covers various fertility treatments such as Ovulation Induction (OI), Artificial Insemination (KI), Intra-Uterine Insemination (IUI), IVF and ICSI. These treatments have an age limit of 43 for women and are subject to the deductible. Of IVF and ICSI, a maximum of 3 attempts per continuous pregnancy are reimbursed. There must be a medical reason for these treatments.

If you are pregnant

• Prenatal care: all regular check-ups, such as visits to the midwife. You do not have to pay any deductible for care from the obstetrician. If you are referred to the gynecologist, this is also reimbursed, but the deductible applies. 
• Complications during pregnancy: if there are concerns when the pregnancy does not go quite as hoped, the basic insurance provides coverage for medical interventions such as ultrasounds, blood tests, the NIPT and other tests. Care if it is determined that there is a complication, such as gestational diabetes or hypertension, is also covered.
• Pelvic physiotherapy for incontinence: the first 9 treatments are reimbursed, you pay the deductible. If you need more treatments you can take out additional insurance.

Childbirth

• Childbirth: you can give birth in different locations. Depending on the location and medical situation, a co-payment may apply.
  • Home: for a home birth with the assistance of a midwife, the cost is fully reimbursed.
  • Hospital or birth center without medical indication: a co-payment applies for a hospital birth without medical necessity.
  • Hospital or birth center with medical indication: a hospital birth with medical necessity is fully reimbursed. 
• Pain management: if there is a medical indication, the cost is fully reimbursed. 
• Cesarean section: if there is a medical indication, the cost is fully reimbursed.

After childbirth

• Maternity care: the basic insurance reimburses maternity care, including home visits by the maternity nurse. You can also get maternity care at other locations, such as a maternity hotel or birth hotel. However, there is a co-payment, which we will discuss in more detail later in this article.  

Reimbursed by the government   

Not all care is covered by your health insurance. Some things are paid for by the government, such as the NIPT test without medical indication, 13-week ultrasound and 20-week ultrasound, and the explanations (counseling) about these screenings. You do not have to pay for these yourself.
 

Own risk 

The deductible is a mandatory amount that everyone over the age of 18, must pay themselves for care from the basic insurance. For 2025 and 2026, the deductible is set at € 385,-. This means that you must pay the first € 385,- you incur in medical expenses yourself. There are exceptions to the deductible for example for the general practitioner and the midwife. For examinations such as gynecological examinations or blood tests there is a deductible. This also applies, for example, to medication or care by the gynecologist. When you have fully paid the amount of €385, you will be reimbursed for the care from basic insurance. The deductible is not the same as the co-payment. 

Own contribution   

In addition to the deductible, you pay a co-payment in some situations. You pay these costs yourself, unless you have supplementary insurance that provides coverage for this. Note: if you have not yet used up the deductible, both the co-payment and the deductible may apply. 

• Outpatient childbirth without medical indication: for a delivery in hospital without medical necessity, part of the costs are reimbursed by the basic insurance. In 2025, a maximum of €261 will be reimbursed. The personal contribution is the difference between the total costs (the hospital rate) and amount € 261. The national maximum (hospital) rate for a delivery without medical indication is € 841.51. So if your hospital uses the maximum rate, the co-payment is € 580.61 (€ 841.51- € 261.00 = € 580.61). However, the average co-payment is about €500. For this co-payment you can get additional insurance, the co-payment will then be fully or partially reimbursed depending on the insurer and the chosen package.
• Maternity care at home: you pay €5.40 per hour of co-payment in 2025. Basic insurance entitles you to a minimum of 24 hours and a maximum of 80 hours of maternity care, depending on the situation. On average, 49 hours of maternity care is provided; this amounts to a co-payment of €269.50.
• Maternity care at another location: for maternity care in a birth center or maternity hotel you pay € 21.50 per day for the child and € 21.50 per day for the mother. If the rate of the location is higher than € 152.00 per day for the child and € 152.00 for the mother, you must also pay the amount above yourself.
• Own contribution medication: when the price of the medication is higher than the maximum reimbursement set, you must pay the difference. This co-payment is a maximum of €250 per year.
  
  
  

Additional insurance 

Many insurers offer coverage related to pregnancy, childbirth and maternity in their supplementary packages. Exactly what coverage is offered and how extensive it is varies by insurer and package. Below you will find examples of reimbursements that appear in supplementary insurance policies. This list is not exhaustive.

Before you get pregnant

• (Self-)assistance programs (e.g., Smarter Pregnant): insurers usually reimburse a (self-)help program once during the insurance period. Reimbursement is not per calendar year, so you won't get a new reimbursement every year.

If you are pregnant

• Pregnancy courses: reimbursement of courses such as pregnancy yoga, hypnobirthing or a 'puff' course. Insurers usually reimburse up to a maximum amount between € 50,- and € 200,- per year, depending on the package. The average cost of these courses is between € 150,- and € 250,-.
• Pelvic physiotherapy: many pregnant women experience pelvic pain. Pelvic physiotherapy can help. As described earlier, pelvic physiotherapy for incontinence is covered by the basic insurance. But if there is another reason such as ligament pain, most supplementary insurance policies also allow you to use the reimbursement for physiotherapy for treatments for pelvic pain. If you are not insured for this, the costs are on average € 50 per single treatment. 

Childbirth

• Maternity package: includes supplies such as an umbilical clamp, maternity dressings, sterile gauze, disinfectant and a mattress pad. You can request the package from your health insurance company. (With some insurers, the maternity package is covered by the basic health insurance and you do not need to take out additional insurance to apply for a maternity package).
• Outpatient birth co-payment: insurers reimburse the co-payment, in whole or in part, depending on the package. 
• TENS pain relief: some supplementary insurances offer (partial) reimbursement for renting or buying a TENS device, usually up to a certain maximum amount, e.g. €50 to €100.

After childbirth

• Incubator aftercare: is a form of special maternity care intended for parents of a baby who has spent at least 5 days in the incubator ward or a total of 8 days in the hospital. Additional hours can be reimbursed from the supplementary insurance. 
• Maternity care co-payment: the supplementary insurance reimburses the co-payment partially or fully depending on the insurer and the package chosen.
• Extra maternity care after hospitalization or with a medical indication: some supplementary packages reimburse extra hours of maternity care if there is a specific reason for it. The reimbursement varies with different insurers and the package chosen.
• Lactation assistance: is help with breastfeeding problems. Additional insurances often offer reimbursement for this up to a maximum amount, for example € 200,- per year. The costs of lactation expert help are on average around € 120 per consultation or € 150 for an extensive consultation.
• Breast pump: reimbursement for a breast pump varies greatly among insurers. Some insurers reimburse a certain amount for buying a new breast pump, others also for renting or for new parts of an existing pump. Reimbursement can be one-time or per delivery. A single electric breast pump costs between €80 and €200. Reimbursements are often around € 75- and € 80,-.

Health insurance for baby 

Everyone in the Netherlands must have basic health insurance, including children. For children up to the age of 18, you pay no premium and no deductible applies. It is important to register your child with a health insurer within four months of birth. If you and your partner are not on a policy together, you can register your baby with your own health insurance or that of the other parent. It is advisable to sign the baby up with the parent with the most comprehensive coverage. If you and your partner are on the same policy, your baby will automatically receive the same coverage as the parent with the most comprehensive insurance. Tip: check carefully if this is also processed properly by the insurer, this sometimes goes wrong. 

Helpful tips

• Check: whether your health insurer has a contract with the health care provider of your choice. Without a contract, reimbursement is often lower.
• Compare: supplemental health insurance policies, premiums and conditions in our health care comparator to make the best choice.
• Check: whether it is interesting for you to take out supplementary insurance. If you already know that you want to give birth at home or will give birth in hospital with a medical indication, you will not be subject to the co-payment for outpatient childbirth. This may leave you with only the co-payment for maternity care. As described earlier, this co-payment averages €269.50. If this is the only reason for you to take out additional insurance, it is probably not interesting. The premium you pay extra for the additional package is probably higher than the reimbursement you receive. If you expect to make use of more reimbursements such as the co-payment for outpatient childbirth, a pregnancy course, pelvic physiotherapy or the maternity package, then taking out supplementary insurance quickly becomes interesting. 
• Increasing the deductible
  There are many young, healthy women who are used to opting for an increased or even maximum deductible of €885. You then get a discount on your premium and if you incur few health care expenses, this can be beneficial. When you are expecting, it is a good idea to reconsider. It's true that obstetric care and maternity care are exempt from the deductible, so if you have a pregnancy without complications, chances are you won't even complete the mandatory deductible. You may only have to pay the deductible for a blood test yourself.
  If you are pregnant and going into labor, however, chances are that you will have to deal with care that does fall under the deductible are a lot higher. If you are referred to a gynecologist or if you have to be transported by ambulance, you will soon incur more than € 385,- (or even € 885,-) in expenses that fall under the deductible.
  So weigh up whether you think the extra discount outweighs the risk of having to pay the entire deductible yourself. In doing so, also take into account whether you can spare the amount if you are suddenly faced with these costs. 
• Medical selection: Health insurance companies are not allowed to refuse you for the basic insurance, even if you are pregnant. For the supplementary insurance, however, some insurers do apply a medical selection for the most comprehensive packages. In practice, this selection often takes the form of a questionnaire about your health, which rarely includes questions about pregnancy.
• Pregnant during the health insurance switching period: since pregnancy normally lasts nine months, chances are that you will have the opportunity to switch health insurance during your pregnancy, during the annual switching period in November and December. This often makes it attractive to still adjust your health insurance (and especially the additional coverage) to suit your needs around childbirth and maternity. However, if you are unlucky and give birth just before the switchover period, some health insurance companies offer a so-called 'grow with' or family service. This allows you to add supplementary insurance with reimbursement for the personal contribution for maternity care or other relevant care to your policy. 

The benefits of group health insurance

• Take advantage of broader benefits than with individual insurance.
• Health insurance is there for you, your partner and children.
• We arrange your switch. Make a choice and we'll do the rest!  

Conclusion 

The arrival of a new child brings much happiness, but also many practical things to arrange. A good health insurance that suits your needs and wishes during pregnancy and after delivery can take away a lot of stress and unexpected costs. Make sure you are well informed about your current coverage and consider additional insurance if needed.

That way you can focus on what really matters: caring for your new baby.