Pregnant women: 100% care (Health insurance)

Verified 15 September 2022 - Directorate for Legal and Administrative Information (Prime Minister)

Are you expecting a baby? Be aware that the mandatory medical examinations as part of the follow-up of your pregnancy (maternity) are taken care of at 100% the sickness insurance rate. This includes tests from the start of pregnancy until 12 days after delivery. In addition, under certain conditions, you can benefit from a non-medical temporary accommodation service. We're talking abouthospital hotel.

Pregnancy-related consultations

The Health Insurance covers 100% with an exemption in advance of fees (third party paying) the mandatory medical examinations as part of the follow-up of your pregnancy. For example:

  • Mandatory prenatal consultations (one before the end of 3e month of pregnancy, then one per month from 4e months of pregnancy)
  • Birth and parenting preparation sessions, including early prenatal examination
  • Laboratory tests (including those for the father-to-be).

The first 2 ultrasound scans done before the end of 5e months of pregnancy are managed at 70%.

In case of pathological pregnancy or fetal pathology (fetal malformations, infectious or genetic context...), other ultrasound scans can be prescribed and taken care of.

FYI  

You must declare your pregnancy before the end of 3e months of pregnancy to benefit as soon as possible from the treatment of your pregnancy by maternity insurance.

Dentist

You can benefit from the 4e months of pregnancy, a dental prevention examination.

Upon receipt of your declaration of pregnancy, your health insurance fund will send you an invitation letter accompanied by the printed copy of your oral examination.

All you have to do is make an appointment with your dentist. You go there with your pick-up paper and your vital card.

This preventive examination is fully covered by the Health Insurance. You don't have to advance any fees.

Other consultation

Non-pregnancy consultations and medical expenses are reimbursed at the usual rates.

Medical expenses covered

All your reimbursable medical expenses (pharmaceutical, analysis, laboratory tests, hospitalization) are covered at 100%. You do not have to make an advance payment (third party).

This is for all your expenses whether or not they are related to your pregnancy.

Example :

The Health Insurance covers 100% with an exemption in advance of fees (third party paying) the mandatory medical examinations as part of the follow-up of your pregnancy. This is the case for compulsory prenatal consultations.

The 3e Ultrasonography is supported by 100%. In case of pathological pregnancy or fetal pathology (fetal malformations, infectious or genetic context...), other ultrasound scans can be prescribed and taken care of under the same conditions.

Please note

These supports at 100% are based on and within the limits of the sickness insurance rates. Excess fees are not covered by the Health Insurance. They can be taken care of by your health supplement, if the contract provides for it. You can check with your health supplement.

You also benefit from the exemption in advance of the fees (third party paying) on the part covered by the Social Security (excluding overpayment of fees) at the health professionals practicing in town for the following examinations and care:

  • Mandatory Pregnancy Tests
  • Mandatory examinations for children under six years of age
  • Care, whether or not related to maternity, from the 1st day of the 6th month until 12 days after delivery.
Dentist

You can benefit, up to the 12the day after giving birth, a preventive oral examination.

Upon receipt of your declaration of pregnancy, your health insurance fund will send you an invitation letter accompanied by the printed copy of your oral examination.

All you have to do is make an appointment with your dentist. You go there with your pick-up paper and your vital card.

This preventive examination is fully covered by the Health Insurance. You don't have to advance any fees.

Hospitable hotel

Health care facilities can set up a non-medical accommodation.

This accommodation can be offered if you are staying in a commune where the center is more than 45 minutes by car from the nearest establishment.

This temporary accommodation shall last for a maximum of 5 consecutive nights before the expected date of delivery.

FYI  

Other durations may apply in Guyana or in case of a pregnancy at risk.

Medicare pays for this accommodation if you are in one of the following situations:

  • Social Insurance
  • Recipient of State medical assistance (AME)
  • Social Security Recipient in Mayotte
  • Member of a social security scheme of a Member State of the European Economic Area (EEA), Switzerland or any other country pursuant to an agreement.
Delivery costs

Delivery costs and care vary depending on which institution you choose: hospital/clinic or clinic not.

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Conventional hospital or clinic

Delivery costs and subsistence costs, up to 12 days except for personal comfort (private room, television...), are paid at 100% and are reimbursed directly to the establishment by your health insurance fund.

In principle, you will not be asked to contribute to the costs, except for any extra fees and costs for personal comfort.

The hospital package is fully covered from 1er day of 6e months of pregnancy until 12e day after delivery.

In addition, the costs of transport to the hospital or clinic, by ambulance or other means of transport, can be covered on medical prescription.

Unconventional clinic

Delivery and subsistence costs, up to 12 days except for personal comfort (private room, television...), are reimbursed to 100% on the basis of and within the limits of the sickness insurance rates.

If you choose to give birth in an unlicensed private clinic, be aware that the prices charged are generally higher there. The costs remaining to you (extra fees, costs for personal comfort) can therefore be very high and you will have to make advance payments.

You continue to be supported at 100% and to benefit from the waiver in advance of fees (third party) for all your medical expenses, whether or not they are related to your pregnancy.

To facilitate your return home, you can benefit from a follow-up at home by a midwife for you and your child.

It is advisable to contact her even before leaving the maternity ward.

Your midwife, after her first visit, will tell you what follow-up is needed.

This monitoring is supported at 100% by Health Insurance, until 12e day after your baby is born.

You can benefit, up to the 12the day after giving birth, a preventive oral examination.

Upon receipt of your declaration of pregnancy, your health insurance fund will send you an invitation letter accompanied by the printed copy of your oral examination.

All you have to do is make an appointment with your dentist. You go there with your pick-up paper and your vital card.

This preventive examination is fully covered by the Health Insurance. You don't have to advance any fees.

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