Every person living in Germany is supposed to have health insurance. But if it happens that you still do not have health insurance, you should seek advice and support as soon as possible. This is especially true if you're pregnant. If you don't have health insurance, you'll have to pay for the ten recommended check-ups for pregnant people yourself. That can be expensive. However, these examinations are important in order to detect and treat problems during pregnancy in good time. Certain conditions, such as diabetes, that occurs during pregnancy, can be dangerous for you and your baby. Therefore, get advice as soon as possible on how you can get insurance coverage again and thus gain access to examinations and a safe birth. In many cases, a path to health insurance can be found.
It is possible to cover the costs of check-ups, childbirth and care from a midwife by yourself. But it's expensive. The total cost of medical care for pregnancy and birth is around €10,000. Don't wait until you get sick to start worrying about health insurance. If you're in poor health, it's much harder to arrange for help. In acute emergencies, doctors are obliged to help you. But afterwards you’ll get a bill for it, which can be very high.
If you are a member of a statutory health insurance plan and have not been able to pay fees for more than two months, your health insurance benefits will be suspended. This means that you can only have medical examinations or treatment in exceptional cases during this time. This includes the treatment of acute illnesses and pain conditions, examinations for the early detection of certain serious illnesses such as cancer, and services required during pregnancy and maternity. You are only entitled to all normal health insurance benefits again when all outstanding contributions have been paid or you have entered into an agreement to pay in installments. Besides, you already have to pay the installments the way they are supposed to be paid. The insurance suspension can also end if it is determined that you are in need of assistance in the sense of social law (SGB II or SGB XII). As proof of your need for assistance, you must submit a social security benefit statement to your health insurance company.
Even if you have private health insurance and are behind in paying your fees, you are not completely without health insurance coverage. But as soon as your debts have reached the amount of two monthly premiums and your health insurance company has sent you a reminder, your contract is suspended. Then you are automatically insured through what’s known in Germany as an ‘emergency tariff’. This means that you are only entitled to the most necessary medical services, namely the treatment of acute illnesses and pain, as well as pregnancy and maternity benefits. Once all debts are paid, you will automatically revert back to the original plan. The suspension of the contract can also end if you are considered to be in need of assistance in the sense of social law (SGB II or SGB XII). You can prove that you are in need of assistance either by having a notice of actual receipt of social benefits or with a so-called ‘certificate of need’ from the Social Welfare Office (Sozialamt) or the Jobcenter.
There are many counseling centres that can help you. Which one is best for you depends on why you don't have full health insurance coverage, among other things. Maybe you don't have a regular residency status or you're homeless. Maybe as a student you can't afford the contribution to health and long-term care insurance, or maybe you were self-employed and now you don't have the money for health insurance contributions.
First, you can contact the help line for Pregnant People in Distress (Schwangere in Not). There you will find advice and support in 18 different languages. The number is free to call: 0800 40 40 020. It is valid throughout Germany and is staffed around the clock with experienced advisors. If you wish, they can put you in touch with a pregnancy counselling centre near your home. Then you can discuss everything calmly with a consultant. If you wish, your conversation will remain confidential. You can remain anonymous at both the helpline for pregnant people in distress and the pregnancy counselling centre. So, you don't have to give your name if you don't want to.
General questions about health insurance can also be answered by the Independent Patient Advice Service. It provides information on all basic questions free of charge. Many associations and church institutions in your region, such as Diakonie or Caritas, also offer help. Another possible point of contact is the consumer advice centre responsible for your federal state. However, there is usually a charge for this.
Several non-profit initiatives in different cities organise consultation hours by doctors for people without health insurance. These include, for example, the Malteser Hilfsdienst and Doctors of the World. There you can get medical care until everything is settled with the health insurance. The organisation Malteser Medicine for People without Health Insurance offers special consultations and open hours by gynaecologists at 14 locations (Arnstadt, Augsburg, Berlin, Darmstadt, Duisburg, Erfurt, Fulda, Hanover, Mannheim, Munich, Münster, Oldenburg, Osnabrück, Stuttgart). In Berlin there is also the Clearing House for People Without Health Insurance, which you can contact. They aim to give pregnant people without health insurance access to check-ups, medical care and, of course, a safe birth. The counselors there will first try to find a way to help you get health insurance. If this is really not possible, volunteer doctors will take care of the check-ups and make sure that you find a place to give birth in a hospital in time.
Pregnant people without health insurance and with a low income can, under certain conditions, also receive help with pregnancy and maternity costs from the Social Welfare Office (Sozialamt). The office then pays for services that would otherwise be covered by health insurance. In some cases, you may also be able to get help from the Social Welfare Office for the time after the birth. You can get individual information from the Social Welfare Office. In principle, you are also entitled to this form of support even if you do not have German citizenship. However, the rules are complicated for, among others, citizens of the European Union. If you are in doubt, get help from a social counselling centre or a lawyer if you want to make such an application or if the Social Welfare Office has rejected your application for support.