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Applying for maternity benefit as a person with statutory health insurance

Source: Zuständigkeitsfinder Schleswig-Holstein (Linie6Plus)

Service Description

If you become a mother, you can receive maternity benefit. You are also entitled to maternity benefit after a miscarriage from the 13th week of pregnancy, provided you take maternity leave.

You can receive maternity benefit for the protection periods before and after childbirth and for the day of childbirth. The maternity protection periods normally begin 6 weeks before the birth and normally end 8 to 12 weeks afterwards.

If you continued to work voluntarily during the protection period before the birth of your child, this will affect your maternity benefit:

  • If you continue to work full-time, no maternity benefit will be paid alongside this; it will be suspended.
  • If you only continue to work part-time or on an hourly basis, you will normally receive maternity benefit. However, the partial pay you continue to receive will be deducted from your maternity benefit if it is subject to contributions.

In both cases, it does not matter whether you are employed or self-employed.

You will also receive maternity benefit if you received sickness benefit before the start of the protection period. Even if you fall ill during the maternity protection period, you will continue to receive maternity benefit.

Women who suffer a miscarriage from the 13th week of pregnancy are also entitled to maternity benefit.

The entitlement exists in the event of a miscarriage:

  • from the 13th week of pregnancy up to 2 weeks
  • from the 17th week of pregnancy up to 6 weeks
  • from the 20th week of pregnancy up to 8 weeks

The maximum amount of maternity benefit is EUR 13 per day. It is based on your average net salary for the last 3 billed calendar months before the start of your maternity protection period. If your net salary was higher than EUR 13 per day during this period, your employer will pay you the difference.

However, the amount of your maternity benefit also depends on your insurance status:

  • as a legally insured employee, regardless of whether you are voluntarily or compulsorily insured: maximum EUR 13 per day, paid by your health insurance fund
  • as a legally insured unemployed person: Maternity benefit in the amount of sickness benefit, equivalent to the amount of your unemployment benefit, paid by your health insurance fund
  • as a self-employed person, voluntarily insured in the statutory health insurance scheme with entitlement to sickness benefit: Maternity benefit in the amount of your sickness benefit, paid by your health insurance fund

Women who are exclusively self-employed do not receive maternity benefit if they

  • are insured with a statutory health insurance fund without entitlement to sickness benefit or
  • have private health insurance.

Women with private health insurance are entitled to payment of the agreed daily sickness benefit in addition to maternity benefit during the maternity protection period if they have taken out private daily sickness benefit insurance.

Civil servants continue to receive their official or prospective civil servant's pay during maternity leave. They may be entitled to maternity benefit if they have a part-time job that is classified as employment within the meaning of the Maternity Protection Act.


Process flow

You can apply for maternity benefit from your statutory health insurance fund by post or in person at the office of many statutory health insurance funds.

  • To do this, have your doctor or midwife issue you with a certificate of the calculated date of birth (so-called sample 3).
  • Fill in the back of the certificate of the calculated date of birth and, if necessary, a separate application form from your health insurance company.
  • Submit the certificate of the calculated date of birth and the completed application form (if applicable) together to your health insurance fund.
  • You do not need to do anything else until the date of delivery. Your health insurance fund
    • will contact you if there are any queries or missing documents,
    • informs you whether and to what extent you are entitled to maternity benefit and
    • will transfer the first payment of maternity benefit for the period up to the expected date of birth as soon as the necessary data has been provided by your employer.
  • After the birth, you submit the birth certificate or proof of your baby's birth to your health insurance fund. In the event of a premature birth or a medically diagnosed disability of your child, you should also submit the medical certificate confirming the premature birth or disability of the child.
  • Your health insurance fund will then transfer the second part of the maternity benefit to you for the period up to the end of the maternity protection period.
  • After the second payment, your health insurance fund will automatically send you a certificate of receipt of maternity benefit for the parental benefit office.

For miscarriages:

  • Have your doctor issue you with the certificate of miscarriage (transitional certificate until 31.12.2025 or so-called model 9 from 01.01.2026).
  • Add the information on the application for payment of maternity benefit to the respective certificate and, if necessary, a separate application form from your health insurance fund.
  • Submit the certificate you have completed and, if applicable, the additional completed application form together to your health insurance fund.
  • You do not need to do anything else. Your health insurance fund
    • will contact you if there are any queries or missing documents,
    • informs you whether and to what extent you are entitled to maternity benefit and
    • transfers the maternity benefit to you as soon as the necessary data has been reported by your employer.
Requirements

You can apply for maternity benefit from the statutory health insurance fund if you

  • are a member of statutory health insurance yourself - family insurance is not sufficient
  • are an employee at the start of the maternity protection period or
  • your employment relationship has been terminated by your employer during your pregnancy or the maternity protection period, or
  • you receive unemployment benefit I or
  • you are self-employed and are entitled to sickness benefit as a person with voluntary statutory health insurance.
  • do not receive any pay due to the protection period (e.g. students with employment exempt from insurance or those in marginal employment with voluntary insurance)
  • You will not receive maternity benefit if
    • you receive wages subject to contributions within the statutory maternity protection periods due to full continued employment, earned income or vacation pay. Your entitlement is suspended during this period.
    • you are a civil servant. You will then continue to receive your salary.
    • you are an adoptive mother.
    • Your entitlement to unemployment benefit I is suspended because you are receiving parental benefit for an older child.
    • you receive unemployment benefit II.
Which documents are required?

For the application to your statutory health insurance fund:

  • Certificate from the doctor or midwife about the calculated date of birth, the so-called MET certificate or the so-called sample 3
  • In the event of a miscarriage: certificate from the doctor about the miscarriage (transitional certificate until 31.12.2025 or the so-called model 9 from 01.01.2026)
  • After the birth: your baby's birth certificate or proof of birth; in the event of a premature birth or disability of the child, the medical certificate of premature birth or disability of the child must also be submitted, so-called model 9
  • Further documents may be required in individual cases. Please contact your health insurance company for more information.
What are the fees?

There are no costs.

What deadlines do I have to pay attention to?

If possible, you should apply for maternity benefit at the beginning of your maternity protection period. However, you can also submit the application after the birth of your child. However, a limitation period applies in this case. This begins at the end of the year in which your protection period began, i.e. on January 1st of the following year. It ends 4 years after this year on 31.12..

Processing duration

Processing time: 3 - 6 Days
Die Bearbeitungsdauer durch Ihre gesetzliche Krankenkasse ist abhängig vom Eingang der Verdienstbescheinigung.

Legal basis
Appeal
  • Objection
    • Detailed information on how to lodge an objection can be found in the notification of your application
  • Social court action
What else should I know?

Depending on your insurance status and professional situation, you can also apply for maternity benefit from the Federal Social Security Office (limited to a one-off payment of EUR 210).

Weiterführende Informationen
Author
Forwarding service: Deep link to the original portal

GKV-SV

The text was automatically translated based on the German content.

Teaser

If you become a mother, you can receive maternity benefit. You are also entitled to maternity benefit after a miscarriage from the 13th week of pregnancy, provided you take maternity leave.

Process flow

You can apply for maternity benefit from your statutory health insurance fund by post or in person at the office of many statutory health insurance funds.

  • To do this, have your doctor or midwife issue you with a certificate of the calculated date of birth (so-called sample 3).
  • Fill in the back of the certificate of the calculated date of birth and, if necessary, a separate application form from your health insurance company.
  • Submit the certificate of the calculated date of birth and the completed application form (if applicable) together to your health insurance fund.
  • You do not need to do anything else until the date of delivery. Your health insurance fund
    • will contact you if there are any queries or missing documents,
    • informs you whether and to what extent you are entitled to maternity benefit and
    • will transfer the first payment of maternity benefit for the period up to the expected date of birth as soon as the necessary data has been provided by your employer.
  • After the birth, you submit the birth certificate or proof of your baby's birth to your health insurance fund. In the event of a premature birth or a medically diagnosed disability of your child, you should also submit the medical certificate confirming the premature birth or disability of the child.
  • Your health insurance fund will then transfer the second part of the maternity benefit to you for the period up to the end of the maternity protection period.
  • After the second payment, your health insurance fund will automatically send you a certificate of receipt of maternity benefit for the parental benefit office.

For miscarriages:

  • Have your doctor issue you with the certificate of miscarriage (transitional certificate until 31.12.2025 or so-called model 9 from 01.01.2026).
  • Add the information on the application for payment of maternity benefit to the respective certificate and, if necessary, a separate application form from your health insurance fund.
  • Submit the certificate you have completed and, if applicable, the additional completed application form together to your health insurance fund.
  • You do not need to do anything else. Your health insurance fund
    • will contact you if there are any queries or missing documents,
    • informs you whether and to what extent you are entitled to maternity benefit and
    • transfers the maternity benefit to you as soon as the necessary data has been reported by your employer.

Requirements

You can apply for maternity benefit from the statutory health insurance fund if you

  • are a member of statutory health insurance yourself - family insurance is not sufficient
  • are an employee at the start of the maternity protection period or
  • your employment relationship has been terminated by your employer during your pregnancy or the maternity protection period, or
  • you receive unemployment benefit I or
  • you are self-employed and are entitled to sickness benefit as a person with voluntary statutory health insurance.
  • do not receive any pay due to the protection period (e.g. students with employment exempt from insurance or those in marginal employment with voluntary insurance)
  • You will not receive maternity benefit if
    • you receive wages subject to contributions within the statutory maternity protection periods due to full continued employment, earned income or vacation pay. Your entitlement is suspended during this period.
    • you are a civil servant. You will then continue to receive your salary.
    • you are an adoptive mother.
    • Your entitlement to unemployment benefit I is suspended because you are receiving parental benefit for an older child.
    • you receive unemployment benefit II.

Which documents are required?

For the application to your statutory health insurance fund:

  • Certificate from the doctor or midwife about the calculated date of birth, the so-called MET certificate or the so-called sample 3
  • In the event of a miscarriage: certificate from the doctor about the miscarriage (transitional certificate until 31.12.2025 or the so-called model 9 from 01.01.2026)
  • After the birth: your baby's birth certificate or proof of birth; in the event of a premature birth or disability of the child, the medical certificate of premature birth or disability of the child must also be submitted, so-called model 9
  • Further documents may be required in individual cases. Please contact your health insurance company for more information.

What are the fees?

There are no costs.

What deadlines do I have to pay attention to?

If possible, you should apply for maternity benefit at the beginning of your maternity protection period. However, you can also submit the application after the birth of your child. However, a limitation period applies in this case. This begins at the end of the year in which your protection period began, i.e. on January 1st of the following year. It ends 4 years after this year on 31.12..

Processing duration

Processing time: 3 - 6 Days
Die Bearbeitungsdauer durch Ihre gesetzliche Krankenkasse ist abhängig vom Eingang der Verdienstbescheinigung.

Legal basis

Appeal

  • Objection
    • Detailed information on how to lodge an objection can be found in the notification of your application
  • Social court action

What else should I know?

Depending on your insurance status and professional situation, you can also apply for maternity benefit from the Federal Social Security Office (limited to a one-off payment of EUR 210).

Weiterführende Informationen

Author

Forwarding service: Deep link to the original portal

GKV-SV

The text was automatically translated based on the German content.

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