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Maternity insurance

Eligibility conditions

Entitlement to maternity benefits is confirmed when you receive a maternity record book from the Medical Benefits Department of the C.C.S.S. (after receipt of the mother-to-be's pregnancy declaration) containing the various forms needed to obtain:

  • the reimbursement of the medical expenses incurred throughout the pregnancy,

and the Prenatal Allowances paid by the Family Allowances Department.

In order to obtain this document, the mother-to-be or her spouse, if she herself does not have an occupational activity entitling her to similar benefits, must satisfy the following condition:

  • proof that a registration has not ceased to have effect for the entire duration of the period between the start of the pregnancy and the delivery date.

Reimbursement of medical expenses

For the mother-to-be, some medical expenses are covered in full. These are:

  • treatments included in the maternity record, the reimbursement of which is requested using a form from this record book,
  • treatments performed after the sixth month of pregnancy,
  • along with maternity-related hospital stays, up to a maximum of 12 days.

Full coverage or exemption from patient contribution, does not mean that the medical expenses incurred will be fully reimbursed, but simply that no deduction will be applied to the fund's reimbursement tariff.

However, the reimbursement tariff may, in some cases, be less than the invoiced fee, particularly:

  • if you have used a non-contracted doctor, or
  • if you are not in the green category and the delivery takes place in a clinic or public hospital with the choice of a practitioner's private practice.

Healthcare professionals contracted to the C.S.M.