Applying for maternity benefit as a statutory health insurance policyholder

If you become a mother, you can receive maternity benefit. Even after a miscarriage from the 13th week of pregnancy onwards, there is an entitlement to maternity benefit, provided that maternity leave is taken.

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

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

• If you continue to work full-time, no maternity benefit will be paid in addition; it is suspended.
• If you continue to work only part-time or on an hourly basis, you will normally receive maternity benefit. However, the continued partial remuneration will be offset against the maternity benefit to the extent that it is subject to contributions.

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

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

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

The claim 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 amount of the maternity allowance is a maximum of 13 EUR per day. It is based on your average net salary of the last 3 settled calendar months before the start of your maternity leave periods. If your net salary during this period was higher than 13 EUR per day, your employer will pay you the difference. 

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

• As a statutory insured employee, regardless of whether you are voluntarily or compulsorily insured: a maximum of 13 EUR per day, paid out by your health insurance fund
• As a statutory insured unemployed person: maternity allowance in the amount of sickness benefit, corresponds 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 with entitlement to sickness allowance: maternity benefit in the amount of the sickness allowance, paid by your health insurance fund 

Only self-employed women do not receive maternity benefits if they  

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

Privately insured women are entitled to payment of the agreed daily sickness allowance during maternity leave periods, in addition to maternity benefit, if they have taken out private daily sickness allowance insurance.

Female civil servants continue to receive their official or candidate pay during maternity leave. An entitlement to maternity benefit may exist if they perform secondary employment that counts as employment within the meaning of the Maternity Protection Act. 

You can submit the application for maternity allowance to your statutory health insurance fund by mail or, at many statutory health insurance funds, submit it in person at the office. 

• Have your doctor or midwife issue you the certificate of the estimated date of confinement (so-called Form 3) for this purpose. 
• Fill out the back of the certificate of the calculated due date, as well as a separate application form from your health insurance company if applicable.
• Submit the certificate of the estimated date of confinement and, if applicable, the additionally completed application form together to your health insurance fund.
• You do not need to do anything else until the due date. Your health insurance company 
  • will contact you if there are any questions or if documents are missing,
  • will write to you whether and in what amount you are entitled to maternity benefit and
  • will transfer the first maternity benefit payment for the period up to the expected due date as soon as the necessary data has been reported by the employer.
• After the birth, you submit your baby's birth certificate or proof of birth to your health insurance fund. In the event of a premature birth or a medically diagnosed disability of your child, you also submit the medical certificate regarding the premature birth or disability of the child.
• Your health insurance fund will then transfer the second part of the maternity allowance to you for the period up to the end of the maternity leave period.
• Your health insurance fund will automatically send you a certificate regarding the receipt of maternity benefit for the parental allowance office after the 2nd payout.

In cases of miscarriage:

• Have your doctor issue you the certificate of miscarriage for this (interim certificate until December 31, 2025, or so-called Form 9 from January 1, 2026 onwards). 
• Complete the information regarding the application for payment of maternity benefit on the respective certificate and, if applicable, enclose a separate application form from your health insurance fund.
• Submit the certificate you have completed, along with any additional completed application form, together to your health insurance fund.
• You don't need to do anything else. Your health insurance company 
  • will contact you if there are any questions or if documents are missing,
  • will write to you whether and in what amount you are entitled to maternity benefit and
  • will transfer the maternity allowance to you as soon as the necessary data has been reported by the employer.

You should submit the application for maternity allowance as early as possible at the beginning of your maternity protection period. However, you can also submit the application after the birth of your child. A limitation period applies to this, however. This begins after the end of the year in which your maternity protection period began, i.e., on January 1 of the following year. It ends 4 years after this year on December 31.

There are no costs.

• Objection
  • detailed information on how to file an appeal can be found in the notice regarding your application
• social court action