Giving birth in another EU country whilst insured in Kela

[nemi]

Hello!

I'm looking for anyone who is EU citizen, insured through Kela, but has given birth in another EU country.

My story in short: I am German, have been in Finland for years, am working and insured through Kela. As I will be a single mom and have no family in Finland, I'd like to give birth at home in Germany, where I have the support of my family during the crucial times before, during and after the birth. I would stay in Germany for about 9 months, then come back to Finland just before my maternity leave ends. According to EU legal information, it should not be a problem, because as EU citizen I should have the right to give birth in my home country.

I applied for form E112, which was rejected by the local sairanhoitopiiri, because birth and pre-/post-natal care are part of the Finnish public health system, so no need for me to go abroad in their opinion. They completely ignored the circumstances around it. Without that approval Kela won't issue the form. It is possible to complain about the decision via court, but I was told this takes about 6 months - don't have the time for that since the baby is coming already in 4 months...

So I called German health insurance about my options, and they said that the E112 is not even necessary, it would be enough if I can bring a E106 - which is what they would issue to their customers in a similar situation. In fact, it would even be better, because the baby would immediately be covered by it as well, no matter how long the registration process with maistraatti and Kela takes after birth. Again, Kela refuses to issue the E106, because a) my stay is less than 12 months (Germany does not have the 12-month regulation), and b) I am currently registered in Finland (of course, as I can only register in Germany after I have actually moved...). I am not in a financial situation that I could pay the medical bills myself (not even if I were reimbursed later), so I need to have these insurance matters properly taken care of before I can leave here so that there won't be any surprise bills.

Has any of you been in a similar situation? Any experiences about giving birth in another EU country whilst insured on Kela? How was the situation solved for you, what kind of papers did you get? Any feedback would be appreciated, kiitos!

[rinso]

The rejections are in line with the general policy.
Moving to an other country for medical treatment while the treatment is also available in the country where you live, in not necessary.
Therefore they don't cooperate for the financial compensation.

I don't know if this non-cooperation can be challenged under EU regulations.
But as you said, you don't have the time for those proceedings.
You can try to talk to the regional manager instead of the local organization.
The lower in the organization, the less flexibility.

[Flossy1978]

If you are a German citizen, can't you just go home without any need for forms and turn up at a hospital and give birth?

Go for a 'holiday' around the time the baby is due and when you go in to labour, they have no choice but to let you have the baby there LOL.

And I don't understand why you'd have to pay, if you are a German citizen?

Sorry, I know nothing about these things. Just curious.

[Adrian42]

If you are a German citizen, can't you just go home without any need for forms and turn up at a hospital and give birth?

Go for a 'holiday' around the time the baby is due and when you go in to labour, they have no choice but to let you have the baby there LOL.

They will definitely have her let her baby there (no matter what her citizenship is).

But the relevant question is whether she will have to pay for all the costs herself.

And I don't understand why you'd have to pay, if you are a German citizen?

Citizenship does not automatically give you access to the health care systems of all countries you have citizenship of.

When you are not a (paying) member of one of the German health insurances, then usually none of them will pay anything for you.

Just like a Finnish citizen living in another country is usually not covered by Kela.

[Adrian42]

According to EU legal information, it should not be a problem, because as EU citizen I should have the right to give birth in my home country.

What legal information exactly? URL?

I'm asking since it would be unusual for EU legislation to give you special rights based on your citizenship(s). What you write sounds more like applying to cross-border workers who e.g. reside in Estonia but work (and therefore have their health insurance) in Finland.

[Flossy1978]

Ah, ok. Thanks.

If I were to go on holiday to Australia and happened to go into labour at the time, I am covered by KELA. I know this because my son had to go to hospital when we visited last time. They saw he was from Finland and said Australia has a policy with Finland and our KELA insurance was accepted. We didn't have to pay a cent for his care. We would have had to pay some admittance fee, but this happened on a weekend and their cash office wasn't opened. So that too was then covered by KELA. We never heard a word about it when we got home. No papers, nothing.

[Adrian42]

If I were to go on holiday to Australia and happened to go into labour at the time, I am covered by KELA. I know this because my son had to go to hospital when we visited last time.

No, you don't know that.

You are correct that immediately necessary medical treatments are covered by the agreement between Finland and Australia.

Planned medical treatments are not.

Without checking the details of this agreement, chances are that the costs of an unexpected preterm birth after 6 months might be covered, but when you are at the expected date of labor in Australia that might not be covered.

They saw he was from Finland and said Australia has a policy with Finland and our KELA insurance was accepted.

Finland and Australia have a bilateral agreement on medical care. This is strictly between these two countries and without any involvement of the EU.

What is relevant for the OP are the EU rules on health care coverage within the EU.

These two are completely unrelated with different rules, and your experiences in Australia are therefore not applicable to the case of the OP.

[Pursuivant]

Again, Kela refuses to issue the E106, because a) my stay is less than 12 months (Germany does not have the 12-month regulation),

See now here is your problem. You divulge them information they use to say NO. Just say you will be there a year and a day - are they going to deport you back to Germany if you decide to cut it short?

[Adrian42]

As far as Australia goes, Flossy is probably correct because birth isn't considered planned or elective, although prenatal care I don't know. The only probably costs would be medications required after leaving hospital.

http://www.health.wa.gov.au/circularsne ... c_ID=12945

RHCA’s include medical coverage for the birth of a child. The only exclusion is where a person has come to Australia for the sole purpose of having their child delivered here.

But meh. In countries without "free for all citizens" medical coverage the story might be different. Kela is not an insurance-based system, you don't have to pay into it to be covered, but you must reside here and qualify to receive coverage. It's entirely possible that Germany has the same rules or even a different rule for eligibility for care which might depend on several factors like length of residency and when you arrived.

This is not about Finnish or German rules.

She will never be covered by both Kela and German social security, and which one covers her is defined by EU legislation.

I think the best option would be to pretend you're a migrant into Germany and search online for info on how migrants would get health care

Sounds like a bad option to me.

If she would manage to switch to the German social security system, she might no longer be eligible for getting maternity and parental allowances paid from Finnish taxes.

[Adrian42]

Again, Kela refuses to issue the E106, because a) my stay is less than 12 months (Germany does not have the 12-month regulation),

See now here is your problem. You divulge them information they use to say NO. Just say you will be there a year and a day - are they going to deport you back to Germany if you decide to cut it short?

"more than a year" = permanently

At that point she will usually lose all Kela coverage, including maternity and parental allowances.

[Pursuivant]

You can move out of Finland "temporarily" and be out max 2 years... for a "reason" of course as always...

[Adrian42]

You can move out of Finland "temporarily" and be out max 2 years...

There is no 2 year limit, e.g. 5 years is usually the limit for workers posted to another EU country.

2 years are a relevant limit for Permanent Right of Residence and Permanent Residence Permit, but that's a completely different topic.

[Flossy1978]

My intentions were not to compare Finland and Germany with Finland and Australia. Sorry if you thought that, Adrian.

What if I were pregnant but visiting Australia before the cut off for being able to fly went into affect? Say 7 months pregnant. I believe you can still fly then. If I went into labour, that would then have to be covered by KELA. It's not a planned happening, but a medical emergency at such a month during pregnancy.

Doesn't matter. I was just curious.

[Adrian42]

What if I were pregnant but visiting Australia before the cut off for being able to fly went into affect? Say 7 months pregnant. I believe you can still fly then.

It would then likely be relevant whether you had a ticket to fly back during the middle of the 7th month, or whether you came to Australia during the 7th month with a ticket back 4 months later.

For definite answers one would have to ask a lawyer.

If I went into labour, that would then have to be covered by KELA.

I am not sure whether Kela is actually paying the bills when you go to a doctor in Australia, or whether Medicare is paying for it.

[Flossy1978]

I think it might be KELA.

When we took our son to the hospital, they told us KELA covered us while we were there. So ultimately somehow it must eventually get back to KELA.

I don't think Australia would be happy to cover a non Australian child's medical expenses out of it's own pocket LOL. From what I've heard, the medical care situation is heading towards the American system there. Friends can't afford braces for their kids etc, these days. I wouldn't know how I'd survive there if I were to move back right now. I don't pay to see the doctor through my employer or anything else here. I've just been paying for medicines needed. I am using a lot of the medical system right now. Albeit normal doctors and specialists have been through work, but another medical area I am dealing with is public and I've not paid a cent towards it (ok, out of my taxes, yes LOL). I don't believe I'd get the level of care in Australia as I am getting here, right now.