Pregnancy
Definition / Purpose of the benefit
Pregnancy as a new sickness benefit is provided from 1 April 2021:
only to a pregnant woman, an insurance company of the Social Insurance Agency
the purpose of the pregnancy is to provide the pregnant insurance with an income that will serve to compensate for the increased expenses during the pregnancy
Pregnancy is not a pregnancy scholarship provided by schools to pregnant students
Who is entitled
The following are entitled to pregnancy:
insurance policy which arose for pregnancy after the termination of sickness insurance in protection period
insurance policy that has interrupted compulsory insurance due to taking parental leave (employee) or receiving parental allowance (SZČO)
Claiming
The claim is made by application for pregnancy.
It is a form of the Social Insurance Agency that is not freely available:
the insurance company will issue it to the doctor of the medical facility (gynecologist) at the first preventive examination, at the beginning of II. trimester after reaching the 13th week of pregnancy, as entitlement to pregnancy arises only for women whose pregnancy was not terminated at the beginning of the 27th week before the expected date of birth
the doctor confirms the expected date of birth on the form
if the insurance company wants to claim pregnancy from several sickness insurances, the doctor will issue and confirm a separate form for each of them
Before sending to the Social Insurance Agency, the insurance policy is obligatory:
fill in and sign the "Insurance Statement" on the other side of the form
After the end of the pregnancy, the doctor of the medical facility in which the pregnancy was terminated or the doctor (gynecologist of the insurance company) who learned of the termination of the pregnancy will issue a Certificate of termination of the pregnancy, at which
confirms the end date of pregnancy (date of birth, date of abortion, date of miscarriage)
if the insurance company has claimed pregnancy from several health insurance policies, the doctor will issue and confirm only one confirmation of the termination of the pregnancy
the insurance company submits the form to the locally competent branch of the Social Insurance Agency, which pays the pregnancy insurance
Where and when should you make a claim?
the insurance company will deliver the application to the relevant branch of the Social Insurance Agency (employee according to the employer's registered office, SZČO and voluntarily sickness insured person according to permanent residence)
the insurance company that is the employee does not submit the application to its employer, as the employer does not confirm any data on the application
It is best to submit a pregnancy application immediately after the application (see Prescription ).
Terms of claim
Employee
the reason for granting a pregnancy - the day corresponding to the beginning of the 27th week before the expected date of birth (13th week of pregnancy) - must arise during the period of sickness insurance or in protection period or during the interruption of the employee's compulsory sickness insurance due to parental leave
at least 270 days of sickness insurance in the last two years before the reason for the pregnancy
the previous period of any sickness insurance completed shall be taken into account
the period of interruption of the employee's compulsory health insurance due to the use of parental leave and the period of interruption of the compulsory health insurance of a self-employed person due to the right to parental allowance are also included
it is not monitored whether the policyholder has paid sickness insurance premiums
neither the receipt of other benefits nor the absence of income is monitored
Compulsory sickness insurance self-employed person
the reason for granting a pregnancy - the day corresponding to the beginning of the 27th week before the expected date of birth (13th week of pregnancy) - must arise during the period of sickness insurance or in protection period or during the interruption of the compulsory sickness insurance SZČO, which is entitled to parental allowance and does not perform the activity of the compulsorily insured and the compulsorily insured SZČO
at least 270 days of sickness insurance in the last two years before the reason for the pregnancy
the previous period of any sickness insurance completed shall be taken into account
the period of interruption of the employee's compulsory health insurance due to the use of parental leave and the period of interruption of the compulsory health insurance of a self-employed person due to the right to parental allowance are also included
payment of sickness insurance premiums in the correct amount from the inception of the sickness insurance until the end of the calendar month preceding the month in which the reason for the provision of pregnancy arose, at most for the last five years, usually by the end of the calendar month in which the reason for the provision pregnancy (except if the reason for granting the pregnancy arises in the calendar month in which the insurance was first taken out or during the protection period or during the interruption of compulsory insurance due to the right to parental allowance)
it is not monitored whether the self-employed person earns an income while receiving a pregnancy
no other benefits are monitored
When assessing the condition of payment of health insurance premiums, the amount of outstanding health insurance premiums is tolerated in total less than 5 euros. By paying the claim, the condition of payment of the insurance premium is considered fulfilled for the entitlement to the benefit.
Voluntarily sickness insured
the reason for granting a pregnancy - the day corresponding to the beginning of the 27th week before the expected date of birth (13th week of pregnancy) - must arise during the period of sickness insurance or within the protection period
at least 270 days of sickness insurance in the last two years before the reason for the pregnancy
the previous period of any sickness insurance completed shall be taken into account
the period of interruption of the employee's compulsory health insurance due to the use of parental leave and the period of interruption of the compulsory health insurance of a self-employed person due to the right to parental allowance are also included
payment of sickness insurance premiums in the correct amount from the inception of the sickness insurance until the end of the calendar month preceding the month in which the reason for the provision of pregnancy arose, at most for the last five years, usually by the end of the calendar month in which the reason for the provision pregnancy (except if the reason for granting the pregnancy arises in the calendar month in which the insurance first arose or within the protection period)
When assessing the condition of payment of health insurance premiums, the amount of outstanding health insurance premiums is tolerated in total less than 5 euros. By paying the claim, the condition of payment of the insurance premium is considered fulfilled for the entitlement to the benefit.
Protection period
Duration
seven days after the end of the sickness insurance
if the sickness insurance lasted less than seven days, as many days as the sickness insurance lasted
in the case of an insurance policy whose sickness insurance expired during pregnancy, eight months
The expiry of the protection period (if not earlier) shall end on the day on which
sickness insurance was created (not social security of the force)
a right to an old-age pension, an early retirement pension or an invalidity pension has arisen
Duration of suspension of compulsory sickness insurance
Unlike other sickness benefits, a pregnant employee who has a reason to provide pregnancy during the period of interrupted compulsory sickness insurance of the employee due to taking parental leave is also entitled to pregnancy benefits. If the employee claims to be pregnant during this period, the suspension of the employee's compulsory sickness insurance due to parental leave continues.
Unlike other sickness benefits, a pregnant SZČO is also entitled to maternity benefits. If the SZČO asserts a claim for pregnancy during this period, the suspension of the SZČO compulsory sickness insurance, which is entitled to parental allowance and does not carry out the activity of the compulsorily insured and the compulsorily insured SZČO, continues.
Amount of the benefit in 2022
Pregnancy is determined from the daily assessment basis (DVZ) or the probable daily assessment basis (PDVZ).
DVZ = share of the sum of assessment bases from which the insured paid the sickness insurance premium in the number of days of the decision period. DVZ is rounded up to four decimal places.
The DVZ - DVZ limit may not be higher than the DVZ determined from twice the general assessment base valid in the calendar year two years preceding the calendar year in which the reason for the provision of sickness benefit arose (from 1 January to 31 December 2022 = 74, 4987 euros)
PDVZ = one-thirtieth of the assessment base (VZ), from which the sickness insurance premium would be paid for the calendar month in which the reason for the provision of sickness benefit arose (assumed VZ). PDVZ is rounded up to four decimal places.
If the PDVZ is higher than the amount corresponding to one-thirtieth of the minimum VZ (ie VZ referred to in § 138 paragraph 5 of Act No. 461/2003 Coll.), Which is valid on the day on which the reason for the provision of sickness benefit arose (from 1 1. to 31. 12. 2022 = 566.50 euros), PDVZ is the amount corresponding to one-thirtieth of the minimum VZ (from 1. 1. to 31. 12. 2022 = 18.8834 euros).
The amount of pregnancy represents 15% of the daily assessment base (DVZ) or the probable daily assessment base (DVZ) or the total DVZ / PDVZ, provided that the amount must not be lower than the dose determined from 10% of the maximum daily assessment base and higher than the dose determined from the maximum assessment basis
In practice, this means that if the maximum daily assessment base for 2022 is € 74.4987, the pregnancy rate in 2022 will be as follows:
The minimum pregnancy per calendar day will be € 7.44987000
maximum pregnancy per calendar day will be 11.17480500 euros.
Amount of the benefit in 2021
Pregnancy is determined from the daily assessment basis (DVZ) or the probable daily assessment basis (PDVZ).
DVZ = share of the sum of assessment bases from which the insured paid the sickness insurance premium in the number of days of the decision period. DVZ is rounded up to four decimal places.
The DVZ - DVZ limit may not be higher than the DVZ determined from twice the general assessment base valid in the calendar year two years preceding the calendar year in which the reason for granting the sickness benefit arose (from 1 January to 31 December 2021 = 71, EUR 8028)
PDVZ = one-thirtieth of the assessment base (VZ), from which the sickness insurance premium would be paid for the calendar month in which the reason for the provision of sickness benefit arose (assumed VZ). PDVZ is rounded up to four decimal places.
If the PDVZ is higher than the amount corresponding to one-thirtieth of the minimum VZ (ie VZ referred to in § 138 paragraph 5 of Act No. 461/2003 Coll.), Which is valid on the day on which the reason for the provision of sickness benefit arose (from 1 1. to 31. 12. 2021 = 546 euros), PDVZ is the amount corresponding to one-thirtieth of the minimum VZ (from 1. 1. to 31. 12. 2021 = 18.2000 euros).
The amount of pregnancy represents 15% of the daily assessment base (DVZ) or the probable daily assessment base (DVZ) or the total DVZ / PDVZ, provided that the amount must not be lower than the dose determined from 10% of the maximum daily assessment base and higher than the dose determined from the maximum assessment basis
In practice, this means that if the maximum daily assessment base for 2021 is € 71.8028, the pregnancy in 2021 (from 1 April 2021) will be as follows:
The minimum pregnancy per calendar day will be € 7.18028000
maximum pregnancy per calendar day will be in the amount of 10.77042000 euros.
Exception - PDVZ of an employee and a compulsorily insured self-employed person who did not have a self-employed person in the decisive period due to temporary incapacity for work, maternity leave, interruption of compulsory sickness insurance of an employee due to parental leave or interruption of compulsory sickness insurance who is entitled to parental allowance is one-thirtieth of the anticipated public health allowance, from which the sickness insurance premium would be paid for the calendar month in which the reason for the provision of sickness benefit arose.
Limitation of PDVZ - the same as for DVZZ
Cases in which pregnancy is determined from the PDVZ (not from the DVZ)
if the employee, the compulsorily insured self-employed person and the voluntarily insured person did not have
if the employee who in the current sickness insurance did not reach 90 days of payment of sickness insurance premium before the reason for the provision of sickness benefit, or in the relevant period, which is the calendar year preceding the calendar year in which the reason for the provision of sickness benefit arose, did not reach 90 days of payment sickness insurance premiums for other employers
if the compulsory sickness insurance of a self-employed person has a reason for providing sickness benefit on the day of the origin of this sickness insurance (the origin of sickness insurance due to the end of its interruption is not taken into account)
if the voluntarily sickness insured person has been continuously voluntarily sickness insured for less than 26 weeks
The amount of pregnancy represents 15% of the daily assessment base (DVZ) or the probable daily assessment base (DVZ) or the total DVZ / PDVZ, provided that the amount must not be lower than the dose determined from 10% of the maximum daily assessment base and higher than the dose determined from the maximum assessment basis
In practice, this means that if the maximum daily assessment base for 2021 is € 71.8028, the pregnancy in 2021 (from 1 April 2021) will be as follows:
The minimum pregnancy per calendar day will be € 7.18028000
maximum pregnancy per calendar day will be in the amount of 10.77042000 euros.
Decisive period
if the sickness insurance of an employee, self-employed person or voluntarily insured person has lasted continuously from at least 1 January of the calendar year preceding the calendar year in which the reason for the pregnancy arose, the decisive period for finding DVZ is the calendar year preceding the calendar year in which reason for granting a pregnancy
if the employee's sickness insurance was established in the calendar year preceding the calendar year in which the reason for the provision of pregnancy arose or in the calendar year in which the reason for the provision of pregnancy arose and the period of sickness insurance for which sickness insurance premiums are paid was at least 90 days before the day on which the reason for the provision of pregnancy arose, the decisive period for finding DVZ is the period from the origin of the health insurance to the end of the calendar month preceding the calendar month in which the reason for the provision of pregnancy arose
if the period of sickness insurance of the employee for which the sickness insurance premium is paid before the reason for the provision of pregnancy was less than 90 days from the origin of this sickness insurance, the decisive period for determining DVZ is the calendar year preceding the calendar year in which the reason for provision if the period of sickness insurance of the employee for which the sickness insurance premium is paid in the previous calendar year was at least 90 days, except for the period of sickness insurance obtained with the employer for which the reason for granting the pregnancy arose (ie on the basis of assessment not taken into account)
The decisive period for determining the DVZ for determining the amount of a pregnant employee who has been transferred to another job due to pregnancy is determined on the day of this transfer
if the sickness insurance of a self-employed person arose
in the calendar year preceding the calendar year in which the reason for granting pregnancy arose, the decisive period for determining DVZ is the period from the origin of sickness insurance to the end of the calendar year of the previous year in which the reason for granting pregnancy
in the calendar year in which the reason for the provision of pregnancy arose, the decisive period for finding DVZ is the period from the origin of the health insurance to the end of the calendar month of the previous month in which the reason for the provision of pregnancy arose
in the calendar month in which the reason for the provision of pregnancy arose, the decisive period for finding DVZ is the period from the origin of the health insurance to the day preceding the day in which the reason for the provision of pregnancy arose
if the sickness insurance of the voluntarily sickness insured person lasted for at least 26 weeks and arose
in the calendar year preceding the calendar year in which the reason for granting pregnancy arose, the decisive period for determining DVZ is the period from the origin of sickness insurance to the end of the calendar year of the previous year in which the reason for granting pregnancy
in the calendar year in which the reason for the provision of pregnancy arose, the decisive period for finding DVZ is the period from the origin of the health insurance to the end of the calendar month of the previous month in which the reason for the provision of pregnancy arose
if the entitlement to pregnancy arose for an employee, a self-employed person or a voluntary sickness insured person within the protection period, the decisive period for finding out the DVZ is ascertained on the day of the termination of the sickness insurance
when determining the decisive period for the determination of DVZ and for the purposes of the employee's health insurance to determine 90 days of health insurance for which health insurance premiums are paid, the occurrence and termination of the interruption of compulsory health insurance is not considered as the origin and termination of health insurance compulsory sickness insurance does not specify a new decisive period and 90 days of payment of sickness insurance premiums are monitored from the onset of the employee's sickness insurance)
for the purposes of determining the decisive period, the sickness insurance of an employee of the same type with one employer, which expired and subsequently arose the following calendar day, is considered continuous (§ 20 para. 1 is not affected)
Periods for which the policyholder is not obliged to pay sickness insurance premiums and periods of interruption of compulsory sickness insurance are excluded from the decisive period for the determination of DVZ
Pregnancy amounts are rounded up to ten eurocents.
Payment of the benefit
Method of payment
preferably to the account of the recipient of the pregnancy in a bank or a branch of a foreign bank
at the request of the recipient of the pregnancy, the pregnancy is paid in cash, ie by means of a payment voucher or district district (Slovenská pošta, as)
at the written request of the pregnant recipient, the pregnant woman is credited to the husband's account in a bank or a branch of a foreign bank if the pregnant husband has the right to dispose of funds in this account at the time of receiving the pregnancy and if the pregnant husband agrees to this method of remittance ( see Forms ).
Deadlines for payment of benefits
benefits are paid by the end of the month following the calendar month for which the pregnancy is paid.
Benefit period
Provision
for calendar days
even on days when the insured person receives income or receives other benefits
Pregnancy provision period
Entitlement to pregnancy arises:
from the day corresponding to the beginning of the 27th week before the expected date of birth (13th week of pregnancy)
if the beginning of the 27th week before the expected date of childbirth by the designated doctor occurred before 1 April 2021, the policyholder will be granted a pregnancy entitlement from 1 April 2021, the conditions of the pregnancy entitlement being assessed and its amount determined on 1 April 2021
Entitlement to pregnancy and its payment lapses:
on the date of termination of pregnancy
on the day of termination of the pregnancy other than by childbirth (eg abortion, miscarriage)
the death of the insured person during the period of entitlement to pregnancy; the claim expires on the day of the insured's death (the last day of the claim is the day of her death)
How to use maternity pay for maternity and maternity pay
In the case of determining the origin of the entitlement to pregnancy, ie the beginning of the 27th week before the expected date of birth of the insured, the column of the date of birth will look for the specified date in the column Physician's determined day;
In the given line:
on the left (the first column of PREGNANCY) is the date indicating the beginning of the entitlement to pregnancy (beginning of the 27th week before the expected date of birth)
Lehotník does not take into account the transfer year.
Batch Return / Limitation
The recipient of the benefit is obliged to return the pregnancy or part thereof from the day from which it did not belong to her or did not belong to the provided amount, if
has not fulfilled an obligation imposed by law (eg did not prove termination of pregnancy)
received the pregnancy or part of it, even though she knew or should have assumed in the circumstances that it had been paid wrongly or in an amount higher than it was entitled to (eg her branch was paid by her subsidiary from a higher daily assessment base than stated in the pregnancy award decision);
knowingly caused the pregnancy or part of it to be paid wrongly or in an amount higher than it should have (for example, it did not inform the branch that it was also insured under the legislation of an EU Member State)
If a natural or legal person has incorrectly confirmed the facts determining entitlement to the benefit, the right to its payment or its amount and as a result the Social Insurance Agency provided the benefit incorrectly or in an amount higher than it belonged, this person is obliged to reimburse unduly paid amounts (eg , higher assessment bases in the decisive period or did not send registration letters of a natural person proving the origin and termination of the interruption of compulsory health insurance in the decisive period).
Entitlement to the payment of the pregnancy or part thereof shall expire three years after the date on which the pregnancy or part thereof belonged. The limitation period does not expire at the time of the pregnancy proceedings and during the period in which the guardian, who must have a guardian, has not been appointed guardian.
Abroad and the EU
If a pregnant person who is insured under sickness legislation in the Slovak Republic and during pregnancy is in the care of a doctor other than a doctor in the Slovak Republic, ie in another EU Member State, Switzerland, the Kingdom of Norway, the Republic of Iceland and the Principality of Liechtenstein EU State ”), claims for pregnancy in the relevant branch of the Social Insurance Agency:
by a doctor's certificate issued in an EU Member State - the expected date of birth must be confirmed by the doctor on the form (translation of such a certificate is not required), or
if the pregnant person is in the care of a doctor in the territory of the state with which the Slovak Republic has a social security contract, and the subject of this contract are also sickness benefits (eg Ukraine), the Social Insurance Agency as the competent institution for the payment of sickness benefits certificates and forms issued in the Contracting State.
If the pregnant person is in the care of a doctor in the territory of the state with which the Slovak Republic has not concluded a social security contract, he / she claims the pregnancy through the confirmation of the doctor of the given state, where the expected date of birth must be confirmed. Such confirmation must be provided by an official translation into Slovak. The doctor's certificate must be accompanied by an informal application for payment of the benefit and state the method of payment and the necessary payment details.
Rights and obligations
Insurance rights
to claim the pregnancy and the right to its payment
apply for a certificate of entitlement to pregnancy, entitlement to payment and its amount
Obligations of the insured / beneficiary
state birth number (social security identification number) in applications
the relevant branch of the Social Insurance Agency to prove the facts decisive for the origin and termination of the right to pregnancy, the right to its payment and its amount
after a written request from the Social Insurance Agency to prove these facts within eight days from the date of delivery of the request, unless it has specified a different deadline
the origin of the right to pregnancy is proved in particular
request for pregnancy
termination of entitlement to pregnancy and its amount is proved in particular
Confirmation of termination of pregnancy (childbirth, abortion, miscarriage).
the recipient of the benefit is obliged to notify the relevant branch of the Social Insurance Agency within eight days of the change in the facts decisive for the duration of the entitlement to the benefit, the entitlement to its payment and its amount
Obligations of the employer
submit Employer's confirmation of the employee for the purpose of claiming sickness benefit on an individual request of a branch of the Social Insurance Agency due to the fact that it does not record data on the employee (assessment bases, registration data) necessary for the assessment of entitlement to pregnancy or if the pregnancy is determined from the PDVZ
Duty of the attending physician
confirm the expected date of birth and the date of termination of pregnancy on the form specified by the Social Insurance Agency
Obligations of the Social Insurance Agency
carry out sickness insurance in accordance with applicable legislation, EU coordination regulations and international agreements
decide on the right to sickness benefit within 60 days from the beginning of the proceedings (delivery of the application to the locally relevant branch of the Social Insurance Agency), in extremely difficult cases to extend the time limit by another 60 days (obligation to notify the party)
pay pregnancy within the deadlines set by the branch
issue, at the request of the recipient of the pregnancy, a certificate of entitlement to the benefit, the right to its payment and the amount of the pregnancy