Does health insurance pay for breastfeeding advice?

What basic health insurance pays

Breastfeeding advice is expressly set out in law: Art. 29 para. 2 let. c of the Federal Health Insurance Act (KVG) counts necessary breastfeeding advice among the specific benefits for maternity. The details are in Art. 15 of the Health Care Benefits Ordinance (KLV). This applies in the same way with every health insurer.

Benefit	Scope	Co-payment
Breastfeeding advice	three sessions (Art. 15 para. 2 KLV)	none
Midwife’s home visits after the birth, with advice on feeding the child	up to 10 in the 56 days after the birth; up to 16 for first-time mothers, premature, multiple or caesarean births (Art. 16 para. 1 let. c KLV)	none
Second visits on the same day	at most 5 in the first 10 days (Art. 16 para. 1 let. c no. 2 KLV)	none
Breast pump	only on a doctor’s prescription and for an indication listed in the MiGeL, up to the maximum amount	none until 8 weeks after the birth, then deductible and retention fee
Breastfeeding allowance	not a benefit of basic health insurance	–

Three groups may give advice (Art. 15 para. 1 KLV): approved midwives, midwives’ organisations and nurses with special training in breastfeeding advice. Basic health insurance cannot pay other advisers.

No deductible, even after the postnatal period

The insurer may not charge any co-payment on benefits under Art. 29 para. 2 KVG (Art. 64 para. 7 let. a KVG). This applies to the three sessions regardless of when they take place and regardless of your deductible (Franchise). It is different for general benefits in the event of illness, such as a breast pump or a doctor’s visit for mastitis: they are only exempt until eight weeks after delivery (Art. 64 para. 7 let. b KVG). The period ends at midnight on the 56th day after the birth (Art. 105 para. 3 of the Health Insurance Ordinance, KVV).

Basic health insurance pays for a breast pump under the Aids and Appliances List (MiGeL), item 01.01, only on a doctor’s prescription and for an indication listed there. The MiGeL as of 01.07.2026 lists, for example, at most CHF 2.31 per day for hiring an electric pump and at most CHF 175.65 for buying a single electric pump. More on this under Does health insurance pay for a breast pump?.

What supplementary insurance pays

For anything beyond three sessions, and for benefits that the KVG does not provide, you need voluntary supplementary insurance under the Insurance Contract Act (ICA). The law does not prescribe anything there. The insurer sets out in its general terms and conditions:

• whether it pays for further breastfeeding advice sessions, for example with advisers who are not approved for basic health insurance,
• whether it pays a breastfeeding allowance, how much it is and which proof it requires,
• whether it contributes towards a breast pump without a medical indication or above the MiGeL maximum amount,
• whether the contribution is part of a maternity package and from when it applies.

Supplementary insurance may not cover the deductible and retention fee of basic health insurance (Art. 64 para. 8 KVG). When you take out a policy, the insurer may ask health questions (Art. 4 ICA); if you only look for supplementary insurance during pregnancy, you should expect reservations. We are building a benefits comparison of supplementary products under Supplementary insurance. What counts are always the general terms and conditions and the information from your insurer.

Conditions

• Approved adviser: The midwife needs approval under Art. 45 KVV, and the nurse needs special training in breastfeeding advice. Before the first appointment, ask whether the adviser bills basic health insurance.
• No prescription: You do not need a prescription or a referral for the three sessions.
• Three sessions: The KLV limits cover to three sessions, with no deadline after the birth. The advice given during the midwife’s postnatal visits does not count towards these three.
• Breast pump only with a prescription: A pump requires a doctor’s prescription and an indication listed in the MiGeL, for example premature birth or engorgement. The dispensing outlet must be approved (Art. 20 KLV); anything it charges above the maximum amount you pay yourself (Art. 24 KLV).
• Billing: The adviser bills according to the tariff, either directly to the insurer or via you with a reimbursement claim form. Because there is no co-payment, you get the full amount back.
• Insurance model: In the GP, HMO or telemedicine model, the model conditions determine what applies without first contacting your point of contact. If you are unsure, clarify this with your insurer.

Sample calculation

Example with fictitious people and an assumed price. Julia is 29 and has a CHF 1,500 deductible. On 14.04.2026 her second child is born without complications. The period without co-payment for general benefits ends at midnight on 09.06.2026, the 56th day. Because of engorgement, the doctor prescribes an electric breast pump for hire for 28 days on 20.04.2026. Julia has two breastfeeding advice sessions in May and one in July, and a fourth in August, assumed to cost CHF 90. The amounts come from Art. 15 and 16 KLV, Art. 64 para. 7 KVG and the MiGeL as of 01.07.2026.

Separate rules apply to the child: from birth the child needs its own basic health insurance, which you must take out within three months. How this works is explained in Insuring your baby. You compare the premium in the child premium calculator or in the premium calculator.

How to proceed

1. Look for an adviser early: Already during pregnancy, ask your midwife or the hospital about a breastfeeding adviser who bills basic health insurance.
2. Use the postnatal visits: Also ask questions about breastfeeding during the midwife’s home visits; these do not count towards the three sessions.
3. Ask the doctor if there are problems: The insurer only pays for a breast pump with a prescription. Within the 56 days, there is no co-payment.
4. Check the general terms and conditions: If you need more than three sessions or expect a breastfeeding allowance, read the conditions of your supplementary insurance.
5. Check the bills: If the statement for a breastfeeding advice session shows a deductible or retention fee, complain to your insurer.

Common mistakes

• Expecting to pay the deductible. The three breastfeeding advice sessions are always free of deductible and retention fee, even months after the birth.
• Confusing postnatal visits and breastfeeding advice. The advice during home visits is covered separately; you keep your three sessions.
• Hiring a pump without a prescription. Without a doctor’s prescription and an indication, basic health insurance pays nothing.
• Overlooking the 56 days. For the breast pump and other general benefits, the exemption ends on the 56th day after the birth.
• Expecting a breastfeeding allowance from basic health insurance. It does not exist there, at most in supplementary insurance.

How preparation for the birth is paid for is explained in Does health insurance pay for an antenatal class?, and the full care provided by the midwife has its own page. You will find further benefits under What does health insurance cover?, and the insurers’ profiles in the health insurer profiles.