What basic insurance covers – ultrasounds and check-ups
How many ultrasounds does Swiss insurance cover – gynaecologist Basel
FMH Gynecology
Board certified
SGGG
Member
Colposcopy diploma
Certified
DE · EN
Languages
Spalenvorstadt 3
4051 Basel
Swiss compulsory health insurance (OKP, «basic insurance») pays for medically necessary care – and for screening and pregnancy examinations the law defines a specific number.
Many women assume every check-up and every ultrasound is automatically covered. It is not. Knowing the rules means knowing in advance what insurance pays and what you pay yourself.
All patients: during pregnancy, at the annual check-up and whenever symptoms require more frequent monitoring.
Key facts
At a glance.
- Uncomplicated pregnancy: 7 check-ups and 2 ultrasound scans are covered benefits.
- The two pregnancy scans take place at 11–14 weeks and 20–23 weeks.
- With risk factors or abnormal findings, additional check-ups and scans are covered – with a medical indication.
- Gynaecological screening with a smear: every three years when findings are normal.
- A gynaecological ultrasound without symptoms is not a covered benefit – it is a self-pay service.
- From week 13 of pregnancy until eight weeks after birth, the deductible and co-payment do not apply to pregnancy-related care.
Causes
Background and risk factors.
Covered benefits are defined in the Health Care Benefits Ordinance. It states not only what is covered, but how often. For examinations without symptoms – pure screening – a fixed interval applies; beyond that, insurance pays only when a medical reason is documented.
Risk factors
- Expecting an ultrasound at every single check-up as standard
- Wanting a yearly smear despite normal previous results
- Follow-up appointments without symptoms and without a documented indication
- A supplementary policy whose scope is unknown
Symptoms & findings
How does it present?
Typical symptoms
- Surprise on the invoice because an examination was not covered
- Uncertainty about how many scans in pregnancy are «normal»
- Confusion about whether screening is paid yearly or every three years
When an additional examination is covered anyway
As soon as there is a medical reason, the limit no longer applies: bleeding, pain, abnormal findings, monitoring the baby's growth, previous surgery, pre-existing conditions, a high-risk pregnancy or follow-up after treated cell changes. Then the examination is treatment – and a covered benefit.
Diagnostics
How the diagnosis is made.
In an uncomplicated pregnancy, seven check-ups are provided for, plus two ultrasound scans: the first between weeks 11 and 14 (dating and first-trimester screening), the second between weeks 20 and 23 as the anomaly scan. After birth there is one postnatal check between weeks 6 and 10, plus breastfeeding advice and midwifery care.
Examinations
- 2 pregnancy ultrasounds in an uncomplicated course (11–14 weeks, 20–23 weeks)
- 7 pregnancy check-ups in an uncomplicated course, more with a medical indication
- 1 postnatal check 6–10 weeks after birth
- First-trimester screening; NIPT is a covered benefit only with an increased risk
- Gynaecological screening with Pap smear every 3 years when previous results are normal
- Mammography in the cantonal screening programme from age 50 every 2 years (10% co-payment, no deductible)
What do the findings mean?
In short
the number applies to an uncomplicated course. An extra scan «just to see that everything is fine», without symptoms or risk factors, is an elective service and self-paid. An extra scan for bleeding, pain, growth concerns or a pre-existing condition is a covered benefit. Supplementary insurance may cover more – only your insurer can confirm what exactly.
Treatment
Possible approach.
Watchful waiting
We plan check-ups so that they make medical sense – not so that as many appointments as possible are generated. If an examination is not covered, we say so beforehand and name the price.
Medication
Self-pay area
additional ultrasound scans without an indication, HPV testing in screening, the Premium check-up with ultrasound (CHF 681) and elective services without medical necessity. These are deliberately offered as options – not as a standard every woman needs.
Surgery
Deductible and co-payment
they do not apply to pregnancy-related care from week 13 until eight weeks after birth. Outside that window, your personal deductible and the statutory 10% co-payment apply.
Prevention
What you can do yourself.
- Tell us at the appointment if you want to know what is covered – we clarify it beforehand
- Ask your insurer once, in writing, what your supplementary policy covers
- Describe symptoms specifically: this matters medically and also decides coverage
- One concern per appointment – it keeps the consultation focused and the billing clean
One appointment. One main concern. So we can give you our full, unhurried attention, we address one main topic per appointment. We're happy to schedule additional or complex questions in a separate appointment. This is what allows consultations to run on time and without long waiting times – thank you for your understanding.
Frequently asked questions
FAQ.
Related topics
Keep reading.
Medically responsible.
Dr. med. Anna Margareta Wagner is a board-certified FMH specialist in gynecology and obstetrics with her own practice at Spalenvorstadt 3 in Basel. Special focus on surgical gynecology; further focus areas: gynecological check-ups, colposcopy and dysplasia consultations, intimate surgery, pregnancy care, and consultations for girls and adolescents.
- FMH specialist certification in gynecology and obstetrics
- Special focus: surgical gynecology
- SGGG member
- Certified colposcopy diploma
- Languages: German, English
- Service area: Basel-Stadt, Basel-Landschaft, northwestern Switzerland
The content on this page is reviewed regularly against current specialist medical recommendations.
Sources
Your questions – discussed in a safe space.
Every situation is individual. During your consultation, we take the time to review your findings and find the right next step together.