Having a baby in your first year in Andorra: what CASS pays and what depends on dates

Is there something unusual about your case? Tell us in the questionnaire

Two separate questions

If you are moving from the UK, Ireland or elsewhere, you may be used to a system where maternity care and maternity pay sit in different offices. In Andorra both run through CASS, the public social security fund, but the rules are different for each.

The medical side covers check-ups, the birth, the hospital stay, care after the birth and the baby's costs while in hospital. CASS pays 100 % of its own tariffs if you go through the preferred pathway. Outside it, it pays 33 %.

The money side is the paid leave you get while you are off work. That one has date requirements, and they are what catches newcomers out.

What CASS pays for pregnancy and birth

Through the preferred pathway, CASS pays 100 % of its liability tariffs to members who contribute on at least the minimum wage, and also to self-employed members, people on special regimes, pensioners and dependants. So a partner who does not work and is registered on your CASS is covered too.

The 100 % includes:

• Fees for the birth.
• The hospital stay.
• Care that follows from the birth.
• 4 check-ups: one in the first 3 months, then in the fourth, sixth and eighth month.
• The baby's costs while in hospital.

Mind the word "tariffs". CASS pays on its own price list, not on whatever each doctor charges. If a doctor bills above the tariff, you pay the difference. That gap is why many families add a private health policy.

The form: CASS-0019

To get the 100 %, you need the maternity declaration, form CASS-0019. The doctor fills it in and you hand it to the CASS medical control office by appointment. CASS then gives you an indicative calendar of check-ups and the vouchers.

Do it as soon as the doctor confirms the pregnancy. If you arrive part-way through, bring the reports from check-ups done in your home country.

Arriving pregnant: what your dates mean

Paid leave asks for two things at once: CASS registration at least 6 months before the birth, and 3 months of contributions within the 6 months before it.

The CASS maternity page does not set its own waiting period for pregnancy costs. For ordinary medical refunds, the first time you need 25 days of contributions. Ask the medical control office whether that affects your first check-up when you hand in the form.

If you will not qualify for paid leave, check two things before you move: what your home country still owes you, and what your employment contract says.

Tell your employer early

If you plan to use the optional weeks of leave, tell your employer in writing 3 months ahead and keep a copy.

Giving birth abroad

Plenty of newcomers want to give birth near family. You can, but cover depends on where:

• A centre with an agreement, or through the CASS preferred route. CASS works with hospitals outside Andorra for care that is not available locally. Ask CASS which ones apply.
• A centre with no agreement. CASS refunds 20 %. The same goes for check-ups done abroad in such a centre.
• On holiday in Spain or France. Andorra is outside the European health card scheme, as our EHIC guide explains. Travel forms exist, but only for care that cannot wait. They are not a way to plan a birth.

Ask CASS before the third trimester. If you have private cover, ask your insurer which hospitals it covers too.

Questions for a private health insurer

A private policy does not change what CASS pays. It can cover the tariff gap, a private room or a birth abroad. Ask in writing:

• Is there a waiting period for childbirth, and how long?
• Does the policy cover a pregnancy that already exists when you sign?
• Is the baby covered from birth, and how do you add them?
• Which hospitals outside Andorra are included?
• Does it pay the excess over the CASS tariff, or a fixed amount?

Our guide to health insurance in Andorra explains how CASS and a policy fit together. Always check the insurer is licensed to operate in Andorra.

Your first year, in order

1. Register with CASS as soon as you start work. A partner who does not work registers as your dependant.
2. Form CASS-0019 as soon as the pregnancy is confirmed.
3. If you will use the optional weeks, tell your employer in writing 3 months ahead.
4. Decide where to give birth before the third trimester.
5. If you want a policy, sign knowing its waiting periods.

The moving checklist puts every step in order, and the Andorra insurance planner has a profile for couples who move together.

On the blog you will also find Family on CASS and CASS waiting periods.