A  - Salaried workers

The quality of "salaried worker" entitles a woman to maternity benefits just as it entitles her to health insurance and work-related injury benefits. However, unlike health insurance and work-related injury benefits, maternity benefits are only granted provided a certain number of conditions are fulfilled.

a)  To be entitled to "benefits in kind" (reimbursement of expenses) by the maternity insurance, the insured person must justify :

- having worked at least 60 hours, or having contributed on the basis of a salary that is at least 60 times the hourly SMIC during 1 month, or
- having worked at least 120 hours, or having contributed on the basis of a salary that is at least 120 times the hourly SMIC over a 3 month period, or :
- having worked at least 1200 hours, or having contributed on the basis of a salary that is at least 2030 times the hourly SMIC during 1 year.

For benefits "in kind", their entitlement begins either with the date of conception or with maternity leave (a pre-natal rest 42 days before the expected date of birth). The payment of benefits "in kind" is automatic and coverage is 100% starting from the first day of the sixth month of the pregnancy to the 12th day following the expected date of birth.

b)  To be entitled to "cash benefits" (maternity leave compensation or daily allowance), the woman insured must justify :

- having worked at least 200 hours over the 3-month period preceding the maternity leave or :

- having contributed on the basis of a salary at least 1 015 times the hourly SMIC over the 6-month period preceding the maternity leave.

The salaried woman must also justify having been registered with the Social Security for at least 10 months at the expected date of birth.

The entitlement of benefits begins either with the date of conception or with maternity leave.

Note : The same conditions apply for the entitlement of a daily allowance in case of adoption or paternal leave.

 
B - Non-salaried women (spouses of scientists)

a) Registration as a ayant-droit :

Spouses of scientists are entitled to maternity benefits under the status of ayant-droit d'un assuré social" (eligible as a spouse of a person who is registered with the social security). Independent of whether her husband's health cover is through his status as a salaried worker or as an affiliate with the CMU, she will be registered with the Social Security through her husband as an ayant-droit.

As mentioned above, partners and children of scientists can, under certain conditions, be considered also eligible under as an ayant-droit. This status entitles them to the same benefits in kind from the health and maternity insurances (reimbursement of expenses) ; however, since they do not work, they are not entitled to cash benefits. Had they been employed, they would have been covered directly under the quality of salaried worker.

For non-working beneficiaries, the qualifying conditions are the same as those for a salaried woman, except that the minimal period of employment and registration with the social security is not requested.

Consequently, spouses of scientists are entitled to maternity insurance through their husband. However, the basic rule for registration as a ayant-droit is to have a valid residency permit (this means only after the 3-month qualifying period) before being entitled to  benefits in kind.

If the conditions for qualification under the "maternity" clause are not fulfilled, expenses will be reimbursed (benefits in kind) under the "sickness" clause. The difference concerns the rate of reimbursement : in France, sickness is covered up to 70% (80% for hospital stays) whereas maternity expenses are reimbursed 100%. Spouses registered with the Social Security who do not meet the requirements for maternity cover will have to pay the remaining 30% of the costs (20% for hospitalization). They will be reimbursed only 70% of the expenses linked to their pregnancy.

b) Affiliation as a principal beneficiary of the CMU :

If the scientist receives a stipend through a grant and is covered through a private insurance (for example, EGIDE, AXA,...), the spouse does not qualify for registration with the national health insurance system. These spouses can request a personal registration with the CMU (see point I, B, a). In this case, sickness and maternity benefits will be paid after the qualifying period of 3 months of continuous residency and presentation of the residency permit.

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