From spontaneous travelers to parents: Having a baby abroad

Travel teaches you to be flexible. Parenthood… it demands it even more. The lessons come thick and fast and well, they’re not always in the brochure. We are sharing a story of two nomads – Franz and Yukiko – who went from booking last-minute flights to navigating hospital systems in five countries, translating medical documents and ultimately welcoming their daughter into the world in Tokyo. Along the way, they discovered what works, what doesn’t and why choosing the right international health insurance before you need it is one of the most important decisions traveling parents can make.

The Discovery: Finding out you’re pregnant… halfway across the world

Our clients were used to spontaneity. Cheap flights from A to B, often without even deciding on a destination beforehand. Then came the unexpected: they were pregnant and they were far from home. Healthcare abroad works, but the administrative friction can be intense. They were in Italy when the pregnancy was confirmed. They already had their travel plans mapped out: Colombia, Dubai, Australia, Japan. But now everything had an added layer: 

“Where will we get our next prenatal checkup? Will our insurance cover it? What documents will we need?”

Prenatal care across four continents

Italy: The pregnancy was confirmed here. The Italian documents had to be translated before submission to BDAE (the insurer). Once translated and submitted, the claim was accepted without issue.

Colombia: The search for an English-speaking doctor proved difficult. Appointments didn’t quite come together and the language barrier pushed Franz and Yukiko to move on sooner than planned.

Dubai: A brief stopover, no appointments needed, easy.

Australia: They stayed in Sydney for about six months. Prenatal checkups were straightforward, documents were in English and the insurer reimbursed them without translation headaches. 

“In Sydney everything was in English, and the insurer compensated us without any problems.”

– Franz Biler

Japan (Tokyo): The birth destination. And here’s where things got complicated…

Giving birth in Tokyo: World-class medicine with administrative headaches

The baby was born at St. Luke’s International Hospital in Tokyo – one of the city’s most respected facilities. The medical care was excellent. The administrative experience… not as much. Many Japanese hospitals weren’t prepared for international patients who weren’t already living in Japan. They expected mothers to come in person for preliminary exams, to redo tests already done abroad, and to follow standard Japanese protocols designed for residents. Despite the mother being Japanese, the mismatch between Japanese standard procedures and an internationally mobile lifestyle left them with limited options. St. Luke’s, as an international hospital, was the natural choice but even there, expectations of “international service” didn’t always match reality. Nurses spoke zero English whatsoever. Appointment scheduling required persistent back-and-forth. English-language documents weren’t readily available.

The birth: An unplanned c-section

After considering all options, a c-section was recommended for medical reasons. The procedure went smoothly with total costs of approximately €6.000 for the delivery and hospital stay.

Interesting fact: in Japan the cost of a c-section is regulated the same way across all hospitals – there’s a national fee schedule billed in “points” with defined values. The price doesn’t vary by hospital quality. This is strikingly different from systems like the US, where the same procedure can range dramatically and it’s paid for by the government.

The insurance experience: A lesson in patience

BDAE (the insurer) did not have a direct billing arrangement with the Japanese hospital for international patients. Our travelers had to pay €6.000 out of pocket upfront and seek reimbursement afterward. But one of the most frustrating discoveries was the insurer’s document translation requirement. Any document not in German or English had to be professionally translated before the insurer would process it. That included Italian medical records, Japanese invoices and hospital correspondence. The insurer required proper translations for claims processing: this meant additional time, effort and expense for every non-English/German document.

By contrast, other international insurers we work with accept original documents in any language: no translation required. Christoph’s experience with Barmenia, a German private insurer is a perfect example. After a motorcycle accident in Thailand requiring surgery and THB300.000 in treatment, Barmenia accepted the original Thai invoices without question. 

“And this is a domestic German insurer providing worldwide coverage, not even an explicit international insurance specialist.”

– Christoph Huebner, Insurance Broker

Children’s Insurance: The right every parent should know about

Once the baby arrived, a new question emerged: How do you insure a newborn? In Germany the law is clear. Under §198 VVG (German Insurance Contract Act), a newborn child must be accepted by the parent’s insurer without a medical examination, provided:

• At least one parent has been with the insurer for at least three months
• Registration within two months of the birth
• The requested tariff is not higher than the parents’ own plan

This is a powerful, legally guaranteed right and it’s unique to Germany’s dual insurance system (statutory plus private). Most other countries don’t have equivalent protections because their systems don’t allow full withdrawal from public health insurance. Despite this clear legal entitlement, the insurer in our story attempted to add bureaucratic obstacles: a signature form, additional requirements. It took us invoking the law with a firm deadline to get the child registered:

“We are the legal representatives of the client. There is a legal entitlement under §198 VVG. You are not allowed to put further bureaucratic obstacles in the way. We are setting you this deadline: register the child by next Tuesday.”
– Christoph Huebner, Insurance Broker

Six days of silence followed… Then the confirmation arrived but with a needless request for the child’s citizenship, information already on file. This was the first newborn registration we had ever needed to escalate with this particular insurer. With every other insurer it’s a routine process handled the next day.

The pregnancy coverage gap you haven’t thought about

Here’s a critical insight most parents miss: once the umbilical cord is cut, all healthcare services for the child are billed separately to the parents. Neonatal care, NICU stays, newborn checkups – all of these fall under children’s insurance, not the mother’s pregnancy coverage. An insurer might cover pregnancy and delivery beautifully but leave you scrambling if the baby needs intensive care. If your policy caps pregnancy at €20.000 – like Foyer Global Health – that might cover a routine delivery. But it will not cover a NICU stay for a premature baby.

Citizenship Complications: A bonus headache

As if insurance weren’t complicated enough, international families face citizenship questions that compound the challenge. In our story, the child was eligible for both German and Japanese citizenship, but Japan officially doesn’t allow dual citizenship past age 20. The child can hold both until then, at which point a decision must be made. This affects insurance choices because eligibility for national health systems often depends on citizenship and residency status.

The bottom line

Having a baby while living an international life is extraordinary and complex. The right insurance doesn’t eliminate every challenge, but it ensures that the challenges you face are medical and logistical, not financial or bureaucratic.

We specialize in helping traveling families navigate exactly these waters. From pregnancy coverage to children’s insurance, from document requirements to direct billing, we know which insurers deliver and which ones only create obstacles. We’ve seen the €500,000 premature birth claim paid in full, and we’ve seen the €100 reimbursement that took three months without escalation.

The difference is in the details. And the details matter most when you’re holding a newborn in a country that isn’t home.

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