Today I will share with you knowledge about the reimbursement scope of maternity insurance. It will also explain the maternal hospitalization expenses and birth reimbursement scope. If it happens to solve the problem you are facing now, don\’t Forget about following this site, start now!
Contents of this article
- Taiyuan City Maternity Insurance Reimbursement Scope and Standards
- Guangzhou maternity insurance reimbursement scope and standards
- Public institution maternity insurance reimbursement scope and standards Standard
- Maternal hospitalization expenses and birth reimbursement scope
- Shenzhen Maternity insurance reimbursement scope and standards
- 2023 Dongguan Social Security Maternity Insurance reimbursement scope
1. Taiyuan City Maternity Insurance Reimbursement Scope and Standards
Reimbursement of 2,800 yuan for natural delivery and 3,000 yuan for difficult labor Yuan, the reimbursement for cesarean section is 5,200 Yuan, the reimbursement for in-hospital artificial abortion is 1,095 Yuan, and the reimbursement for mid-term hospitalization induction is 1,700 Yuan.
2. Guangzhou Maternity Insurance Reimbursement Scope and Standards
1. Overview of the reimbursement scope and reimbursement standards of Guangzhou’s maternity insurance
2. The scope of Guangzhou’s maternity insurance mainly includes family planning surgery fees and maternity medical fees:
3. 1. Family planning surgery expenses: The maternity medical expenses incurred by the insured person for medical treatment that comply with the provisions of maternity insurance will be paid by the Guangzhou Municipal Medical Insurance Bureau and designated medical institutions according to the cost of childbirth and family planning surgery. The average standard settlement of medical expenses.
4. a. Medical expenses incurred by insured employees in non-selected hospitals due to emergencies (including childbirth, obstetric diseases, and abortion) that are covered by maternity insurance. ;
5. b. Medical expenses for giving birth or terminating pregnancy in other places within the country upon approval;
6. c. During maternity leaveMedical expenses incurred due to obstetric complications;
7. d. Other medical expenses that comply with maternity insurance regulations.
8. Within a social insurance year, designated medical institutions provide high-quality medical services to the insured without violating maternity insurance regulations. The actual births of the insured will be If the total medical expenses reach more than 90% of the total fixed reimbursement, the social insurance agency will reimburse the full amount according to the fixed amount; if the total medical expenses do not reach 90% of the total fixed reimbursement (excluding 90%), the social insurance agency will reimburse according to the actual amount of expenses.
9. The insured person’s maternity medical expenses incurred by seeking medical treatment in non-selected medical institutions due to emergencies, seeking medical treatment in other places with approval, and other circumstances that meet the regulations can be paid with Submit relevant information to the social insurance agency to apply for reimbursement. After review, if the expenses that meet the regulations are lower than the quota standards of designated medical institutions of the same level in this city, they will be reimbursed according to the actual rates; if they are higher than the quota standards, they will be reimbursed according to the quota standards.
10. If the insured person has enjoyed prenatal examination benefits at the selected medical institution, only the corresponding hospital delivery expenses will be reimbursed, which is an actual hospital delivery that meets the regulations. If the cost is lower than the fixed standard for hospital delivery in designated medical institutions of the same level in this city, the actual reimbursement will be made; if the cost is higher than the fixed standard, the fee will be reimbursed according to the fixed standard.
11. If the insured person has paid cumulative premiums for the city’s maternity insurance for more than 1 year and has not gone through the medical confirmation procedures or failed to seek medical treatment in accordance with regulations, he or she may give birth, Within one year after abortion or family planning surgery, the employer or insured person shall apply to the social insurance agency for payment of a one-time maternity medical expense subsidy based on relevant information. The subsidy limit standard is 60% of the corresponding quota standard for designated medical institutions of the same level in this city.
12. If you become pregnant or undergo family planning surgery while participating in this city\’s maternity insurance but the cumulative payment is less than 1 year, you can wait until the cumulative payment has been completed for 12 months. Within one year, the employer shall apply to the social insurance agency for reimbursement based on relevant information. The limit reimbursement standard is 80% of the corresponding quota standard for designated medical institutions of the same level in this city.
13. Unemployed spouses can only enjoy the city’s maternity medical expenses, but not maternity subsidies. The treatment standards for maternity medical expenses for unemployed spouses shall be based on the maternity medical treatment standards of the Basic Medical Insurance for Urban and Rural Residents in this city. The specific standards are as follows:
14. (1) Medical expenses for prenatal examinations that meet the regulations will be covered by the maternity insurance fund at a standard limit of 300 yuan per person per pregnancy. Pay.
15. (2) Outpatient medical expenses that comply with regulations for termination of pregnancy or family planning surgery shall be paid by the maternity insurance fund at a rate of 50%.
16. (3) The prescribed maternity medical expenses incurred during hospitalization will be covered by the maternity insurance fund at the rate of 85% for primary medical institutions and 70% for secondary medical institutions. %, and tertiary medical institutions pay 55%.
17. (4) The maternity insurance fund’s payment limit for outpatient and inpatient maternity medical expenses incurred by an unemployed spouse shall be based on the corresponding corresponding levels of designated medical institutions of the same level in this city. Quota standards are implemented.
18. The medical management and sporadic reimbursement standards for maternity medical expenses for the unemployed spouse shall be implemented with reference to the relevant regulations of the insured person.
19. In addition, maternity insurance also requires payment of maternity allowance (that is, salary during maternity leave)
20. The calculation and disclosure is: the unit’s average monthly salary of employees in the previous year ÷ 30 × the prescribed number of vacation days.
3. Reimbursement scope and standards of maternity insurance in public institutions
Public institutions The reimbursement scope of the unit\’s maternity insurance includes prenatal examination fees, medical expenses during hospitalization and childbirth, and business allowances for female employees during maternity leave or wage subsidies for male employees during paternity leave. The scope is these. The reimbursement standards are based on the local maternity insurance policy and the payment level. There are differences in different regions. It is best to consult the local maternity insurance reimbursement department for standards
4. Maternal hospitalization expenses and birth reimbursement scope
Maternal hospitalization expenses and birth reimbursement scope vary according to the national and regional medical insurance systems. There is a difference. The following is an overview of general maternal hospitalization expenses and birth reimbursement scope:
Maternal hospitalization expenses usually include prenatal examination, delivery surgery expenses, hospitalization expenses, etc. Depending on local health insurance policies, some or all of the cost may be reimbursed. The specific reimbursement ratio and amount vary depending on national and regional medical insurance systems.
Birth expenses usually include newborn care, vaccinations, etc. according toDepending on your local health insurance policy, some or all of the costs may be reimbursed. The specific scope and amount of reimbursement vary depending on national and regional medical insurance systems.
In China, reimbursement of maternal hospitalization expenses and birth expenses mainly relies on social medical insurance, including basic medical insurance and critical illness insurance. In addition, some areas may also provide welfare policies such as maternity allowances. The scope and proportion of reimbursement vary depending on factors such as individual insurance type, payment years, region and level of medical institutions.
To know the specific maternal hospitalization expenses and birth reimbursement scope, please consult the medical insurance department or social insurance agency in your area. They will provide you with detailed reimbursement information based on your insurance type and specific circumstances.
5. Shenzhen Maternity Insurance Reimbursement Scope and Standards
1. Prenatal examination: A one-time payment of 2,000 yuan is required for providing the baby\’s birth certificate. The rest will be reviewed and reimbursed according to the prenatal examination items and fee standards stipulated by this city. The amount exceeding 2,000 yuan will not be paid;
4. Multiple births: Based on the corresponding delivery standards, an additional 1,000 yuan will be added for each additional birth. The cost of terminating pregnancy is based on the standards of corresponding family planning projects.
2. What is maternity insurance? Maternity insurance (maternity insurance) is legislation passed by the state, which is provided by the state and society when pregnant and childbirth female workers temporarily interrupt their labor. A social insurance system that provides medical services, maternity benefits and maternity leave. The state or society provides necessary economic compensation and medical care to employees who give birth. Maternity insurance benefits in my country mainly include two items. One is maternity allowance, and the other is maternity medical treatment.
6. 2023 Dongguan Social Security Maternity Insurance Reimbursement Scope
1. Maternity nutrition subsidy and perinatal health care subsidy. Female employees who have a maternity leave of more than 90 days (inclusive) can enjoy maternity nutrition subsidy and perinatal health subsidy of RMB 10,000.
2. One-time maternity subsidy. After the female employee who originally participated in maternity insurance in the unit loses her job, and while receiving unemployment insurance benefits, she gives birth in compliance with the family planning regulations. You can enjoy one-time maternity subsidy: RMB 1, RMB for normal birth, and RMB for multiple births. For male employees who participate in maternity insurance, their spouses are not included in the scope of maternity insurance., when you give birth to your first child in compliance with family planning regulations, you can enjoy a one-time maternity subsidy of 50%. and If a cesarean section is performed, the maternity allowance will be increased by half a month; if there are multiple births, the maternity allowance will be increased by half a month for each additional birth;
4. Those who give birth or induce labor more than 3 months (including 3 months) or less than 7 months will enjoy one and a half months of maternity subsidy; those within 3 months due to pathological reasons will enjoy one month of maternity subsidy. Maternity allowances are calculated based on the average monthly maternity insurance paid wages of female employees in the 12 months before childbirth or family planning surgery.
5. Maternity allowances are compensated to the unit, and the basic salary, bonus and welfare fees of insured female employees during their maternity leave will be paid by the unit as usual. Family planning surgery fees, including the costs incurred for placement (removal) of intrauterine devices, surgery, induction of labor, skin embedding surgery, sterilization and recanalization surgery due to family planning needs, are included in the scope of payment of the maternity insurance fund
The article ends here. If the issues shared this time about the scope of maternity insurance reimbursement and maternal hospitalization expenses and birth reimbursement have solved your problem, then we sincerely feel happy!
