How does maternity insurance reimburse miscarriage, and how does maternity insurance reimburse misca

If an employee terminates a pregnancy due to spontaneous abortion, fetal death, intrauterine or other diseases, he or she shall enjoy maternity allowance and reimbursement of prenatal examination and medical expenses for the same period in accordance with the provisions of the enterprise's employee maternity insurance; Other expenses that meet the provisions of basic medical insurance shall be paid by basic medical insurance**, and maternity insurance shall not be paid. (If it is ****, it will definitely not be reimbursed, and the abortion certificate should also indicate whether the cause of the miscarriage is a natural abortion or artificial intervention abortion, and the artificial abortion does not seem to be reported) "The prenatal examination fee limit from pregnancy to delivery has been adjusted from 1200 yuan to 1400 yuan, including: prenatal examination fees for the weekend of pregnancy 1 to 12:

520 yuan; Prenatal examination fee for weekends from 1 to 27 days of pregnancy: 850 yuan; Prenatal examination fee from the 13th to the 27th weekend of pregnancy: 330 yuan; Examination fee from the 13th week of pregnancy to the pre-delivery period:

880 yuan; Examination fee from the 28th week of pregnancy to before delivery: 550 yuan. (Look at the comparison between the time of spontaneous abortion and the reimbursement of prenatal examination expenses, provided that married women are suitable, and unmarried abortions are not reported) "Maternity leave time is calculated according to the number of natural days.

The maternity leave for a female employee who has a miscarriage of less than 12 weeks (inclusive) is 15 days; 30 days of maternity leave for miscarriage between 12 weeks and 16 weeks (inclusive); Maternity leave is 42 days for miscarriage between 16 weeks and 28 weeks inclusive. If the pregnancy is terminated at more than 28 weeks of pregnancy, she will enjoy 90 days of normal maternity leave, including 15 days of prenatal leave" (this is the maternity allowance after the miscarriage, with the employee's maternity insurance payment base 30 days * maternity leave days is her maternity allowance, and at the same time, when the maternity payment base is 30 days, two decimal places should be kept and multiplied by the number of maternity leave days is his maternity allowance, and this allowance application needs to fill in the birth form (1)!) ）

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As long as the cumulative payment is met for 12 months; If the conditions are met, it can be used, the original and copy of the medical charge bill (invoice), and the original and copy of the corresponding expense summary list, and the original and copy of the discharge summary (discharge record); Medical insurance card: You can settle the outpatient treatment with the medical insurance card.

How should maternity insurance be reimbursed?

1. Scope of acceptance.

Second, the unit operation steps.

3. Materials to be submitted by the unit.

How to reimburse maternity insurance for miscarriage? Can I insure maternity insurance for miscarriage?

Legal analysis: 1. Declaration and reimbursement:

The applicant should go to the maternity reimbursement window in the lobby of the local medical insurance office to apply for a pregnancy miscarriage insurance claim, including medical expenses, maternity allowances, family planning surgery fees and medical expenses for complications.

2. Audit qualification:

The handling agency shall review the relevant qualifications of the applicant, and pay attention to the fact that if the cost of fertility complications needs to be appraised, the expert will conduct the review after 30 working days.

3. Receiving compensation:

After the review is passed, the handling agency will issue a statement of settlement, and the applicant will take the employee's social security card to the bank to apply for compensation.

Legal basis: Article 54 of the Social Insurance Law of the People's Republic of China If an employer has paid maternity insurance premiums, its employees shall enjoy maternity insurance benefits; The unemployed spouse of an employee shall be entitled to maternity medical expenses in accordance with the provisions of the state. The required funds are paid out of maternity insurance**.

Maternity insurance benefits include maternity medical expenses and maternity allowances.

**Maternity Insurance Reimbursement Process:

1. Before the abortion of a female employee, the staff of the employer, the neighborhood or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office;

2. After the staff accepts and approves the application, the medical certificate will be issued;

3. Within 30 days of maternity leave, the employer or the staff of the labor security service station of the neighborhood or town shall bring the application materials to the maternity insurance window of the district social labor insurance office to handle the settlement of benefits;

4. After the staff accepts and approves the application, the maternity medical expenses and maternity allowance shall be paid.

What are the features of maternity insurance?

1. The objects of maternity insurance are mainly female employees, so the group of people who enjoy the treatment is relatively narrow. With the progress of society and economic development, some areas allow female employees to give their spouses a certain amount of leave to take care of their wives after giving birth, and pay them holiday wages; In other areas, financial benefits are provided to spouses of male workers.

Second, the conditions for enjoying treatment vary from country to country. Some countries require the beneficiary to have a record of participation, years of service, citizenship, etc. China's maternity insurance requires that the recipient must be legally married, that is, it must meet the legal age of marriage, go through legal formalities in accordance with the provisions of the Marriage Law, and comply with the national family planning policy.

3. Regardless of the outcome of the pregnancy, female employees may be compensated in accordance with the regulations. That is to say, regardless of whether the fetus is alive or not, the mother can enjoy the relevant benefits, and including miscarriage, induced labor, and accidents between the fetus and the mother, etc., can enjoy the maternity insurance treatment.

Fourth, the medical services during the childbirth period are mainly based on health care, consultation and examination, which are different from the medical services provided by medical insurance. Medical services during childbirth focus on guiding pregnant women to deal with the relationship between work and recuperation, health care and exercise, so that they can successfully pass the childbirth period. Antenatal check-ups, as well as midwifery and midwifery during childbirth, are medical means to help mothers give birth smoothly.

Childbirth is a natural phenomenon and does not require special conditions under normal circumstances**.

5. There are fixed requirements for maternity leave. Maternity leave should be arranged according to the childbearing period, divided into prenatal and postnatal leave. Prenatal leave cannot be used earlier or later.

Maternity leave must also be taken during childbirth and cannot be accumulated for other periods. The duration of maternity leave varies from country to country. The normal maternity leave stipulated in China is 90 days, of which 15 days are prenatal leave and 75 days are postnatal leave.

6. Maternity insurance benefits have a certain welfare color. The financial compensation during childbirth is higher than that of old-age and medical insurance. The maternity allowance provided by maternity insurance is generally the original salary level of female employees who give birth, which is also higher than that of other insurance items.

In addition, in China, individual employees do not pay maternity insurance premiums, but are paid by the insured units according to a certain proportion of their total wages.

1. After a female employee becomes pregnant, has a miscarriage or has a family planning operation, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office; 2. After the staff accepts and approves, the medical certificate will be issued; 3. Within 30 days of maternity leave, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office to handle the settlement of benefits; 4. After the staff accepts and approves the payment, the maternity medical expenses and maternity allowance shall be paid. Miscarriage leave: pretending to be pregnant for less than 2 months and 15 days; Pregnancy less than 4 months and 30 days; 42 days from more than 4 months (including 4 months) to less than 7 months; 75 days of stillbirth, stillbirth, and premature birth over 7 months of age.

Article 53 of the Law on Social Limb Insurance: Employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with national regulations, and employees shall not pay maternity insurance premiums.

1. After a female employee becomes pregnant, has a miscarriage or has a family planning operation, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office; 2. After the staff accepts and approves, the medical certificate will be issued; 3. Within 30 days of maternity leave, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office to handle the settlement of benefits; 4. After the staff accepts and approves the payment, the maternity medical expenses and maternity allowance shall be paid. Miscarriage leave: less than 2 months and 15 days of pregnancy; Pregnancy less than 4 months and 30 days; 42 days from more than 4 months (including 4 months) to less than 7 months; 75 days of stillbirth, stillbirth, and premature birth over 7 months of age.

The Chinese People's Social Insurance Law on Poor Travel and National Demolition

Article 53.

Employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with national regulations, and employees shall not pay maternity insurance premiums.

Social Insurance Law of the People's Republic of China

Article 54.

If the employer has already paid the maternity insurance premium, its employees are entitled to maternity insurance benefits;

The unemployed spouse of an employee shall be entitled to maternity medical expenses in accordance with the provisions of the state. The required funds are paid out of maternity insurance**. Maternity insurance benefits include maternity medical expenses and maternity allowances.

1. After a female employee becomes pregnant, has a miscarriage or has a family planning operation, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office to make a quick declaration. After the results are reviewed, a medical certificate will be issued if the conditions are met.

2. If a female employee has a miscarriage, after the abortion leave, the employer or the staff of the labor security service station of the street or town shall bring the application materials to the maternity insurance window of the labor insurance department of the district community and the Huzhihui to handle the settlement of benefits.

3. After acceptance and approval, Songyuan will pay maternity medical expenses and maternity allowance.

In addition, the required declaration materials include: medical expense declaration; ID card or social security card; Medical records; Original production charges; Itemized Expenses; Wait a minute.

1. After a female employee becomes pregnant, has a miscarriage or has a family planning operation, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office; 2. After the staff accepts and approves, the medical certificate will be issued; 3. Within 30 days of maternity leave, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office to handle the settlement of benefits; 4. After the staff is approved by the staff, they will pay the maternity medical expenses and maternity allowance. Miscarriage leave: less than 2 months and 15 days of pregnancy; Pregnancy less than 4 months and 30 days; 42 days from more than 4 months (including 4 months) to less than 7 months; Stillbirth, stillbirth, and premature birth over 7 months of age will not survive for 75 days.

Article 55 of the Social Insurance Law.

Maternity medical expenses include the following:

1) Medical expenses for childbirth;

2) Medical expenses for family planning;

3) Other project expenses as provided for by laws and regulations.

1. After the woman and the employee become pregnant, have a miscarriage or family planning operation, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office; 2. After the staff accepts and approves, the medical certificate will be issued; 3. Within 30 days of maternity leave, the employer or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance office to handle the settlement of benefits; 4. After the staff accepts and approves the payment, the maternity medical expenses and maternity allowance shall be paid. Miscarriage leave: less than 2 months and 15 days of pregnancy; Pregnancy is less than 4 months and 30 days of skin leakage; 42 days from more than 4 months (including 4 months) to less than 7 months; 75 days of stillbirth, stillbirth, and premature birth over 7 months of age.