Scope of maternity insurance, scope of maternity insurance

The maternity medical expenses stipulated in the maternity insurance include the medical examination fees, midwifery fees, surgery fees, hospitalization fees and drug expenses incurred by female employees due to pregnancy and childbirth.

Maternity insurance is a social insurance system in which the state provides medical services, maternity allowance and maternity leave by the state and society when pregnant and pregnant women workers temporarily interrupt their work, and the state or society provides necessary economic compensation and medical care to employees who give birth.

Maternity Insurance Reimbursement Coverage:

1) Maternity medical treatment.

Payment items. 1) The medical expenses incurred by employees due to the implementation of family planning surgery to insert (remove) intrauterine device, abortion, induction of labor, sterilization and reversal surgery after sterilization, etc., shall be paid by maternity insurance** if they meet the scope of maternity insurance**.

2) During the period of pregnancy and childbirth, if the diagnosis fee, examination fee, examination fee, examination fee, midwifery fee, operation fee, hospitalization fee and drug fee incurred by the female employee during the pregnancy and childbirth period meet the scope of maternity insurance, the maternity insurance shall pay for it.

2) Maternity allowance.

1. Calculation and issuance standards.

Female employees who give birth within a plan or have a planned pregnancy or have a miscarriage or induced abortion are entitled to maternity allowance in accordance with regulations, and the social insurance agency shall pay it in accordance with regulations, and the unit salary (referring to the base item of the paid wages) shall be suspended during the period when the employee is entitled to the maternity allowance. The maternity allowance is divided by 30 by the monthly salary base of the individual's individual contribution to maternity insurance in the current year (or previous month) as the maternity allowance that should be calculated and paid on one day, and is calculated and paid in a lump sum according to the corresponding number of days.

1) 90 days for normal childbirth and 60 days for late childbirth; an increase of 15 days in dystocia; In the case of multiple births, 15 days will be added for each additional birth;

2) If the pregnancy is more than 4 months old or the labor is induced or stillborn, it is 42 days; In the case of miscarriage under 4 months of pregnancy, it is 15 to 30 days.

2. Payment (application) method.

1) Maternity allowance is socialized.

2) Insured employees shall, in the following month after giving birth, or having an abortion or inducing a child, apply for maternity allowance at the social insurance agency with the "one card, one certificate, one book" or birth certificate, written resident ID card of the principal and proof of suspension of wages by the unit (if a female employee plans to have an abortion or induce labor, she shall also hold the "Certificate of Family Planning Surgery for Urban Employees" issued by the unit) and other materials, according to the social insurance work management authority.

3) The social insurance agency shall make a deposit receipt for the maternity allowance within 7 days from the date of application for the maternity allowance by the insured employee. Among them, the employees of enterprises and units shall be paid by the social labor insurance agencies, and the employees of government institutions and institutions shall be paid by the social insurance agencies of government institutions and institutions.

I remember two or three times ago with such a question, and it seems that it has reached the peak of fertility again. First of all, I don't know where you live, maternity insurance varies slightly from place to place, but the general direction is the same, as long as the child you give birth to is a planned birth, or in the vernacular"There are indicators"Then you can enjoy maternity insurance benefits. This is a matter of policy.

See below for details: Article 13 (Conditions for applying for allowances and subsidies) Women who apply for maternity living allowance and maternity medical expense subsidy must meet the following conditions at the same time: (1) Have an urban household registration in this city; (B) to participate in the city's urban social insurance; **3) It is a planned birth; (Note this article) (4) Giving birth or abortion (including spontaneous abortion and induced abortion) in a medical institution that has set up an obstetric department or ** in accordance with regulations.

Article 14: (Period of Maternity Living Allowance) Women who give birth in accordance with the provisions of Article 13 of these Measures are entitled to maternity subsistence allowance for the following periods: (1) If they give birth after 7 months (including 7 months) of pregnancy, they shall enjoy maternity subsistence allowance for 3 months; (2) If the pregnancy is less than 7 months and is born prematurely, the maternity living allowance shall be enjoyed at the rate of 3 months; (3) If the pregnancy is more than 3 months (including 3 months) but less than 7 months of miscarriage, the maternity living allowance shall be enjoyed for one and a half months; (4) If the pregnancy is less than 3 months old or the pregnancy is less than 3 months old, or the uterine pregnancy suffers, the maternity living allowance shall be enjoyed on the basis of 1 month. Women who are entitled to maternity subsistence allowance in accordance with the provisions of items (1) and (2) of the preceding paragraph may also enjoy maternity subsistence allowance in accordance with the following provisions:

1) In case of dystocia, the maternity living allowance of half a month shall be increased; (2) Where the conditions for late childbearing are met, the maternity living allowance shall be increased by one month; (3) In the case of multiple births, half a month's maternity living allowance shall be increased for each additional child. I hope mine can help you and good luck! Don't forget to give me a good review, hehe!

Maternity insurance is a social policy in which the state provides economic and material assistance to workers who give birth through social insurance legislation. This reflects the support and love given by the state and society to women in this special period. Maternity insurance is social security.

There are many benefits that can be enjoyed by maternity insurance, but it is also necessary for the important positions of the Dongshi Bank to meet the corresponding conditions and meet certain needs in order to enjoy the maternity insurance benefits. Let's learn more about maternity insurance.

Scope of maternity insurance.

Urban enterprises and their employees.

State organs, people's organizations, public institutions, and their staffs.

Application process. 1. Application materials:

1) Medical and maternity insurance legal handbook "Social Insurance Registration Form";

2) Table of Increases and Decreases of Persons Participating in Basic Pension, Work-related Injury and Maternity Insurance;

3) Summary Form of Declaration of Basic Pension, Work-related Injury and Maternity Insurance for Employees of Enterprises;

2. Handling procedures:

1) The employer shall report to the business hall of the Social Labor Insurance Department with the application materials;

2) The staff accepts the application materials, and after approval, stamps and returns a summary table and an increase or decrease table;

3) The employer shall pay the fee at the local local taxation department in the following month;

The requirements of the state for female employees who enjoy maternity insurance benefits are:

1) Conform to the national family planning policy or carry out family planning surgery;

2) The employer participates in maternity insurance in accordance with the regulations and pays the full amount of the employee continuously for more than one year. "Paying in full for more than one year" means that the employee has paid the maternity insurance premiums in full for more than one year before giving birth.

Conditions for declaration of insurance benefits:

1) Employees of enterprises whose units at the time of childbirth or family planning surgery have participated in and fulfilled their payment obligations in accordance with the regulations, and have paid maternity insurance premiums for them for a total of 3 months.

2) Employees who give birth or perform family planning surgery in line with the national family planning policy.

3) The above conditions must be met at the same time.

In order to maintain the safety of maternity insurance, maternity insurance stipulates that 9 consecutive months of contributions are required to receive maternity allowance to avoid selective insurance. In order to ensure that female employees can reasonably enjoy the benefits of maternity allowance, maternity insurance also determines the principle of supplementary benefits: if the insured employee has paid for less than 9 consecutive months before childbirth, and has paid for 12 consecutive months after the month of childbirth, the employee's maternity allowance will be supplemented by the maternity insurance**.

The standard of supplementary payment is the average monthly salary of the employee of the employer divided by 30 days and multiplied by the number of days of maternity leave in the month in which the employee declares to receive the allowance.

How do I receive my maternity insurance premium?

After a female employee gives birth or has a miscarriage, she or her enterprise shall go through the formalities at the local social insurance agency with the family planning certificate issued by the local family planning department and the certificate of birth, death or miscarriage of the baby, and receive the maternity allowance and reimbursement of maternity medical expenses.

Maternity insurance coverage: Employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with national regulations, and employees who laugh at scumbags shall not pay maternity insurance premiums. To put it simply, the scope of maternity insurance is for employees of enterprises, regardless of gender, regardless of age.

Article 54 of the Social Insurance Law stipulates that 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 state regulations. The required funds are paid out of maternity insurance**. Maternity insurance benefits include maternity medical expenses and maternity allowances.

Scope of maternity insurance: 1. Maternity leave wages and maternity medical expenses for female employees who give birth. 2. Maternity social insurance, including maternity allowance and maternity medical expenses.

3. After giving birth or having a miscarriage, the maternity allowance and maternity medical expenses of the female employees of the insured units shall be paid. Article 54 of the Social Insurance Law If an employer has already paid the insurance premium for the birth of the employee, the employee shall enjoy the benefits of the maternity insurance; The unemployed spouse of an employee shall be entitled to maternity medical expenses in accordance with state regulations. The required funds are paid out of maternity insurance**.

Maternity insurance benefits include maternity medical expenses and maternity rotation allowance.