Can maternity insurance be reimbursed for IVF, and can IVF be reimbursed for medical insurance

IVF is not eligible for reimbursement.

The cost of IVF generally cannot be reimbursed, and all the costs of assisted reproduction in China are not covered by medical insurance, and are generally borne by the patient, but the money from the medical insurance card can be used. However, some examinations and **, such as female hysteroscopy, etc., can be reimbursed by medical insurance if they are done in **, but cannot be reimbursed if they are done in the infertility department.

Legal basisArticle 23 of the Social Insurance Law of the People's Republic of China.

Employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

What is generally covered by medical insurance?

1. Medical insurance drug catalog: The drug catalog of medical insurance is generally divided into class A and class B. Class A drugs are all included in the scope of reimbursement, and then they are reimbursed according to the prescribed proportion, while Class B drugs need to pay a certain proportion of the individual first, and the remaining part is included in the scope of reimbursement and reimbursed according to a certain proportion.

Some drugs are not reimbursable, such as: ** drugs, infertility and other drugs;

2. Catalogue of diagnosis and treatment items: reimbursable diagnosis and treatment items that are necessary, safe, effective and appropriate in clinical diagnosis and treatment, and the price department has customized the charging standard. The rest of the items cannot be reimbursed, such as: ** fee, plastic surgery, dental beauty and other items cannot be reimbursed;

3. Directory of medical-related service facilities: generally provided by designated medical institutions, the insured will generally receive the necessary service facilities in the process of receiving diagnosis, ** and nursing.

IVF is not reimbursable for medical insurance. Assisted reproductive technology does not fall under the category of disease** and cannot be reimbursed through medical insurance and new rural cooperative medical care. If the family member has medical insurance, the expenses incurred when they are hospitalized can be partially reimbursed by the medical insurance.

The reimbursement scope of medical insurance refers to the scope of reimbursement of drug catalogs, diagnosis and treatment items and medical service facilities in order to ensure the basic medical needs of the insured and standardize the management of drugs, diagnosis and treatment and other aspects of basic medical insurance. The medical expenses incurred by the insured in the designated hospital in accordance with the three major catalogs shall be paid by the medical insurance** in accordance with the regulations. Urban medical reimbursement mainly refers to the hospital to see a doctor, medication, hospitalization, surgery, etc., can be reimbursed for medical expenses through the medical insurance card in accordance with the relevant regulations, urban medical insurance is more specific, the scale and coverage of the project is larger, but its compensation for major diseases or accidents is limited, at this time the author suggests that the insured can purchase a combination of commercial serious illness medical supplementary insurance and social security to reduce their economic losses.

Social Insurance Law of the People's Republic of China

Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit. The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.

Is there a time limit for medical reimbursement.

Different cities have different reimbursement time limits, for example, if the insured person in Shenzhen pays the medical expenses in advance, he or she should apply for reimbursement within 12 months from the date of occurrence or discharge of the expenses, and will not be reimbursed after the deadline. At present, China has not realized the national network of medical insurance, so if the employee medical insurance participant seeks medical treatment in another place, he must first pay the medical expenses, and then bring his ID card, social security card, hospitalization expense list and other information to the social security institution to go through the hospitalization expense reimbursement procedures. In order to ensure the safety of medical insurance**, various regions in China have imposed restrictions on the reimbursement time of medical insurance in different places.

The reimbursement time period varies depending on the actual situation in different places, but the basic period is 6 months to 1 year.

IVF medical insurance is not reimbursable.

At present, all the costs of infertility in China are not covered by medical insurance, and the cost of IVF also needs to be paid by yourself. However, you can use the money from your health insurance card and cannot reimburse the cost of hospitalization (if there is a hospitalization) because it is not a hospitalization for illness.

The cost of IVF includes the cost of drugs and surgery, and the cost of ovulation induction is high, and the external conditions required for egg fertilization and embryo development are high, so the cost of doing a "test tube baby" is also higher.

Therefore, if an infertile couple wants IVF, in addition to meeting the requirements of their own conditions, they must also consider their own economic strength. Due to the different dosage of drugs used by each patient, the cost of IVF varies for each case, and in general, young, ovarian reactive patients have a higher chance of success and require a slightly lower cost.

The cost of IVF is generally not reimbursable, because it is not covered by medical insurance, and it is generally paid by the baby's family; 1.If you have maternity insurance or medical insurance, you can be reimbursed proportionately during the hospitalization period for IVF. 2.

In another case, if there are three generations in the family, and there is a specialized hospital at or above the municipal level that certifies that IVF must be done, the Family Planning Commission or the unit where you work will give you a certain amount of economic compensation. 3.However, there are different economic policies according to different places, so when you want to do IVF, you should contact the relevant local departments to see if you can be reimbursed, which is likely to be generally not reimbursed.

This is not reimbursable, because the medical insurance will reimburse some major diseases, or pre-chronic diseases. You belong to fertility. This is not covered by medical insurance, and those with medical cosmetology are not covered by reimbursement.

At present, the first cost of infertility in China is not within the scope of medical insurance, and IVF is a self-paid item.

Social Insurance Act

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 the maternity insurance**. Maternity insurance benefits include maternity medical expenses and maternity allowances.

Social Insurance Act

Article 56.

Employees who have any of the following circumstances may enjoy maternity allowance in accordance with national regulations:

1) Female employees are entitled to maternity leave for childbirth;

2) Take leave for family planning surgery;

3) Other circumstances provided for by laws and regulations.

The maternity allowance shall be calculated and paid according to the average monthly wage of the employee in the previous year.

The maternity insurance benefits of the insured employees shall be paid by the personnel of the insured unit to the social security institution within three months to two years after the delivery (within half a year of miscarriage). Employees who gave birth before January 2009 should apply for reimbursement before June 23, 2018, and if they fail to apply within the time limit, they shall be paid by the employer. If a couple meets the provincial family planning regulations and has a spontaneous abortion after receiving the "Birth Service Certificate" and other relevant family planning certificates, they can enjoy maternity insurance benefits once in accordance with the relevant regulations, but male employees do not enjoy it.

When applying for maternity insurance benefits, the original and photocopies of the following materials should be submitted for review and retention by the maternity insurance agency: (1) When applying for maternity insurance benefits for female employees, they should provide: 1. Application form for maternity insurance benefits for employees of enterprises (in duplicate); 2. My ID card; 3. Maternity service certificate; 4. Baby's birth certificate; 5. Only child certificate (135 days of maternity leave required); 6. Marriage certificate; 7. Discharge summary; 8. Original invoices for medical expenses; 9. The hospital stamps the doctor's order; 10. The hospital stamps and summarizes the list of medical expenses; 11. Female employees who have miscarriage must bring the initial perinatal outpatient medical records and doctor's orders, a list of summarized medical expenses and a family planning certificate issued by the family planning department; (2) When applying for maternity insurance benefits for male employees, in addition to providing 1-7 materials required for applying for maternity insurance benefits for female employees, it is also necessary to provide:

1. ID cards of both men and women; 2. The woman's household registration book (if the woman's agricultural household registration is not specified in the household registration book, the certificate of the nature of the agricultural household registration issued by the police station or town where the household registration is located shall be provided); 3. If the spouse belongs to the urban household registration, the unemployment certificate shall be provided (if the unemployment certificate is valid beyond three months before and after the birth, it is necessary to go to the community where the household registration is located to issue an unemployment certificate during the birth period); If the spouse belongs to a rural household registration, he or she should provide a certificate of unemployment issued by the village committee. (3) In line with the two-child birth policy, when applying for the second-child birth insurance benefits, in addition to the above materials, it is also necessary to provide: 1. If both husband and wife are only children, provide the only child certificates of both parties; 2. If both husband and wife are rural household registration, provide the household registration book of both parties (if the household registration book does not have a clear agricultural household registration, it is necessary to provide the certificate of the nature of the agricultural household registration issued by the police station or town where the household registration is located); 3. In case of divorce and remarriage, the divorce certificate of the divorced party shall be provided.

4) Enterprises that go through the procedures for the payment of maternity insurance benefits shall, on the basis of providing the above-mentioned relevant application materials, also provide one original and one copy of the following materials: 1. The "Social Insurance Premium Declaration Form" and the "Social Insurance Premium Declaration Schedule" of the month in which the maternity benefits are reimbursed; 2. The "Tax Payment Book of the People's Republic of China" (work-related injury, maternity or pension) or the "Fujian Provincial Tax Treasury Horizontal Network Electronic Tax Payment (Fee) Voucher" or "Electronic Tax Payment Voucher" (work-related injury, maternity or pension) in the month of maternity treatment reimbursement; 3. Proof of payment of arrears of work-related injury and maternity insurance.

According to the law, if the employer has paid the maternity insurance premium, its employees are entitled to maternity insurance benefits; The unemployed spouse of the employee shall enjoy the treatment of maternity medical expenses in accordance with the provisions of the state. The required funds are paid out of maternity insurance**.

Social Insurance Law of the People's Republic of China

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 the maternity insurance fund.

Maternity insurance benefits include maternity medical expenses and maternity allowances.