Maternity insurance is a social insurance system through which the state and society provide medical services, maternity benefits and maternity leave when pregnant and childbirth female workers temporarily interrupt their work. The state or society provides A social insurance system that 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. The Ministry of Human Resources and Social Security's "Maternity Insurance Measures (Draft for Solicitation of Comments)" will be open to the public to solicit opinions from November 20, 2012. The opinion draft makes it clear that maternity insurance benefits will no longer be limited to household registration, and units that do not pay maternity insurance will have to pay maternity fees.
1. Reimbursement objects
Insured female employees
Starting from the month after the first batch of insured employees of the insured unit have paid their premiums or the new insured employees have continued to pay their premiums. After one year, you can enjoy maternity insurance medical treatment and maternity subsidy; if the newly insured person has paid continuously for less than one year, you can only enjoy maternity insurance medical treatment (but not maternity subsidy) from the month after the payment.
The spouse of an insured male employee
The spouse of an insured male employee gave birth to his first child, and his spouse did not participate in employment. (It turns out that it is also useful for male employees to participate in maternity insurance!)
Additional explanation: If you want to enjoy maternity insurance, you must apply for "Maternity Insurance Benefit Registration" before giving birth, and you must apply for "Maternity Insurance Benefit Registration" after giving birth. Apply "Oh!
2. Registration of maternity insurance benefits
Processing materials:
1) Wuhu Urban Employees Maternity Insurance Benefit Registration Form (in duplicate), original social security card and photocopy, original and photocopy of reproductive health service certificate. (Please use A4 paper for copies, the same below).
2) If the applicant is the unemployed spouse of a male employee, he/she must also provide: (1) The original and copy of the spouse’s ID card; (2) The original and copy of the spouse’s household registration book; (3) Documents proving that the spouse is not employed : ① If the household registration and place of residence are both in this city, there is no need to provide proof of unemployment, and the handling agency will directly check the insurance information records for confirmation; ② If one of the household registration or residence is not in this city, and the household registration and residence If you are not in this city, you need to provide proof of recent uninsured information in other places (if your household registration and residence are in the same place, only one copy is required).
Application location:
Local social insurance agency (usually handled by the employer!)
3. Application for maternity insurance benefits
Processing materials:
Application form for maternity insurance benefits for urban employees in Wuhu City (in duplicate), original invoice, original and copy of discharge summary, original and copy of expense list, original and copy of birth medical certificate and a copy.
If the applicant is an insured male employee, and his spouse is working but not insured, he or she must provide proof of whether the employer will pay maternity leave wages during the maternity leave period.
Application location:
Local social insurance agency (usually handled by the employer!)
Application time:
The application for maternity insurance benefits must be made within 180 days after the mother gives birth, and the application will not be processed after the deadline.
Issuance method:
One-time transfer to the bank account of the employee’s social security card
Supplementary instructions: Participants must activate the social security card banking function. To avoid delaying the payment of benefits. Non-local social security card holders, in addition to going through the activation procedures, also need to go to window 31 of the social security hall to go through the related financial account procedures.
4. Maternity insurance benefits
Insured female employees
Maternity insurance benefits for insured female employees include maternity medical expense subsidies, maternity allowances, and family planning surgeries Medical fee subsidy, medical expenses for complications and complications during delivery.
Subsidy for maternity medical expenses
1) For those who give birth more than 7 months of pregnancy or have premature births less than 7 months (inclusive), the subsidy for maternity medical expenses is 1,500 yuan; of which The subsidy for caesarean section is 3,000 yuan;
2) If the pregnancy is more than 4 months and less than 7 months (including 7 months), the subsidy for abortion or induced labor is 400 yuan;
3) For miscarriages under 4 months of pregnancy (including 4 months), the subsidy for maternity medical expenses is 200 yuan.
Maternity allowance
The average monthly salary of employees in the employer in the previous year ÷ 30 × the number of maternity leave days
The number of maternity leave days for normal birth is 158 days, and the number of maternity leave days for caesarean section is 173 days days
Medical subsidy for family planning surgery
1) A subsidy of 100 yuan for inserting (removing) an intrauterine device;
2) Sterilization surgery (included in concurrent The patient will not be paid separately) 100 yuan subsidy;
3) 1,500 yuan subsidy for recanalization surgery.
Medical expenses for complications and complications during childbirth
If the hospital where the child is given is a designated hospital for basic medical insurance in our city, and the medical expenses are in compliance, after deducting the maternity medical subsidy , paid at a rate of 80%, and the individual bears 20%. Non-designated hospitals pay 70%, and individuals bear 30%.
Insured male employees
The maternity insurance benefits enjoyed by the spouses of insured male employees are different from those of female employees, including: maternity medical expense subsidies, maternity allowance subsidies, and maternity combined benefits Symptoms and complications subsidies.
Subsidy for maternity medical expenses
The subsidy for normal delivery is 1,500 yuan, of which the standard subsidy for caesarean section is 3,000 yuan.
Medical expenses for complications and complications during childbirth
The hospital where the baby is given is a designated hospital for my basic medical insurance, and the hospital fees are in compliance with the regulations. After deducting the medical subsidy of the maternity insurance , paid at a rate of 50%, and the individual bears 50%. Non-designated hospitals pay 40%, and individuals bear 60%. ;