How to reimburse maternity insurance? How much is the reimbursement?

(1) After a female worker is pregnant, before abortion or family planning operation, the employing unit 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 agency for handling; (2) After the staff accepts the examination and approval, they will issue medical certificates; (3) Within 30 days of maternity leave, the employing unit 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 agency for treatment settlement; (4) After the staff accepts the examination and approval, they will pay maternity medical expenses and maternity allowance. [Edit this paragraph] Insurance benefits, maternity allowance, maternity medical expenses, family planning operation expenses and other expenses stipulated by the state and this Municipality; (1) Maternity allowance: Maternity allowance is the salary of female employees during maternity leave. If the maternity allowance is lower than my salary standard, the difference will be made up by the enterprise. Maternity allowance is calculated according to the payment base of the month when female employees give birth divided by 30 and multiplied by the number of days of maternity leave. (2) Employees who have participated in maternity insurance for a total of 1 year are still insured when they give birth (abortion) and enjoy maternity insurance benefits according to relevant regulations. (3) Maternity insurance benefits: the payment standard of maternity allowance is based on the average paid salary of the unit in the month of childbirth (abortion), and calculated according to the prescribed holidays: maternity allowance (per capita paid salary of the unit in the month /30 days x holiday days) Holiday days: ① Normal maternity leave is 90 days (including prenatal examination 15 days); ② The one-child leave is increased by 35 days; (3) The maternity leave for late childbirth is increased by 15 days; 4 maternity leave is difficult. Caesarean section and third degree rupture of perineum increased by 30 days; Suction delivery, forceps delivery and breech delivery increased 15 days; ⑤ The maternity leave of multiple births is increased by 15 days for each additional baby; ⑥ Abortion leave: less than 2 months pregnant 15 days; Less than 4 months and 30 days pregnant; 4 months or more (including 4 months) to 7 months is 42 days; In case of stillbirth, stillbirth or premature delivery for more than 7 months, the survival time is less than 75 days; One-time delivery nutrition subsidy ① Normal delivery, abortion for more than 7 months; Last year, the average monthly salary of employees in the city was × 25%; ② dystocia and multiple births: the average monthly salary of employees in the previous year was × 50%. Male spouses of male employees who receive the one-child preferential card enjoy 10 days holiday, and the holiday will be paid according to the unified salary paid by the unit in the month when the child was born. Male spouse's holiday salary = unified salary paid by the unit in the current month ÷ 30 (days) × 10 (days). Note: the processing time of maternity insurance allowance is: within five months after giving birth to a child, the unit where the female employee and the male spouse work shall apply for maternity insurance benefits respectively. Maternity medical expenses After the maternity medical treatment is confirmed, the medical expenses shall be settled by the Municipal Labor and Social Security Bureau and the hospital (the part exceeding 6,543,800 yuan shall be settled according to the approved number). Maternity insurance = maternity allowance+Medicaid allowance: based on the average monthly salary of employees of the employer, normal childbirth lasts for 3 months (90 days), late childbirth lasts for 3.5 months (105 days), and those who have given birth and have received the one-child certificate will be counted and paid in 4. 17 months. For those who have given birth late and have received the One-Child Certificate, the medical subsidy will be paid for 4.67 months (140 days): based on the average monthly salary of enterprise employees in the last year in the Special Zone, it will be paid for normal childbirth for 2 months, and for caesarean section or multiple births for 4 months. [Edit this paragraph] Main features (1) The object of maternity insurance is mainly female employees, so the people who enjoy the treatment are relatively narrow. With the social progress and economic development, some areas allow spouses to take certain holidays to take care of their wives and pay holiday wages after female employees give birth; In some areas, financial assistance is provided to spouses of male employees. (2) The conditions for enjoying treatment vary from country to country. Some countries require beneficiaries to have insurance records, working years, nationality and other requirements. China's maternity insurance requires beneficiaries to get married legally, that is, to reach the legal age for marriage and go through legal procedures according to the marriage law, which is in line with the national family planning policy. (3) No matter what the pregnancy outcome of female employees is, they can get compensation according to regulations. In other words, regardless of whether the fetus is alive or not, pregnant women can enjoy relevant benefits, including abortion, induced labor and accidents between the fetus and pregnant women, and can enjoy maternity insurance benefits. (4) Health care, consultation and examination are the main medical services during delivery, which are different from those provided by medical insurance. Medical service during delivery focuses on guiding pregnant women to handle the relationship between work and self-cultivation, health care and exercise, so that they can successfully pass the childbearing age. Prenatal check-up, delivery and midwifery during delivery are to help the parturient give birth smoothly through medical means. Childbirth is a natural phenomenon and does not need special treatment under normal circumstances. (5) There are fixed requirements for maternity leave. Maternity leave should be arranged according to the growth period and divided into prenatal and postpartum. Prenatal leave cannot be used in advance or postponed. Maternity leave must also be enjoyed during childbirth and cannot be accumulated at other times. The duration of maternity leave varies from country to country. The normal maternity leave in China is 90 days, including prenatal leave 15 days and postpartum leave of 75 days. (6) Maternity insurance benefits have a certain welfare color. Economic compensation during childbirth is higher than pension and medical insurance. The maternity allowance provided by maternity insurance is generally the original salary level of maternity female workers, which is also higher than other insurance items. In addition, in China, individual employees do not pay maternity insurance premiums, and the insured units pay them according to a certain proportion of their total wages. [Edit this paragraph] The role of maternity insurance is to safeguard the basic rights and interests of female workers, reduce and solve the special difficulties caused by physiological characteristics of female workers during pregnancy, childbirth and abortion, so that they can obtain necessary economic income and medical care during childbirth and abortion, and ensure their timely recovery and return to work. Its main functions are as follows: First, the implementation of maternity insurance is the recognition of women's reproductive value. Women's childbearing is the need of social development. While carrying on the family line, they have also made efforts for the reproduction of social labor force and deserve social compensation. Therefore, protecting women's reproductive rights and interests is accepted by most countries and given policy support. At present, 135 countries in the world have passed legislation to protect women's legitimate rights and interests in childbirth. Second, the implementation of maternity insurance is the guarantee for the basic life of female workers. Female employees leave their jobs during childbirth and cannot work normally. The state has formulated relevant policies to ensure that they enjoy relevant treatment when they leave their jobs. These include maternity allowance, medical services and special protection policies when you can't stick to your normal work during pregnancy. It has created favorable conditions for pregnant women to give birth smoothly in terms of living security and health security. Third, the implementation of maternity insurance is the need to improve the quality of the population. Female reproductive energy consumption is high, which requires adequate rest and nutritional supplement. Maternity insurance provides them with a basic salary, so that their living standards will not be reduced because they leave their jobs. At the same time, provide them with medical services, including prenatal examination and perinatal health care guidance, to monitor the normal growth of the fetus. For women who are sick or exposed to toxic and harmful substances during pregnancy, necessary examinations are carried out. If a deformed child is found, the pregnancy can be terminated as soon as possible. For women with abnormal phenomena during pregnancy, focus on protection and treatment. In order to protect the normal growth of the fetus and improve the quality of the population. [Edit this paragraph] Other related maternity insurance laws 1986 The Ministry of Health, the Ministry of Labor and Personnel, the All-China Federation of Trade Unions and the All-China Women's Federation jointly issued the Interim Provisions on Health Care for Female Workers. This regulation was formulated on the basis of a six-year nationwide investigation and study, through scientific argumentation and referring to the laws and regulations of various countries, which played an important role in protecting the legitimate rights and interests of female workers. 1In July, 988, the State Council issued the Provisions on Labor Protection for Female Employees, which is applicable to female employees of all state organs, organizations, enterprises and institutions in China. Military system units can refer to the implementation. Its main content is to make detailed provisions on the employment, working hours, maternity leave, treatment, pregnancy protection and other benefits of female employees. 1994 12 The Trial Measures for Maternity Insurance for Enterprise Employees issued by the Ministry of Labor stipulates that these measures are applicable to urban enterprises and their employees. Maternity insurance is organized and implemented according to the principle of territoriality, and the cost of maternity insurance is co-ordinated by the society. [1] How to reimburse maternity insurance has four contents: First, maternity allowance; Second, maternity medical expenses; Three, family planning surgery medical expenses; Four, other expenses stipulated by the state and the city. Maternity insurance and medical insurance * * * use the blue Beijing Medical Insurance Manual instead of a single maternity insurance manual, and the settlement process is completely in accordance with the medical insurance process. The calculation method of maternity allowance for female employees is to divide the payment base by 30 and multiply it by the number of days of maternity leave. If the maternity allowance is lower than my salary standard, the difference will be made up by the enterprise. The normal maternity leave for female employees is 90 days; The number of dystocia increased 15 days, multiple births increased 1 baby increased 15 days, and late childbirth increased by 30 days. Maternity leave is 15 to 30 days for female employees who are less than 4 months pregnant and have an abortion, and 42 days for female employees who are more than 4 months pregnant. The income of female employees is 3,000 yuan, and the maternity allowance is 100 yuan per day. Normal maternity leave can be subsidized for 90 days, and twins can be 105 days. What if the expenses before and after production exceed the reimbursement expenses? When overspending, it is necessary to sign an agreement with the hospital if the hospitalization quota is exceeded. According to the regulations, except for the baby fee and the bed fee that exceeds the payment standard, medical institutions shall not charge the insured employees extra fees other than the fixed payment items. When the insured workers require other medical services or medicines, the medical institution shall sign a self-funded agreement with the workers. The maternity expenses of non-Beijing employees are paid by medical insurance, and the maternity benefits of non-local registered employees can be solved by medical insurance. Director Zhang introduced that the medical expenses for the implementation of family planning surgery are paid by the basic medical insurance fund according to regulations, and those who have not participated in the basic medical insurance are paid by the employer. Its maternity leave benefits shall be implemented in accordance with the relevant provisions of the state, and maternity leave wages shall be implemented in accordance with the relevant provisions of the Regulations of Beijing Municipality on Wage Payment. Maternity insurance can be reimbursed up to 4000 yuan. Maternity insurance is different from medical insurance. Because maternity insurance only benefits working female employees, many unqualified people have to rely on medical insurance to report maternity expenses. Therefore, the diagnosis and treatment items and drug list of maternity insurance are consistent with medical insurance. However, the maternity insurance payment can be as low as 1900 yuan, and the inspection fee is reimbursed, and the maternity insurance is as high as 4,000 yuan; The medical insurance deductible line is 3,000 yuan, and the maximum payment is 70,000 yuan.