First, the proportion of maternity insurance reimbursement:
Maternity insurance reimbursement ratio: based on the average monthly salary of employees in the previous year, it will be paid in one lump sum according to a certain proportion. These include:
1. The natural delivery rate was 270%.
2. The dystocia rate is 320%.
3. Cesarean section is 420%.
The examination fee, delivery fee, operation fee, hospitalization fee and medicine fee for the birth of female employees shall be paid by the maternity insurance fund. The medical service fee and medicine fee exceeding the prescribed amount shall be borne by the employees themselves.
After the female workers are discharged from the hospital, the medical expenses for diseases caused by childbirth shall be paid by the maternity insurance fund; The medical expenses of other diseases shall be handled in accordance with the provisions of medical insurance benefits.
After the expiration of maternity leave, if a female employee needs rest and treatment due to illness, it shall be handled in accordance with the relevant provisions on sick leave and medical insurance benefits.
Second, how much can maternity insurance be reimbursed?
1. Maternity insurance benefits: maternity insurance benefits include insured employees and unemployed spouses of insured employees.
2, the content of maternity insurance benefits
Maternity medical expenses include examination fees, delivery fees, operation fees, hospitalization fees, medicine fees and family planning operation fees for female employees due to pregnancy and childbirth.
Maternity allowance refers to the living expenses paid to professional women during their separation due to childbirth according to the provisions of national laws and regulations. In areas where social pooling of maternity insurance is implemented, the maternity insurance fund is paid according to the standard of the average monthly salary of employees in the previous year, and the payment period is generally consistent with the maternity leave period, not less than 90 days.
3. What are the basic benefits of maternity insurance?
1 maternity leave
Refers to the paid vacation enjoyed by professional women for a certain period of time before and after delivery. Its purpose is to maintain, restore and improve the physical health, working ability and personal life management ability of protected pregnant women, and to enable babies to be carefully cared for and nurtured by their mothers. According to the requirements of maternity protection convention No.3 19 19, maternity leave should be at least 12 weeks. 1952 recommendation no 95 on maternity protection also proposes that maternity leave should be extended to 14 weeks. Convention 1996/ 1997 in 2000. 183 revised 1952, stipulating that maternity leave should not be less than 14 weeks. At present, most countries have adopted the recommendations of the International Labour Organization. In recent years, with the development of economy and the emphasis on maternal and child health care, the maternity leave regulations in some countries have a tendency to be extended.
2. Maternity allowance
It means that professional women leave their jobs because of childbirth, and their income is interrupted because they no longer engage in paid work, and they are given regular cash subsidies in time to safeguard and guarantee the normal life of women and babies. 19 19 Maternity Protection Convention 13 established the international general standard of maternity allowance for the first time. 1952 when revising the convention, it was made clear that the allowance standard should not be less than two-thirds of women's past income. Proposal No.95 on maternity protection (1952) and proposal No.95 19 1 amendment on maternity protection (1952) both proposed that maternity allowance should be equal to the woman's total income before giving birth.
Maternity allowance is generally paid according to a certain proportion of income. Countries generally adopt more favorable policies when formulating maternity allowance standards, and many countries stipulate that it is equivalent to 100% of the original salary of female employees before childbirth. Some countries or regions stipulate not less than half of the original salary.
3. Medical services
Refers to the medical care and necessary hospitalization for professional women during pregnancy, childbirth and postpartum. After pregnancy, various systems in women's bodies have changed, and the burden on major organs has increased. Regular physical examination of pregnant women and provision of a series of medical services from pregnancy to delivery are of great significance for ensuring the health of women and babies and improving the quality of the population. The medical services provided by maternity insurance for pregnant women in various countries are generally based on their own economic strength and the affordability of insurance funds. Most countries provide medical care and treatment for female workers from pregnancy to postpartum.
Legal basis:
People's Republic of China (PRC) social insurance law
Fifty-third employees should participate in maternity insurance, the employer should pay maternity insurance premiums in accordance with state regulations, and employees do not pay maternity insurance premiums.
Fifty-fourth employers have paid maternity insurance premiums, and their employees enjoy maternity insurance benefits; Unemployed spouses of employees enjoy maternity medical expenses in accordance with state regulations. The required funds are paid from the maternity insurance fund.
Maternity insurance benefits include maternity medical expenses and maternity allowance.
Fifty-fifth maternity medical expenses include the following:
(1) Maternity medical expenses;
(two) family planning medical expenses;
(3) Other project expenses stipulated by laws and regulations.