Maternity insurance: the proportion is 0.8% or 3%, all of which shall be borne by the unit. Only employees who have paid for more than one year can enjoy it. Men can be reimbursed for birth control surgery or vasectomy, while women can be reimbursed for pregnancy check-up, delivery surgery and breastfeeding subsidies.
Question 2: What is maternity insurance?
Maternity insurance is a social insurance system stipulated by national legislation, which provides timely material assistance by the state and society when the labor force is temporarily interrupted due to maternity.
Maternity insurance benefits in China mainly include two items. First, maternity allowance is used to protect the basic needs of female employees during maternity leave; The second is maternity medical care, which is used to ensure the basic medical care needs of female employees during pregnancy, childbirth and birth control surgery.
The legal basis of maternity insurance is:1People's Republic of China (PRC) Labor Law promulgated on July 5, 1994; Trial Measures for Maternity Insurance for Enterprise Employees (No.[1994]504 issued by the former Ministry of Labor in February/April). Relevant regulations include: 2 1, Provisions on Labor Protection of Female Workers promulgated in July, 65438 (the State Council Decree No.9); The former Ministry of Labor 1988 issued the Notice on Several Issues Concerning the Maternity Treatment of Female Workers (Lao Xian Zi [1988] No.2).
How do the insured seek medical treatment?
The insured person should first establish a "Handbook of Pregnant Women's Health Care" in the medical and health care institutions or maternal and child health care institutions designated by the health administrative department. Early and mid-term prenatal examination should be carried out in designated medical institutions of maternity insurance (including medical and health institutions designated by health administrative departments or maternal and child health care institutions that have obtained designated medical services of maternity insurance). If the insured has late prenatal examination and delivery, he shall choose a medical institution as the designated medical institution for late prenatal examination and delivery in the designated medical institution of maternity insurance; Abortion, induced labor and family planning operations shall be carried out in the designated medical (service) institutions of maternity insurance, as the designated medical (service) institutions for abortion, induced labor and family planning operations. Once the medical institutions for prenatal examination, delivery, medical treatment or abortion, induced labor and family planning operations are selected, they will not be changed in principle.
How to enjoy maternity medical expenses subsidies?
Medical expenses incurred during pregnancy and childbirth examination, prenatal examination, delivery, abortion or family planning operation in designated medical (service) institutions shall be paid by individuals first, and after medical termination or delivery, the designated medical (service) institutions shall offset the medical expenses paid by the insured in line with the maternity insurance fund in accordance with the subsidy standards stipulated in these rules.
Due to serious complications, complications and transferred to hospital for treatment or childbirth, the medical expenses incurred in the designated medical (service) institutions that I originally met with the maternity insurance fund shall be paid by the individual first. The maternity medical subsidies that should be enjoyed shall be offset by the newly transferred designated medical (service) institutions according to the subsidy standard stipulated in the Detailed Rules after the insured person ends medical treatment or gives birth.
Medical expenses for delivery, abortion, induced labor, family planning operation or delivery in designated medical (service) institutions other than my choice due to emergency shall be paid in advance by the individual, and after medical termination or delivery, the employer shall apply to the municipal basic medical insurance management center for maternity medical expenses subsidy within the specified time.
What about the allowance?
Insured persons applying for maternity living allowance and maternity medical expenses allowance shall apply to the municipal basic medical insurance management center for formalities within 3 months after delivery, abortion, induced labor and family planning operation (station) are discharged from hospital.
City basic medical insurance management center to review the conditions for the insured to enjoy maternity living subsidies and maternity medical expenses subsidies. For those who meet the conditions, the time limit and standards for their enjoyment shall be approved, and the maternity living allowance and maternity medical expenses subsidy shall be allocated to the employer in one lump sum, and then the employer shall issue them to the insured persons for childbirth, abortion, induced labor and family planning operations according to the standards; Do not meet the conditions, it shall be informed in writing.
Question 3: What does maternity insurance mean?
Maternity insurance refers to the social insurance provided to protect the rights and interests of female workers who give birth. Generally, only female employees who have been insured for more than one year can enjoy this insurance when they give birth. The scope of reimbursement (including childbirth, abortion, dystocia, etc.). ) is generally the hospitalization expenses during the production period, including a certain proportion of surgery expenses. If both husband and wife have maternity insurance, only female employees can apply for reimbursement; If only the man is insured for maternity insurance, the woman generally has to provide unemployment certificates and other materials before she can apply for reimbursement to the man's unit. Maternity insurance is a welfare social pooling insurance, which individuals do not need to pay, and enterprises pay according to the number and proportion of employees in accordance with local policies. The reimbursement rate varies from place to place. Maternity insurance is a local social insurance, and each place has different detailed regulations. It is recommended to consult the local labor and social security bureau.
Question 4: What is the use of maternity insurance for men?
Hello this friend, I want to give you the simplest and clearest explanation:
1. The object of payment should be all members of the company. It's not just lesbians who pay.
Because maternity insurance is a kind of social insurance, which is compulsory by the state, every qualified employee in your company must pay it, which means it is not just a summary of the number of female employees in the company.
2. The function of this kind of insurance
In fact, it is to help the company and society share some, mainly serving all the female employees of the company. This will enter the whole society,
Giving birth as a woman is a great and hard thing, so as men, we should make due contributions to it. This is not generosity, but sincerity and understanding!
I hope my answer can help you understand!
Question 5: What is maternity insurance?
Among the five risks, one is indispensable; The contribution rate is 0.8%, which shall be borne by the unit; Stop payment after evacuation.
In practice, female workers (although male workers also pay fees, but rarely undergo ligation) can enjoy certain (special) reimbursement expenses in hospitals (designated by medical insurance) for family planning (including Sheung Wan); In addition, social security also provides a certain standard maternity allowance for female employees on maternity leave. . .
Question 6: What can maternity insurance do?
Maternity insurance is generally paid by the unit, and individuals do not pay maternity insurance premiums. The main guarantee of maternity insurance:
1. Medical expenses, one-time nutrition allowance and maternity allowance for female workers' outpatient prenatal examination, delivery, birth complications, family planning operation (including male workers themselves).
2. If the spouse of the insured male worker is unemployed, the medical expenses incurred by the outpatient prenatal examination, delivery and abortion operation.
3. After the insured female workers are unemployed, the maternity insurance benefits during the period of receiving unemployment benefits (subject to the time approved by the employment registration certificate) include outpatient prenatal examination, delivery, family planning surgery medical expenses and one-time nutritional subsidies.
4. Maternity insurance benefits for insured female employees after retirement include medical expenses incurred by taking out intrauterine devices and induced abortion.
Question 7: What does maternity insurance mean?
In case a woman has an accident when giving birth, she can get compensation.
Question 8: What expenses can be reimbursed for maternity insurance?
I. Female employees
1, maternity allowance
Maternity allowance = the average payment salary of this unit in the current month ÷30 (days) × holiday days.
Holidays:
(1) Normal maternity leave is 90 days (including prenatal examination 15 days);
(2) The one-child leave is increased by 35 days;
(3) Maternity leave for late childbirth is increased by 15 days;
(4) Difficult maternity leave. Caesarean section and third degree rupture of perineum increased by 30 days; Suction delivery, forceps delivery and breech delivery increased 15 days;
(5) Multiple birth leave, every extra baby 15 days;
(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, it takes 75 days.
2. Maternity medical expenses
(1) The medical expenses for medical treatment after the maternity medical treatment is confirmed shall be settled by the Municipal Labor and Social Security Bureau and the hospital (the part exceeding 1 10,000 yuan shall be settled according to the approved number).
(2) The medical expenses for delivery in different places, which are lower than the quota standard, shall be reimbursed according to the facts; Above the quota standard, according to the quota standard reimbursement.
3. One-time childbirth nutrition subsidy
Normal delivery, abortion for more than 7 months; Last year, the average monthly salary of employees in the city was ×25%.
Dystocia and multiple births: the average monthly salary of employees in the previous year ×50%.
4. One-time subsidy
In primary and secondary hospitals, each person will receive a one-time increase in 300 yuan subsidy.
Second, male workers.
Male spouses who receive the "One-Child Preferential Card" enjoy 10 days holiday, and are paid according to the unified salary of the unit in the month when the child is born.
Male spouse's holiday salary = unified salary paid by the unit in the current month ÷30 (days) × 10 (days).
Third, others.
The approved maternity allowance and male spouse's holiday salary are allocated to the unit by the social insurance agency and managed and paid by the unit. The employing unit shall pay the laborer himself in accordance with the relevant provisions of relevant documents.
1 One-time childbirth nutrition subsidy and one-time childbirth subsidy in primary and secondary hospitals are paid by the employer to the parturient according to the standards allocated by the social insurance agency.
Question 9: What's the difference between maternity insurance and medical insurance?
Social security includes pension, medical care, unemployment, work injury and maternity insurance. If you have a work unit, the medical insurance will be borne by the unit and the individual in proportion, and the maternity insurance will be paid by the company. If the individual does not pay, the individual will not be able to pay.
Medical insurance and maternity insurance are two types and do not conflict. Of course you have to pay medical insurance. Let me tell you the reimbursement policy of medical insurance first:
1. The medical insurance is divided into two accounts, the personal account and the money reflected in the medical insurance card can be used to buy medicines at designated pharmacies, pay outpatient expenses and pay the personal out-of-pocket part of hospitalization expenses; The overall account is managed by the medical insurance center, and the expenses incurred by the insured who meet the local medical insurance reimbursement are paid by the overall account.
2. When seeing a doctor, show the medical insurance card to the designated hospital to prove the identity and registration of the insured. The part of medical insurance reimbursement is settled by medical insurance and hospitals, and individuals do not need to pay in advance before reimbursement. At the time of checkout, the part paid by the individual is paid by the balance of the medical insurance card and cash.
3. There is a deductible when reimbursement for hospitalization (the deductible standard is generally 10% of the average annual salary of employees in the city last year), which means that you need to pay the deductible yourself, and the part that exceeds the deductible can be reimbursed according to local medical insurance regulations. The reimbursement rate varies from place to place, and different hospitals and different projects are also different. I can't give it to you specifically, about 80%. You can go to the local area to learn more about it.
1, maternity insurance usually requires payment for one year, but it is still being paid, so you can enjoy the relevant treatment of maternity insurance. However, maternity insurance is a typical local policy, and the regulations vary from 10 to 6 months or even lower. So I suggest you consult the local social security center (unified telephone: 12333), and their answers will prevail.
2, maternity insurance can enjoy the benefits include:
(1) Maternity allowance (salary during maternity leave, general standard: average payment salary of female employees before giving birth 12 months /30 days × maternity leave days);
(2) Maternity medical expenses (including medical examination expenses, delivery expenses, operation expenses, hospitalization expenses and medicine expenses incurred due to pregnancy and childbirth);
(3) Medical expenses incurred in family planning operation;
(four) other expenses related to maternity insurance as stipulated by the state.
Question 10: What effect does maternity insurance have on female employees?
So, what is the main function of maternity insurance? The following is a detailed introduction for you. The purpose of maternity insurance is to provide maternity allowance, maternity leave and medical services for female employees, to ensure their basic economic income and medical care when they temporarily lose their working ability due to childbirth, and to help female employees recover their working ability and return to work. Maternity insurance covers four aspects: first, maternity allowance; Second, maternity medical expenses; Three, family planning surgery medical expenses; Four, other expenses stipulated by the state and the city. At present, the implementation of maternity insurance in China is divided into two types: the first is that maternity leave wages and maternity medical expenses of female employees are borne by their units. According to the State Council's Provisions on Labor Protection of Female Workers and the Notice of the Ministry of Labor on Several Issues Concerning the Maternity Treatment of Female Workers, the inspection fee, delivery fee, operation fee, hospitalization fee and medicine fee of female workers during pregnancy shall be borne by their units. Pay as usual during maternity leave. The second is maternity social insurance. According to the "Trial Measures for Maternity Insurance for Enterprise Employees" issued by the Ministry of Labor, employers who participate in social pooling of maternity insurance shall pay maternity insurance premiums to local social insurance agencies; The proportion of maternity insurance premium payment shall be determined by the local people's government according to the planned maternity allowance and maternity medical expenses of female employees, and the maximum shall not exceed 0% of the total wages, and individual employees shall not pay. After the female employees of the insured unit give birth or have an abortion, their maternity allowance and maternity medical expenses shall be paid by the maternity insurance fund. Maternity allowance is calculated and paid according to the average monthly salary of employees in the previous year; Maternity medical expenses include examination fee, delivery fee, operation fee, hospitalization fee, medicine fee (beyond the prescribed medical service fee and medicine fee shall be borne by the employees themselves) and medical expenses for maternity-related diseases caused by female employees after discharge. The main functions of maternity insurance are as follows: 1. Women's childbearing is the need of social development. While carrying on the family line, they have made efforts for the reproduction of social labor 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, to ensure the basic livelihood 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 fertility consumes a lot of physical strength and needs adequate rest and nutrition. 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. Note: Female employees are in a weak position in the labor market because of their natural differences in physiological functions from male employees. The state protects their legitimate rights and interests through maternity insurance, so that they will not lose their jobs due to childbirth. Carrying out maternity insurance not only ensures the basic livelihood of female workers, but also recognizes the reproductive value of women.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.