For employees, maternity insurance has always been a popular type of insurance that everyone pays attention to.
Maternity insurance not only reimburses female employees during pregnancy, but also allows female employees to receive maternity benefits during maternity leave.
Many people ask, "How to reimburse for long-distance birth?" Can I receive maternity allowance normally? "Today, I will answer the question.
What are the benefits of maternity insurance for employees? What are the criteria?
Maternity insurance benefits for employees include prenatal examination fees, maternity medical expenses, maternity allowances, family planning medical expenses, and subsidies for maternity medical expenses for male employees' spouses. (Local standards may vary, according to local standards).
1. Standards for maternity treatment for female employees
1. Prenatal examination fee: 700 yuan.
2. Maternity medical expenses: 2,000 yuan for normal birth, 3,000 yuan for dystocia (including cesarean section), and 400 yuan for each additional baby that produces multiple births;
3. Maternity allowance: calculated and paid according to the average daily wage of the employee in the previous year multiplied by the corresponding number of days at the time of childbirth. 98 days of normal birth, 113 days of dystocia (including cesarean section), and 15 days for each additional baby born to multiple births.
Note: Those who have not applied for a maternity service certificate cannot enjoy the prenatal examination fee and maternity allowance.
2. Treatment standards for female employees to terminate pregnancy (abortion and induce labor).
1. Prenatal examination fee: 700 yuan for more than 7 months of pregnancy; 500 yuan for 4 months but less than 7 months of pregnancy; 300 yuan for less than 4 months of pregnancy.
2. Maternity medical expenses: 2,000 yuan for more than 7 months of pregnancy (1,000 yuan for cesarean section); 1,000 yuan for 4 months but less than 7 months of pregnancy; 500 yuan for less than 4 months of pregnancy.
3. Maternity allowance: calculated and paid according to the average daily wage of the employee of the employer at the time of termination of pregnancy in the previous year multiplied by the corresponding number of days. Pregnancy of more than 7 months and 98 days; Pregnancy of 4 months but less than 7 months and 42 days; Pregnancy is less than 4 months and 15 days.
Note: Those who have not applied for a maternity service certificate before the termination of pregnancy cannot enjoy the prenatal examination fee and maternity allowance.
Specific reimbursement process
The reimbursement process is similar in various provinces and cities, and we take Shenzhen as an example
When the insured incurs maternity medical expenses in designated medical institutions outside Shenzhen, he or she needs to pay in advance and apply for a one-time fixed amount reimbursement within 3 years after the delivery, termination of pregnancy or family planning surgery.
Note: In most areas, maternity medical expenses need to be paid in advance.
1. Reimbursement conditions and materials for non-local births
(1) Conditions:
1) Employees can enjoy maternity medical expenses and maternity allowance from the next month after participating in the insurance.
2) Apply for reimbursement or payment of maternity allowance within one year from the day after childbirth, termination of pregnancy or family planning surgery.
(2) Materials:
1. Original resident ID card (pass for Hong Kong, Macao and Taiwan personnel, passport for foreigners);
2. The original receipt of hospital charges (the special receipt for medical expenses printed by the financial department or the original invoice printed by the tax department) (if the electronic invoice is provided, it is necessary to fill in the "Commitment Letter for Reimbursement with Electronic Bills");
3. Original detailed list of expenses (prenatal examination, hospital delivery);
4. Discharge summary and original discharge record (reimbursement of prenatal examination expenses and hospital delivery expenses);
5. The original bank account of the insured person (the financial social security card has been handled, and the default bank account has been handled; If not, provide your own bank account in this city);
6. The original letter of commitment for maternity reimbursement (for the certification materials that cannot be obtained through data sharing or other materials, the commitment shall be filled in by the person).
2. Reimbursement amount
3. Application Guidelines
Step 1: Log in to the system
Open the official website of the Shenzhen Municipal Medical Security Bureau, and the login needs to be verified by real name. (Recommended computer login)**
Step 2: Go to the one-time fixed reimbursement page
Click "**Processing" "Maternity Insurance" "Approval of Medical Expenses of Employee Maternity Insurance";
Step 3: Fill in the information and upload the materials
Fill in the one-time fixed reimbursement information, select the handling mode, click "Next", and the system will guide the insured to upload the required materials according to the reimbursement information;
Step 4: Submit the application and print the application form
After uploading the materials, confirm that the information is correct, submit the materials and print the application form;
Step 5: Prepare the materials and submit the application offline
After the online pre-review is passed, the insured can prepare materials and apply to the comprehensive window of the nearest district (street) administrative service hall that has opened the medical insurance business;
If the insured chooses to submit the materials by mail during the pre-application, the application shall be submitted by mailing the materials to the designated address according to the SMS prompts.
Step 6: Accept the result
Situation 1: The information is complete, and the application is directly accepted on the spot, and the "Receipt of Receipt" and "Notice of Acceptance" are issued.
Situation 2: If the information is incomplete, notify the materials to complete and issue the "Guidance Notice".
Situation 3: If the conditions for acceptance are not met, a "Decision of Inadmissibility" shall be issued.
Maternity insurance is an important part of the social security system, and it is a social insurance system that provides necessary economic compensation and medical security for employees who temporarily interrupt their labor due to pregnancy, childbirth or family planning surgery.