Peony Evening News all -media reporter Wu Yan
What is the employee maternity insurance reimbursement policy?What are the conditions?What is the reimbursement process?In response to the recent concerns of the participating people, the Municipal Medical Insurance Bureau interpreted the city’s 2022 employee maternity insurance reimbursement policy.It is understood that enterprise employees can enjoy maternity insurance benefits for more than a year in full payment. When reimbursement, they can be settled for "one -stop", and 10 working days can be issued in place.
The reimbursement conditions for enterprise employees are: maternity insurance can be allowed to enjoy maternity insurance benefits for more than a year, and maternity insurance benefits can be enjoyed. The fees that are less than one year during maternity pay for maternity insurance benefits after one year of continuous payment for one year.
In the reimbursement process, the insured employees have given birth to a designated hospital in Heze City. After birth, fertility medical expenses and prenatal examinations are settled directly at the hospital.The Land Economic Office Hall can also be declared through the hospital convenience service station, or it can be applied for online, handling, and "mobile video office medical insurance".If you give birth in a different place, you can apply for maternity insurance directly to the place of insurance.In terms of processing time, under the normal payment state of the unit, 10 working days are issued in place.
The cost of maternity medical care is a limited amount of payment. It is 1,000 yuan, it is difficult to produce 1,500 yuan, cesarean section is 2500 yuan, and multi -bred fertility will increase the subsidy of 200 yuan per child.Family planning surgery fee: limit payment, 500 yuan for abortion surgery under 4 months of pregnancy, 800 yuan for more than 4 months of pregnancy, 200 yuan for breeding rings, 800 yuan for sterilization and resumption of surgery.
Medical expenses of fertility complications: Reimbursement items include ectopic pregnancy, pregnancy hypertension syndrome, front placenta, early postpartum bleeding, and early stripping of placenta.Payment standards: The maximum payment limit is 50,000 yuan, the starting line is above 85%or more than 30,000 yuan; the 30001-50,000 yuan is paid at 90%.
Pre -delivery inspection items: Limited payment, prenatal inspection items include B -ultrasound, fetal monitoring, pregnancy examination, etc., with a maximum payment standard of 500 yuan.
Maternity allowances = the average monthly payment salary of my last year/30*Number of maternity leave days.The number of maternity leaves is 98 days, the dystocia and cesarean section increased by 15 days, and each more child for multiple births increased by 15 days.The number of maternity leaves below 2 months of pregnancy is 15 days, 20 days from 2 to 3 months of pregnancy, 30 days from 3 to 4 months of pregnancy, and 42 days of 42 days of pregnancy.
Employees of institutions and institutions can enjoy treatment after participating in the insurance. The reimbursement process, the required materials and the time limit for handling are the same as the employees of the enterprise.
The maternity medical expenses of employees of institutions and institutions are limited to pay, with a smooth birth of 2,200 yuan, a difficult production of 2,500 yuan, a cesarean section of 4,500 yuan, and a multi -child childbirth.Family planning surgery fees: Limited payment, 500 yuan of abortion surgery for less than 4 months of pregnancy, 1,800 yuan for more than 4 months of pregnancy, 200 yuan for breeding rings, 800 yuan for sterilization and resumption of surgery.
Medical expenses of fertility complications: Reimbursement items include ectopic pregnancy, pregnancy hypertension syndrome, front placenta, early postpartum hemorrhage, and early placental stripping.Payment standards: The maximum payment limit is 50,000 yuan, the starting line is above 85%or more than 30,000 yuan; the 30001-50,000 yuan is paid at 90%.The prenatal inspection project fee is limited to payment. Pre -delivery inspection items include B -ultrasound, fetal care, pregnancy examination, etc. The maximum payment standard is 500 yuan.
The maternity insurance benefits of employees and institutions do not include maternity allowances.
Male employees who do not work in their spouses enjoy maternity insurance treatment, and their treatment is 50%of employees’ maternity medical expenses and prenatal inspection cost standards.
In order to implement the three -child maternity insurance benefits, the city’s expenses for the fertility of female employees to feed the female employees are included in the scope of payment of maternity medical insurance benefits.rights and interests.
