Chuzhou City workers medical insurance balance inquiry

Chuzhou Maternity Insurance reimbursement conditions

(1) in line with the provisions of the Chuzhou Municipal Family Planning Policy in Anhui Province;

(2) at the time of delivery or implementation of family planning surgery, the employer has been to participate in the Chuzhou Maternity Insurance for the person and the full payment of maternity insurance premiums for a full 12 consecutive months.

(3) For prenatal checkups and delivery costs, the person concerned carries the marriage certificate, social security card (Citizen's Card) and birth control certificate issued by the street to the designated hospital of Chuzhou Maternity Insurance and settles the bill directly by credit card.

(4) To declare the maternity allowance and one-time nutritional subsidy, you need to fill out the "Chuzhou Maternity Insurance Benefits Declaration Form" and stamp the official seal of the unit, provide the marriage certificate, the one-child certificate (for the child), and the hospital discharge summary, etc., and go to the maternity section of the Municipal Health Insurance Center on a working day between the 1st and 10th of each month to apply for the declaration procedures (the relevant procedures should be handled within one year of the delivery).

Chuzhou Maternity Insurance Reimbursement Procedure

1, after the female worker is pregnant, before the abortion or family planning surgery, the employer or the staff of the labor security service station in the street or town will bring the declaration materials to the maternity insurance window of the district social labor insurance office;

2, the staff will accept and approve the application, and then issue a medical certificate;

3, the maternity female worker will be given a full maternity leave of Within 30 days, the employer or the staff of the labor security service station of the street or town will bring the declaration materials to the Maternity Insurance Window of the District Social Labor Insurance Office for settlement of the treatment;

4. After accepting and approving the application, the staff will pay the maternity medical fee and maternity allowance.

Chuzhou City, the proportion of maternity insurance contributions

(a) unified basic medical and maternity insurance policy for urban workers

1. Unified scope of participation. Employees should participate in the basic medical insurance for employees, by the employer and employees in accordance with the provisions of the basic medical insurance premiums **** the same. Maternity insurance is paid by the employer, and the individual employee does not contribute.

Individual industrial and commercial households without employees, part-time workers who do not participate in the basic medical insurance of employees at their employing units, and other flexibly employed persons may participate in the basic medical insurance of employees, and individuals shall pay the basic medical insurance premiums in accordance with the regulations.

2. Uniform contribution standards. In accordance with the principle of "to determine expenditure on the basis of income, balance of income and expenditure, with a slight surplus", the city's employers and employees unified individual medical insurance contribution standard; in accordance with the principle of "to determine income on the basis of expenditure, balance of income and expenditure", the city's employers unified maternity insurance contribution standard.

(1) Unify the contribution base for medical insurance and maternity insurance. The contribution base for medical insurance and maternity insurance for employers is the total salary of the employees in the unit, and the contribution base for individual employees is their salary income, which is declared on a monthly basis. The monthly contribution salary of the active employees of the employing unit is declared according to the actual situation. If it is lower than 60% of the average salary of the active employees in the province in the previous year, the contribution will be made according to 60%; if it is higher than 300% of the average salary of the active employees in the province in the previous year, the contribution will be made according to 300%. Flexibly employed persons (including renewals) are subject to the same contribution base as that of the active employees of the employing organization.

(2) Unify the contribution rate of employers and individual employees. The contribution rate of the medical insurance unit is 6.5% of the employee's gross salary, and the contribution rate of the individual employee is 2% of his/her salary income. Flexibly employed persons (including those renewing their insurance) pay basic medical insurance premiums at the rate of 8.5% of their declared contribution base.

The contribution rate for maternity insurance is 0.4% of the total wages of the employees for state organs, social organizations and institutions, and 0.8% of the total wages of the employees for all kinds of enterprises and self-employed industrial and commercial households with employees.

(3) unified medical assistance fund contribution standard. Medical aid contribution standard is 10 yuan per person per month.

(4) Uniform minimum contribution period. Unit participants for retirement, their participation in the basic medical insurance minimum contribution period of 30 years for men and 25 years for women, in order to enjoy the basic medical insurance for retirees. September 30, 2000 the city to establish the basic medical insurance system before the relevant provisions of the national policy to recognize the age of the work or the basic pension insurance premiums, deemed to be the number of years to pay the basic medical insurance premiums for employees. Less than the required number of years, by the employer in accordance with the provisions of a one-time contribution to the required number of years before enjoying the retiree medical insurance benefits.

Flexible employment (including renewals) for retirement, the basic medical insurance premiums in line with the relevant policy provisions of the deemed contribution period and the actual contribution period must be added up to 30 years for men and 25 years for women (of which the actual contribution period must be 15 years), in order to enjoy the basic medical insurance treatment of retirees, less than the required number of years, by the participants in accordance with the requirements of the one-time contribution to the required number of years before enjoying the basic medical insurance treatment of retirees, and by the participants in accordance with the provisions of the one-time contribution to the required number of years. After the required number of years, the retiree can enjoy the retiree medical insurance treatment.

Chuzhou Municipal Maternity Insurance Treatment

(1) The city's medical insurance individual account transfer ratio is unified. Active employees according to their own contribution base as their personal account into the base; retirees by the pension insurance agency to issue pensions, according to their pensions as a personal account into the base; by the organization, human resources and social services departments to approve the retirement fee, according to their retirement fees as a personal account into the base. 30 years of age and below into the 3%; 31 to 45 years of age into the 3.3%; 46 years of age and over into the 3.6%; 4% for retirees based on their monthly pension (retirement fee).

(2) Unified hospitalization fund starting standard. The starting standard for the first hospitalization of an active employee in a year is 400 yuan for a first-class hospital, 500 yuan for a second-class hospital, and 600 yuan for a third-class hospital; the second and third hospitalizations are respectively 100 yuan less than the first and second hospitalizations; and the starting standard for the hospitalization of the third or more hospitalizations is based on the standard of the third hospitalization. The starting standard for hospitalization of retirees is 70% of that of active employees.

(3) Unify the proportion of individual out-of-pocket payment for hospitalization. The individual out-of-pocket payment ratio of the insured is implemented according to the current policy for the hospitalization medical expenses of the insured that are in accordance with the provisions of the basic medical insurance within a year, above the starting standard and below the maximum payment limit. For the implementation of the national and provincial medical insurance drug list, diagnostic and treatment items, medical service facilities, as well as the city's artificial organs and materials placed in the body of the price limit standards, the individual out-of-pocket expenses of the insured shall be implemented in accordance with the current policy.

(4) Unify the maximum payment limit of basic medical insurance and the payment limit of medical aid fund. The maximum payment limit for basic medical insurance is unified at 90,000 yuan, and the annual maximum payment limit for medical aid is unified at 250,000 yuan. Municipal human resources and social security departments in accordance with the operation of the medical insurance fund to make timely adjustments.

(5) The standardization of reimbursement for hospitalization outside the city and hospitalization in other places. Participants who are transferred to other hospitals and hospitalized in other places will be implemented according to the current policy.

(6) Unification of chronic disease categories and outpatient medical treatment. Within a year, the starting standard for outpatient treatment of chronic diseases is 500 yuan, and the portion of outpatient treatment costs exceeding the starting standard within the prescribed scope shall be paid by the integrated fund on a proportional basis. The types of chronic diseases, the starting standard and the proportion of payment shall be implemented according to the current policy.

(7) Unification of civil servants' medical assistance treatment. On the basis of participation in the basic medical insurance for employees, the counties (cities, districts) institutions in accordance with the "Chuzhou City Interim Measures for Medical Assistance to State Civil Servants" (Chu Zhengban [2000] No. 39) for civil servants to implement the medical subsidies, the specific standards of subsidies in accordance with the implementation of the current policy.

(8) unified settlement of hospitalization medical expenses. According to the fund revenue and expenditure budget, the implementation of total control, pay per person, pay per disease and other comprehensive settlement methods.

(9) Unification of maternity insurance treatment. Maternity insurance treatment includes maternity medical expenses and maternity allowances, which are paid from the Maternity Insurance Fund.

(10) Unifying the scope and standard of payment of maternity allowance. Female employees of employers paying contributions at the rate of 0.8% enjoy the corresponding maternity allowance treatment as stipulated in Article 11 of the Interim Provisions on Maternity Insurance for Employees in Anhui Province (Decree No. 195 of the provincial government). The maternity allowance is calculated according to the average monthly salary of the employees of the employing unit in which the employees work in the previous year.

Chuzhou maternity insurance reimbursement ratio, what supporting materials are required

Now both men and women in Chuzhou have bought maternity insurance, in Chuzhou Gulou Hospital birth, please ask:

1, can reimbursement of medical expenses?

2. What is the percentage of reimbursed medical expenses?

3. Can I apply for a maternity allowance after reimbursement of medical expenses and how much does it cost?

4. Which department should I go to, what supporting documents are needed, and is there a time limit?

Female workers with maternity insurance can enjoy maternity insurance benefits if they have been insured for more than ten months. Before giving birth, they need to bring their ID cards, marriage certificates, certificates of reproductive health care services, health insurance cards and a copy of each of the above documents to the health insurance centers of the jurisdictions where they live to apply for registration of maternity insurance. The maternity medical expenses will be settled directly in the hospital at a fixed amount (RMB 1400 for a normal delivery and RMB 2800 for a caesarean section; RMB 1300 for a normal delivery and RMB 2600 for a caesarean section in a second-level hospital; RMB 1200 for a normal delivery and RMB 2200 for a caesarean section in a first-level hospital).

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