Why can't medical insurance reimburse missed abortion?

Because the examination and treatment of family planning projects is not within the scope of medical insurance reimbursement, but within the scope of maternity insurance coverage. Missed abortion, also known as overdue abortion or stillbirth, refers to those who remain in the uterus after the death of the embryo, and usually discharge the pregnancy products within 1 ~ 2 months after the symptoms appear. Missed abortion can be reimbursed for medical treatment, but only for hospitalization. Without hospitalization, it can't be reimbursed. Because missed abortion is not positive compared with induced abortion, this kind of operation can be reimbursed, but it needs hospitalization to be reimbursed, and the reimbursement ratio is also related to the local hospital. Generally, the proportion of reimbursement in big cities will be higher, and the proportion of reimbursement in county towns and rural areas will be lower.

Can commercial insurance for missed abortion be reimbursed?

Commercial insurance for missed abortion cannot be reimbursed. All commercial insurance can not report abortion, only social security medical care can. The social security maternity insurance reimbursement provisions are as follows:

1, maternity insurance must be paid for one year to enjoy;

2. After discharge, you need to submit a marriage certificate, all invoices, hospitalization lists and discharge summaries of unmarried children who cannot be reimbursed, and the only child who cannot be reimbursed for the second child, medical records, building size cards, hospitalization and operation expenses, and submit materials to relevant units;

3. The scope of reimbursement includes the examination fee during pregnancy, the hospitalization fee when giving birth to a child, and the operation fee. All expenses can be reimbursed within the scope of medical insurance, plus 4 months' salary, which is subsidized by women's maternity insurance;

4. Male maternity insurance can only reimburse half of the examination fee, hospitalization fee and operation fee, and men can't enjoy the maternity insurance salary subsidy for 4 months.

Maternity allowance standard for missed abortion

Maternity allowance is the salary of female employees during maternity leave. If the maternity allowance is lower than my salary standard, the difference will be made up by the enterprise. Maternity allowance is calculated according to the payment base of the month when female employees give birth divided by 30 and multiplied by the number of days of maternity leave.

Legal basis: Article 25 of the Population and Family Planning Law of the People's Republic of China. Couples who have children in accordance with laws and regulations can get extended maternity leave or other welfare benefits.

Article 7 of the "Special Provisions on Labor Protection of Female Employees" allows female employees to enjoy 98 days of maternity leave, including 15 days before delivery; In case of dystocia, maternity leave shall be increased 15 days; For multiple births, the maternity leave can be increased by 1 5 days for each additional child. Female employees who miscarry less than 4 months after pregnancy are entitled to 15 days maternity leave; Abortion after 4 months of pregnancy is entitled to 42 days of maternity leave.

Article 53 of the Social Insurance Law of People's Republic of China (PRC), employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with state regulations, while employees shall 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.