What proof is needed for family planning medical insurance reimbursement?

The most important documents for reimbursement of caesarean section are ID card and social security card, as well as the baby's birth certificate and the invoice at the time of hospitalization. However, the specific procedures and documents need to be based on local rules and regulations.

However, if caesarean section is to be reimbursed, maternity insurance must be purchased in employee medical insurance or cooperative medical care for urban and rural residents before it is eligible for reimbursement. Moreover, the reimbursement ratio of two kinds of medical insurance reimbursement for caesarean section is different. Cesarean section expenses of urban and rural residents' cooperative medical care shall be reimbursed in a fixed amount, and employees' medical insurance shall be reimbursed in proportion. And the specific costs need to be locked according to the level of local hospitals.

Materials required for reimbursement of caesarean section: one original and one copy of marriage certificate; One original and one copy of the Maternity Service Certificate; One original and one copy of the baby's birth certificate; One original and one copy of the medical diagnosis certificate; "Registration Form for Persons Applying for Maternity Allowance" in duplicate.

Handling process: the unit manager will submit the above materials to the social security center, and pay the maternity allowance within 30 working days after accepting the approval.

If both husband and wife have participated in maternity insurance, the woman's unit shall fill in the "Registration Form for Personnel Applying for Maternity Allowance"; The woman did not participate in maternity insurance, the man has participated in maternity insurance, and the man enjoys maternity allowance. The unit where the man works shall fill in the Registration Form for Personnel Applying for Maternity Allowance (in duplicate) and make a declaration.

How long can caesarean section be reimbursed?

If it is maternity insurance, you need to apply for maternity leave certificate at the company within 60 days after delivery. In addition, you need the hospital's production records and discharge summary, the child's birth certificate, ID card, etc. You can go to the local social security center to get the form and prepare all the information required in the form. The money will be transferred to your account about 1 month after the information is submitted.

The examination fee, delivery fee, operation fee, hospitalization fee and medicine fee for the birth of female employees shall be paid by the maternity insurance fund. The medical service fee and medicine fee (including self-funded medicine and nutritional medicine) exceeding the prescribed amount shall be borne by the employees themselves. After the female workers are discharged from the hospital, the medical expenses for diseases caused by childbirth shall be paid by the maternity insurance fund; The medical expenses of other diseases shall be handled in accordance with the provisions of medical insurance benefits.

What is the reimbursement rate of medical insurance for caesarean section?

The reimbursement rate of caesarean section varies according to different regions, and also according to the different medical insurance you enter. The reimbursement rate of medical insurance for employees is slightly higher than that of urban residents. The specific amount is recommended to consult the local medical insurance center. You can only be reimbursed if you entered the medical insurance in that year. Caesarean section is different from natural delivery, and it takes a long time to recover after operation, and there are relatively many matters needing attention after operation. Although the reimbursement rate of caesarean section is higher than that of natural delivery, the cost of caesarean section is also higher. In addition, caesarean section can only be selected if there are indications for caesarean section.

Legal basis:

Article 54 of the Social Insurance Law

"The employer has paid maternity insurance, and its 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. " The above provisions show that the scope of maternity insurance in China covers all employers and their employees, and extends to the unemployed spouses of employees of employers. However, the coverage of maternity insurance in different regions of China is also different, and the specific coverage is subject to the information published by the local human resources and social security bureau.