How to deal with abortion social security reimbursement?

For medical insurance reimbursement of painless abortion, it depends on the specific situation. Family planning expenses are reimbursed in maternity insurance, but maternity insurance can only be reimbursed if it meets the family planning policy, but it does not meet the family planning policy because maternity insurance cannot be reimbursed. Abortion is not maternity, so it cannot be reimbursed as maternity insurance. The cost of abortion can be swiped by medical insurance card. If you are hospitalized, the expenses can be reimbursed by medical insurance, and some expenses incurred after the funds in your personal account are brushed up can be reimbursed.

1. What are the reimbursement conditions for social security maternity insurance?

1. Employees who meet the following conditions enjoy maternity insurance benefits:

(1) Giving birth or carrying out family planning operation in line with the national family planning policy;

(2) The employer has participated in maternity insurance as required, and paid the full amount for the workers for more than one year.

2. Reimbursement of maternity expenses includes examination expenses, delivery expenses, operation expenses, hospitalization expenses, medicine expenses and treatment expenses incurred by female employees due to pregnancy and childbirth. Medical expenses incurred by employees in placing (taking out) IUD, abortion, induced labor, sterilization and recanalization.

3. Apply for maternity insurance benefits to the local social insurance agency with the following materials:

(1) Original ID card, marriage certificate and medical expense certificate;

(2) In case of normal birth, the family planning service manual or birth medical certificate, newborn birth medical certificate or death medical certificate shall be submitted;

(3) If family planning operation is performed, relevant medical certificates shall be submitted;

(4) If the spouse of a male employee participating in maternity insurance has no work unit, the certificate of the village (neighborhood) committee where the spouse's household registration is located shall be submitted.

4. The maternity allowance for female employees is the average monthly payment salary of the previous year divided by 30 days multiplied by the number of maternity leave days. The maternity leave for normal childbirth of female employees is 90 days, including prenatal leave 15 days; Increased dystocia 15 days; For multiple births, each additional baby will be increased by 15 days; Late childbearing increased by 60 days; If the female employee miscarries within 2 months of pregnancy, the maternity leave is 15 days; Pregnant for more than 2 months but less than 3 months, maternity leave is 20 days; Maternity leave is 30 days for those who are pregnant for more than 3 months but less than 4 months; Pregnant for more than 4 months, maternity leave is 42 days.

2. What is the reimbursement process for medical treatment with social security card?

1. First of all, when the insured person goes to see a doctor, he will write a prescription to pay the fee after seeing a doctor with a social security card.

2. The insured person goes to the outpatient clinic with the registration form, and the doctor registers the insurance card at the registration office.

3. After the insured person takes the prescription to the hospital settlement window for pricing, he can directly brush the social security card to pay the medical expenses within the scope of medical insurance fund payment.

4. If some drugs in the prescription are not covered by the medical insurance fund, the insured needs to pay cash.

Legal basis: Special provisions on labor protection for female employees.

Article 7 Female employees shall 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 will 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 8 The maternity allowance for female employees during maternity leave shall be paid by the maternity insurance fund according to the standard of the average monthly salary of employees of the employing unit in the previous year; Those who have not participated in maternity insurance shall be paid by the employer according to the wage standard of female employees before maternity leave.

Medical expenses incurred by female workers in childbirth or abortion shall be paid by maternity insurance fund according to the items and standards stipulated in maternity insurance. Did not participate in maternity insurance, paid by the employer.