Jin Meng county social security management center

How much is the medical insurance card? It is based on the basic medical insurance premiums paid by individual employees in Article 17 of the Interim Provisions on the Basic Medical Insurance for Urban Employees in Luoyang City, and all of them are included in personal accounts. Part of the basic medical insurance premium paid by the employer shall be transferred to the personal account by the medical insurance agency according to the different age groups of the employees: if the employee is under 45 years old (including 45 years old, the same below), it shall be transferred according to 0.8% of his annual salary; Those over 46 years old (including 46 years old, the same below) will be counted as 65438+ 0.2% of my annual salary; Retirees are counted as 3.2% of the average retirement fee of the unit.

Before July 1 every year, the medical insurance agency shall determine the amount recorded in the personal account. July 1 day of that year to June 30th of the following year is the calculation year of medical expenses for employees. Pooled funds and individual accounts shall be accounted for separately, and shall not be mutually occupied. Personal accounts are mainly used to pay outpatient expenses and medical expenses that should be borne by individuals within the scope of overall fund payment.

1. Payment scope of maternity insurance fund

(1) Maternity allowance; (2) Maternity medical expenses; ⑶ Medical expenses for family planning operation; (4) One-time maternity grants; 5] Other expenses related to maternity insurance stipulated by the state and this province.

2. Conditions for applying for maternity insurance benefits

(a) the conditions for the insured to apply for maternity insurance benefits are that they have participated in maternity insurance for one year and paid in full.

⑵ The conditions for flexible employees to apply for maternity medical expenses are: they have participated in the basic old-age insurance and basic medical insurance for urban workers in our city for 12 months and paid in full.

⑶ Conditions for unemployed people to apply for maternity insurance benefits: Female employees who have participated in maternity insurance 1 year but less than 3 years can apply for maternity medical expenses if they give birth or perform family planning surgery during the 24-month unemployment period after dissolving or terminating the labor relationship with the employer according to law.

Female employees who have participated in maternity insurance for more than 3 years, who have not been employed to give birth or have family planning surgery after dissolving or terminating the labor relationship with the employer according to law, may apply for maternity medical expenses.

(4) giving birth or terminating pregnancy in accordance with the relevant provisions of the state, province and city on population and family planning.

3. Information needed

(1) Information to be submitted by the insured of the insured unit when applying for maternity insurance benefits:

(1) Application Form for Maternity Insurance for Female Workers in Luoyang;

(2) A copy of the baby's birth certificate and birth medical certificate;

(3) Copy of hospitalization medical records, original invoice of medical expenses, general list of hospitalization expenses, discharge certificate or diagnosis certificate (all of which must be stamped with the seal of the hospital);

(4) a copy of the marriage certificate;

⑤ Copy of ID card (in duplicate).

If the spouse of the male employee of the insured unit applies for a one-time maternity grants, it is also necessary to provide two copies of the ID cards of both men and women, the woman's unemployment certificate issued by the unit where the man works, and the woman's unemployment certificate issued by the village (neighborhood) Committee.

Information required for the unemployed to apply for maternity insurance benefits:

① Two copies of resident ID card, original and copy of unemployment certificate, copy of medical certificate of baby's birth, copy of birth certificate and copy of marriage certificate.

② Original discharge certificate or diagnosis certificate, copy of hospitalization medical records, total list of hospitalization expenses and original hospitalization invoice.

(three) information required for flexible employees to reimburse maternity medical expenses:

① Two copies of resident ID card, birth medical certificate, birth certificate and marriage certificate;

② Original discharge certificate or diagnosis certificate, copy of hospitalization medical records, total list of hospitalization expenses and original hospitalization invoice.

3. Handling procedures

Where the above conditions are met, the unit or individual shall carry the above materials to the social insurance agency of the insured place to handle the declaration procedures for maternity insurance benefits and maternity medical expenses for flexible employees.

4. Preventive measures

(a) the units and employees insured by the Municipal Social Insurance Administration shall go to the service window in Area B of the lobby on the second floor of Luoyang Citizen's Home (the intersection of Kaiyuan Avenue and Yongtai Street).

2 in the county (city, district) social insurance center to the county (city, district) social insurance center to submit relevant information.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.