Inquiries on Medical Insurance for Urban and Rural Residents in Xiangyang City

Insurance Bian Xiao helps you answer, and more questions can be answered online.

Reimbursement standard

The reimbursement standard for prenatal examination and outpatient family planning surgery for female employees is:

(1) Prenatal check-up fee 300 yuan/person.

(2) Induced abortion 200 yuan (induced labor 600 yuan)

(3) Put the IUD 50 yuan into the uterus and take out the IUD 25 yuan.

The reimbursement standards for maternity, hospitalization maternity medical expenses and hospitalization family planning operation expenses of female employees are:

1. Natural childbirth 1000 yuan.

2. Manual intervention in delivery 1.500 yuan (refers to forceps delivery and fetal aspiration)

3. Cesarean section 2500 yuan

4. Multiple births increase the quota 200 yuan for each additional child.

Maternity allowance for female employees is calculated and paid according to the average monthly salary of employees in the previous year of the employer where the employees are located. The specific criteria are as follows:

(1)/kloc-If the pregnancy is terminated within 0/2 weeks, the maternity allowance of 15 days will be granted.

(2) If the pregnancy is over 12 weeks but less than 16 weeks, the pregnancy will be terminated, and the maternity allowance will be enjoyed for 30 days.

(3)/kloc-If the pregnancy is terminated less than 28 weeks after 0/6 weeks, 42 days of maternity allowance will be granted.

(4) If the pregnancy is terminated for more than 28 weeks or the delivery is normal, the maternity allowance for 90 days will be enjoyed.

Reimbursement conditions

1. Participate in maternity insurance and pay maternity insurance premium in full and on time for 6 months;

2 in line with the provisions of the state and the city's family planning policy.

3. There is a labor relationship with the payer.

Reimbursement materials

Application materials for maternity insurance benefits

1. Maternity insurance medical application form submitted by Xiangyang social security agency.

2. Marriage certificate (original and photocopy)

3. Birth certificate (original and copy)

4. Birth certificate (death certificate) (original and copy)

5. Identity cards of both parties (original and photocopy)

6. Discharge summary

7. Original invoice for hospitalization and list of daily expenses (such as outpatient medical records and prescriptions for outpatient treatment)

8 prenatal care (maternal health manual) blood and urine routine test sheets, B-ultrasound reports and other related materials.

9. If the spouse of a male employee has no work unit, the certificate of no work unit issued by the village (neighborhood) committee where the spouse is located shall also be provided.

Materials for reimbursement of medical expenses for off-site childbirth

1. Birth license

2. Birth certificate

3. Marriage certificate

4. Original and photocopy of ID card.

5. Hospitalization invoice

6. Discharge summary "one-day list"

Treatment process

Maternity insurance benefits application process

1. First, the unit downloads the birth medical record form online, selects the maternity check-up and maternity hospital, and then seals it and reports it to the work-related injury obstetrics department for the record.

2. After the production, bring the above information to the work-related injury obstetrics department for acceptance and review, and pay it in the next month after the monthly settlement.

The reimbursement process of medical expenses for off-site childbirth

Unit declaration → acceptance → document entry → examination and signature of section chief → examination and signature of leaders in charge → settlement department.

Time limit and address for processing

Processing time: 20 working days

Processing address:

Xiangyang fancheng district urban and rural resident society insurance management bureau

Address: fancheng district, Xiangyang

Baokang county society insurance management bureau

Tel: (07 10)58 12757

Address: No.25 Donghou Street

Nanzhang county village society insurance management bureau

Address: No.0/57, Bianhe Road, Nanzhang County, Xiangyang City, Hubei Province.