How to reimburse individuals for paying social security and fixed-point maternity insurance?

As we all know, working in a company or enterprise, we will ask if there are five insurances and one gold. Maternity insurance is one of the five insurances, and it is a care policy of the state to protect female workers. You can't reimburse yourself if you pay medical insurance and maternity insurance. The following is the related content of maternity insurance reimbursement that I have compiled for you. Let's take a look together.

First, maternity reimbursement conditions

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

2. The employer participates in maternity insurance in accordance with the regulations and pays maternity insurance premiums in full for employees for more than one year.

Second, the scope of maternity insurance reimbursement

1. Maternity allowance for female employees during maternity leave; Maternity allowance is the average monthly payment salary of my previous year divided by 30 days multiplied by the number of maternity leave days.

2. The medical expenses incurred by the birth of female workers include the examination expenses, delivery expenses, operation expenses, hospitalization expenses, medicine expenses and treatment expenses incurred by female workers due to pregnancy and birth.

3. The medical expenses incurred by workers in carrying out family planning operations include the medical expenses incurred by workers in placing (taking out) intrauterine devices, abortion, induced labor, sterilization and recanalization operations.

4 other expenses related to maternity insurance as stipulated by the state.

Three. Specific provisions on maternity insurance

1. If the spouses of male employees who participate in maternity insurance have no work unit and meet the family planning policy, they will enjoy maternity grants at 50% of the maternity medical expenses according to the regulations; If the spouse of a male employee who participates in maternity insurance has a work unit but does not participate in maternity insurance, the maternity insurance fund will not pay the corresponding medical expenses and other maternity insurance benefits.

2 insured workers suffering from pregnancy complications, delivery complications, postpartum complications and complications of family planning surgery hospitalization expenses, borne by the maternity insurance fund; Such as hysteromyoma, ovarian cyst and ovarian tumor. The increased expenses due to the above operations shall be paid by the medical insurance fund. Designated medical institutions according to the project respectively through the maternity and medical insurance network settlement.

3. Long-term participation in maternity insurance, overseas personnel shall go to the medical insurance agency to register maternity insurance in different places with the certificate of medical treatment or maternity issued by the unit, and choose a local medical institution as the designated hospital for my birth. Insured employees suffering from pregnancy complications or childbirth complications shall issue admission records, doctor's advice, detailed list of expenses, etc. , and apply for various maternity insurance benefits in the medical insurance agency the following month.

4. Insured employees who give birth or carry out family planning operations in non-designated medical institutions due to emergency and first aid shall report to the medical insurance agency for the record within 5 days.

5 maternity insurance drugs, diagnosis and treatment and service facilities directory with reference to the provisions of the basic medical insurance for urban workers, diagnosis and treatment projects do not set the proportion of self payment.

Maternity insurance is very important for female employees, so everyone should pay more attention to this policy at ordinary times. The reimbursement ratio of maternity insurance in different regions is also different.