Can you get a maternity benefit if you only have health insurance?

You can't get a maternity allowance if you only pay for medical insurance.

The difference between maternity insurance and medical insurance

While maternity insurance and medical insurance are both part of the social insurance system, they differ in their coverage and scope of payment. Medical insurance is mainly to ensure that the insured can receive necessary medical services and compensation for expenses when they are sick or injured; while maternity insurance is designed to protect the rights and interests of female workers during maternity, including maternity allowances, maternity leave pay, and so on.

The conditions for receiving maternity allowance

According to China's relevant regulations, the following conditions need to be met in order to receive the maternity allowance:

Participation status: the insured person must have participated in maternity insurance and meet the conditions of maternity insurance participation.

Maternity policy: Participants must comply with national and local maternity policies, including family planning policies.

Facts of maternity: the participant must have had a birth or a family planning operation during the period of participation.

Third, the relationship between medical insurance and maternity benefits

While medical insurance and maternity insurance are different in terms of who they cover and the scope of payment, they are not completely independent. In some areas, medical insurance may include partial reimbursement of maternity medical expenses, but this is not the same as a maternity allowance. Maternity allowance is a special treatment for the period of maternity and needs to be applied for and received through maternity insurance.

Four, how to apply for maternity allowance

An insured person who meets the conditions for receiving maternity allowance should submit the relevant application materials, including ID card, social security card, and proof of maternity, to his/her unit or social security agency in a timely manner after the birth or family planning surgery. The social security agency will pay the maternity allowance in accordance with the stipulated standards and procedures after reviewing and approving the application.

In summary:

Paying only medical insurance does not entitle you to receive maternity allowance directly. Maternity allowance is a special treatment for employees who have joined maternity insurance and comply with the maternity policy. In order to receive the maternity allowance, the insured person needs to be enrolled in maternity insurance at the same time and submit the relevant application materials to the social security office after the birth or family planning surgery.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 54 stipulates:

If an employer has paid maternity insurance premiums, its employees shall enjoy maternity insurance benefits; the employee's unemployed spouse shall enjoy the treatment of maternity medical expenses in accordance with state regulations. The necessary funds are paid from the Maternity Insurance Fund. Maternity insurance benefits include maternity medical expenses and maternity allowances.

Special Provisions on Labor Protection for Female Workers and Employees

Article 8 stipulates:

The maternity allowance during the maternity leave of female workers and employees shall be paid by the Maternity Insurance Fund in accordance with the standard of the average monthly salary of the employees of the employing organization in the previous year for those who have taken part in the maternity insurance; and for those who have not taken part in the maternity insurance, it shall be paid by the employing organization in accordance with the standard of the salary of the female workers and employees prior to the maternity leave.