The level of maternity insurance in Yu 'an District of Lu 'an City has improved.

The level of maternity insurance in Yu 'an District of Lu 'an City has improved.

Maternity insurance is a social insurance system in which the state and society provide medical services, maternity allowance and maternity leave when pregnant and pregnant female workers temporarily stop working, and the state or society provides necessary economic compensation and medical care for maternity workers. The following is what I have compiled about the improvement of maternity insurance level in Yu 'an District of Lu 'an City.

In recent years, Yu 'an Medical Insurance Center has taken maternity insurance as an opportunity to continuously improve the level of maternity insurance and strive to provide maternity insurance services for insured female employees. Up to now, the number of female employees in this district is10.05 million, and * * * has paid maternity insurance of 510.7 million yuan.

Care for the health of insured women workers and improve their quality of life. The center organized a free special gynecological examination for female workers who participated in maternity insurance in the whole region, and * * * screened out 1500 female workers with gynecological diseases of different degrees, so that gynecological diseases could be found, prevented and treated early, and their physical and mental health was guaranteed. Strengthen maternity insurance medical services, standardize service processes, select designated medical institutions suitable for maternity insurance requirements and sign maternity insurance medical service agreements with them, clarify the rights and obligations of both parties, and provide fast and convenient services for insured female employees who meet maternity insurance requirements.

In addition, a free maternity policy is implemented for female employees of insured units. Female workers can choose designated maternity or free maternity institutions independently, and the free maternity medical expenses provided by designated medical institutions are settled in one lump sum. The maximum settlement limit of flat delivery in secondary medical institutions is 3,200 yuan, and the cesarean section is 6,000 yuan; The highest settlement of delivery in non-designated hospitals is: flat fetus 1600 yuan, and cesarean section is 3,200 yuan. In addition, the district actively improves the settlement procedures of maternity insurance expenses and shortens the payment cycle. According to the maternity insurance policy, female employees who participate in maternity insurance will be reimbursed or compensated in a certain proportion for hospitalization maternity expenses and prenatal examination expenses.

Extension:

Maternity insurance reimbursement standard:

1. Maternity insurance is applicable to employed or unemployed women who have urban household registration and participate in urban social insurance in this city.

2. Payment base: the employer pays the urban endowment insurance premium and the employer pays the urban maternity insurance premium.

3. Payment regulations: The employer pays the urban maternity insurance premium at 0.8% of the payment base every month. Individuals do not pay urban maternity insurance premiums.

4. Duration of maternity allowance: if you are pregnant for more than 7 months (including 7 months), you will enjoy 3 months. Premature delivery after 7 months of pregnancy, enjoy 3 months. If you are pregnant for more than 3 months (including 3 months) and have an abortion for less than 7 months, you can enjoy 1.5 months. Pregnancy less than 3 months, abortion or ectopic pregnancy enjoy 1 month.

5, maternity living allowance standard (maternity women pay social insurance premiums for a total of one year):

(1) Employed women: calculated and paid according to the payment base of urban old-age insurance premium in the month when I gave birth or miscarried, multiplied by the number of years of maternity living allowance I enjoyed according to regulations.

(2) Self-employed industrial and commercial households and their helpers and freelancers: the maximum salary shall not exceed the average monthly salary of employees in this city in the previous year.

(3) Unemployed women within the period of receiving unemployment insurance benefits: calculated and paid according to the unemployment insurance standard of the month when I gave birth or miscarried, multiplied by the period of maternity living allowance that I enjoyed according to regulations. For example, a 25-year-old professional woman with a monthly income of 2,500 yuan can enjoy a living allowance of about 2,500 yuan per month for three months, plus a maternity medical subsidy of 2,500 yuan, which is about 1 10,000 yuan.

(4) Subsidy standard for maternity medical expenses: if you are pregnant for more than 7 months (including 7 months) or premature for less than 7 months, you will enjoy 2500 yuan. Pregnant for more than 3 months (including 3 months), spontaneous abortion for less than 7 months, enjoy 400 yuan. Pregnancy less than 3 months, spontaneous abortion or ectopic pregnancy, enjoy 200 yuan. If you don't pay maternity insurance, you can't enjoy the above treatment. If you have maternity insurance, you should get it at the local social security center.

Maternity insurance reimbursement conditions

1, insured employees must pay for one year (including one year) to enjoy maternity insurance benefits;

2, the insured workers due to birth or family planning surgery and other expenses.

birth insurance reimbursement process

1. Insured employees give birth outside the overall planning area or in non-designated medical institutions due to emergency and first aid (including business trips, family visits, vacations, etc.). ), the employer or I shall report to the medical insurance agency by telephone within three working days.

2 medical expenses incurred after the approval of the medical insurance agency shall be paid by the individual first.

3. Carry the above materials to the medical insurance agency for settlement within 90 days after discharge. In the overall planning area or non-designated medical institutions for medical treatment, it is necessary to clarify the hospital level, and those who cannot determine the level are regarded as first-class hospitals.

Time limit for reimbursement of maternity insurance

Maternity insurance is a social policy that the state provides economic and material assistance to maternity workers through social insurance legislation. Its purpose is to provide maternity allowance, maternity leave and medical services for female workers, to ensure their basic economic income and medical care when they temporarily lose their working ability due to childbirth, and to help female workers recover their working ability and return to work, thus reflecting the support and care given to women by the state and society in this special period.

Maternity insurance should be purchased continuously for 12 months, reimbursed within 18 months after the baby is born, and insured at the same time. Maternity insurance is a typical local policy, which varies from 10 months to 6 months or even lower. Therefore, the local social security center should prevail.

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