Maternity insurance did not pay enough for a year to give birth to a child can be reimbursed?

If a participant is pregnant or undergoes a family planning operation while enrolled in maternity insurance but has not paid the accumulated contributions for one year, he or she can apply for reimbursement after the accumulated contributions have been paid.

In addition, the following two cases can also be reimbursed as incidental expenses for maternity insurance:

1. Maternity medical expenses incurred by a participant for emergency medical treatment in a non-selected medical institution, medical treatment in a foreign place with authorization, and in other cases in accordance with the regulations

2. If you have not applied for confirmation of medical treatment or have not sought medical treatment according to the regulations, you can apply for a one-time subsidy for maternity medical expenses within 1 year after delivery, abortion or family planning surgery

How to reimburse maternity insurance if you haven't paid for it for a full year

I. Required materials for reimbursement

(1) Basic materials

1. Application for medical treatment of maternity insurance for employees;

2. Specialized receipts for medical expenses printed by the finance and taxation department or special receipts printed by the taxation department. Receipts or invoices printed by the tax authorities;

3. A summary list of medical expenses;

4. Proof of compliance with family planning regulations (subject to the latest regulations on family planning of the administrative department of health and planning, and copies of the originals will be kept after verification).

(2) Special materials for different types of medical services

1. Outpatient services: outpatient medical records (original verified and copies kept).

2. Inpatient services: inpatient medical records or discharge summary, diagnostic certificates (all need to be stamped with the official seal of the medical institution or business seal, the original verified and retained copies).

(C) other types of business special materials

1. Approved in the off-site medical treatment, but also need to provide the original application for the "Employee Maternity Insurance Medical Confirmation Application Form", and by the off-site delivery or implementation of family planning surgery hospitals to fill in the level of hospitals and stamped with the official seal of the hospital or business chapter.

2. If a participant applies for reimbursement of maternity medical expenses after having paid maternity insurance premiums for a total of 12 months, the participant is also required to supplement the labor contract or the employer's proof of recruitment (in case of labor dispatching, the labor dispatching agreement is also required to be provided); proof of payment of wages during the employment period of the employee; and the employer's business license or certificate of registration or institutional code (the original of the original is verified and then a copy of the original is stored, and the copy is stamped with the official seal of the unit).

3. If the unemployed spouse of the insured male employee has not completed the procedures for confirming the birth of a child, he or she is also required to provide:

(1) Marriage certificate (a copy of which will be retained after the original is verified);

(2) Proof that the unemployed spouse of the male employee is not entitled to the basic urban and rural residents' medical insurance (including the basic medical insurance for urban residents or the new type of cooperative medical care for the rural areas) (a copy of which will be retained after the original is verified). The original is verified and a copy is retained.

Description: refers to the domicile of the county above the social insurance agency or health department issued by the basic medical insurance for urban and rural residents (including basic medical insurance for urban residents or the new type of rural cooperative medical care) of the certificate (the original verified and retained a copy of the original) and a valid municipal unemployment registration documents (need to be unemployed during pregnancy registration of the filing of information that can be queried through the information **** enjoy, no need for individuals to provide). provide).

4. If both the husband and wife are foreigners, they do not need to provide proof of compliance with family planning regulations, but they should provide:

(1) proof of employment information (original verification and retention of photocopies);

(2) valid passports of the husband and wife or Hong Kong, Macao and Taiwan Travel Permit (original verification and retention of photocopies).

5. If you apply for disbursement to your personal account, you also need to provide a copy of the front page of the passbook or bank card of the person who opened the account for disbursement in the city.

6. If, for personal reasons, the participant's birth control medical expenses should have been recorded in the medical institution but were not, the participant is also required to provide proof of the reason for not being able to record the expenses from the medical institution.

7. Delegation:

(1) Delegation to another person: a power of attorney, a copy of the delegator's identity document, a copy of the social health insurance voucher, and the original and a copy of the delegatee's identity document are required.

(2) the unit operator: by providing the unit introduction letter and a copy of the operator's ID card in advance in the corresponding health insurance agency for the record, in the handling of the unit of participants in the individual business only need to show the operator's original ID card.

Two, the process

1. unit operator (agent) with relevant information to the second level of the health insurance agency to apply for processing;

2. comply with the provisions of the second level of the health insurance agency to accept the application of the unit operator (agent), and entered into the system;

3. second level of the health insurance agency to audit, settlement of the application for the medical expenses;

4. After the second-tier operator of MPS examines and approves the application, it transmits the settlement of medical expenses to the Municipal Social Security Fund Center, which disburses the medical expenses.

Legal basis:

Provisions on the Labor Protection of Female Workers and Employees

Article 8 The maternity allowance during the maternity leave of female workers shall be paid by the Maternity Insurance Fund in accordance with the standard of the average monthly salary of the employees of the employing unit in the previous year for those who have taken part in the maternity insurance; and the standard of the wages of the female workers before the maternity leave shall be paid by the employing unit in accordance with the wage of the female workers before the maternity leave for those who have not taken part in the maternity insurance. For female workers who have not participated in maternity insurance, the payment shall be made by the employer in accordance with the wage of the female worker before her maternity leave. The medical expenses for the birth or miscarriage of a female worker shall be paid by the Maternity Insurance Fund for those who have participated in the maternity insurance and by the employer for those who have not participated in the maternity insurance in accordance with the items and standards stipulated in the maternity insurance.