The scope and standard of maternity insurance reimbursement in Foshan city

Legal analysis: 1. Reimbursement standard: Insured employees meet the conditions for sporadic reimbursement of medical expenses such as spontaneous abortion, prenatal examination, childbirth, etc. If the expenses that meet the requirements of maternity insurance are lower than the settlement standard of designated medical institutions at the same level in this city, they will be reimbursed according to the actual expenses that meet the requirements of maternity insurance; If it is higher than the settlement standard of designated medical institutions at the same level in the city, it will be reimbursed according to the settlement standard.

2. Reimbursement scope: (1) Maternity medical expenses incurred by insured employees who have gone through the examination and approval procedures for medical treatment in different places and have been working in different places for a long time, such as prenatal examination and/or delivery hospitalization in selected medical institutions in different places;

(two) have received the "medical confirmation certificate" of the insured workers, in the non designated medical institutions emergency, rescue delivery or abortion hospitalization or outpatient medical expenses;

(three) maternity medical expenses incurred by the insured workers in medical institutions approved by social security agencies outside the city.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Fifty-fourth employers have paid maternity insurance premiums, and their employees enjoy maternity insurance benefits; Unemployed spouses of employees enjoy maternity medical expenses in accordance with state regulations. The required funds are paid from the maternity insurance fund.

Maternity insurance benefits include maternity medical expenses and maternity allowance.

Fifty-fifth maternity medical expenses include the following:

(1) Maternity medical expenses;

(two) family planning medical expenses;

(3) Other project expenses stipulated by laws and regulations.

Fifty-sixth employees in any of the following circumstances, can enjoy maternity allowance in accordance with state regulations:

(1) Female employees enjoy maternity leave;

(2) Enjoy family planning operation leave;

(3) Other circumstances stipulated by laws and regulations.

Maternity allowance is calculated and paid according to the average monthly salary of employees in the previous year of the employer.