Hangzhou maternity insurance how to reimbursement process

1. Payment of maternity benefits for enterprises belonging to ministries, provinces and municipalities, public institutions and private non-enterprise units, as well as payment of benefits for retired persons, will be handled at the window of the Municipal Social Security Bureau's business hall for work-related injuries and births;

2. Payment of maternity benefits for enterprises belonging to districts will be handled at the social security business halls of the districts to which they belong.

Two, acceptance time

Monday to Friday (except national holidays)

Three, processing vouchers

(I) Maternity Treatment Payment Declaration Materials

1. Participating employers fill out the "Hangzhou Employees' Maternity Insurance Expense Payment Declaration Form" (one copy), and affix the unit's official seal;

2, Reproductive health service certificate of the declared household union (copy), the issuing unit stamped unclear copy, need to be accompanied by the original;

3, the baby's birth medical certificate or medical diagnosis of infant death (copy);

4, hospitalization medical invoices at the time of delivery (copy);

5, medical diagnosis of maternity issued by the medical department (original);

6, hospitalization or discharge, the medical record on the birth of childbirth (original);

(2) family planning surgery treatment payment declaration materials

1, insured employers to fill out the "Hangzhou Employees' Maternity Insurance Expenses Payment Declaration Form" (one copy), and stamped with the official seal of the unit; (Retirees fill out the report on their own)

2, family planning surgery Medical invoice (copy);

3, medical diagnostic certificate of family planning surgery issued by the medical department (original);

4, outpatient or hospital discharge, medical records on the implementation of family planning surgery (original);

(C) reimbursement of maternity expenses exceeding the payment standard of more than 4,000 yuan

Reimbursement of female employees Reimbursement of maternity medical expenses exceeding the payment standard of more than 4,000 yuan in line with the scope of expenses under the basic medical insurance, in addition to submitting the declaration materials in accordance with the provisions of the above (a), it is also necessary to provide all the original medical invoices for outpatient, hospitalization, medical expense lists and relevant medical records;

Processing results

1. The insured employer submits the declaration materials by the 12th of each month. The social security agency, after examination, after the 20th of the month with the acceptance form to the Municipal Social Security Bureau business hall work injury maternity window (district enterprises to the urban social insurance office) to receive a receipt, maternity insurance treatment costs through the month's settlement of a one-time payment to the employee's unit;

2, insured employers in the 12th of each month after the submission of declarations by the social security agency, after examination, after the 20th of the next month with a receipt to the social security agency, in the next month, after the first day of the month with a receipt to the social security agency, after the second day of the month with a receipt to the social security bureau, after the second day of the month to the social security bureau. After the 20th of the month with the acceptance form to the social security bureau business hall work injury maternity window (district enterprises to the urban social insurance office) to receive a receipt, maternity insurance treatment costs through the settlement of the following month a one-time payment to the employee's unit;

3, retirees declared before the 5th of the month, the social security agency audit, on the 15th of the month, the allocation of the pension to the social account, the 5th of the month, the declaration of the next month, the processing of the next month, the allocation.

Note

1, the employer must be in the female workers postpartum or family planning surgery within six months after the social security agency for the declaration of maternity insurance benefits, beyond the specified acceptance time will not be accepted;

2, female workers due to complications arising from maternity of medical costs, is not part of the scope of maternity insurance payments.

The conditions for reimbursement

(1) giving birth in accordance with the national family planning policy or carrying out family planning surgery

(2) participating in the maternity insurance in accordance with the provisions of the unit and contributing in full for the employee for more than one year

(3) giving birth in a designated medical institution, carrying out an artificial termination of pregnancy surgery, as well as carrying out a family planning surgery in a designated family planning technical service institution. family planning surgery.

Reimbursement standards

The duration of maternity leave for which the maternity allowance is paid is as follows:

(1) 98 days for births in the seventh month of gestation or above, or premature births; an additional 0.5 month for cesarean sections and assisted deliveries in the event of a difficult birth; and an additional 0.5 month for the births of multiple births, for each additional child.

(2) In case of miscarriage or induced abortion in the third month of pregnancy or above, or in the seventh month of pregnancy or below, 1.7 months shall be counted.

(3) In case of miscarriage (including spontaneous and induced abortion) in less than 3 months of pregnancy, 1 month shall be counted.

Maternity medical expenses

1. Maternity medical expenses incurred by female workers during pregnancy, childbirth and puerperium shall be paid in accordance with the regulations if they are covered by maternity insurance.

2. If a female worker gives birth in a designated medical institution of the city's basic medical insurance, she shall settle the maternity medical fees in accordance with the provisions of the basic medical insurance for employees; if a female worker gives birth abroad, the maternity medical fees incurred in the designated medical institution of the place where she gives birth shall be paid in full by the individual, and then settled in accordance with the provisions of the basic medical insurance for employees by the medical insurance agency in the place where she is co-ordinating her birth.

3, female workers in childbirth, the employer has been in accordance with the provisions of the registration procedures for their participation in the maternity insurance, maternity insurance premiums paid for 12 consecutive months, in line with the national, provincial and municipal provisions of the conditions of childbirth, the social insurance agencies to pay a separate maternity medical subsidies, cesarean section 2000 yuan, 1500 yuan of assisted delivery, and normal delivery (including normal delivery, abortion, induced delivery) 1000 yuan.