Changsha maternity insurance reimbursement standard 2023

The reimbursement standards for maternity insurance in Changsha in 2023 are as follows:

1, reimbursement standard for maternity medical expenses:

(1) Prenatal check-up fee: before the 20th week of pregnancy, the prenatal check-up fee will be paid per head, and the outpatient check-up fee for singleton pregnancy will be reimbursed to 600 yuan, and the outpatient check-up fee for multiple pregnancy will be reimbursed to 700 yuan;

(2) Expenses related to childbirth and pregnancy: reimbursement shall be made according to the overall payment items and payment standards in the overall planning area;

(3) Birth control and family planning operation expenses: expenses shall be reimbursed according to the overall payment items and payment standards in the overall planning area. Within an insurance year, the expenses for the second and above termination of pregnancy do not enjoy maternity insurance benefits.

2. Payment standard of maternity allowance: the average monthly payment base of employees of the employer in the previous year /30 days * maternity leave days. In other words, the higher the average monthly payment base of employees in the previous year and the longer the maternity leave days, the more maternity allowance employees can get.

Changsha maternity insurance reimbursement conditions are as follows:

1, in line with national, provincial and municipal family planning policies;

2. Employers and employees shall participate in maternity insurance in Changsha as required;

3. Continuous payment 10 month. Changsha can enjoy maternity allowance if it continuously pays maternity insurance premium 10 month (including those paid within 3 months and can provide valid proof of labor relations); If the payment is overdue for more than 3 months, you can enjoy the maternity allowance from the date of normal payment 10 months later.

Changsha maternity insurance reimbursement process is as follows:

1, born locally: insured employees can bring medical insurance manuals and birth certificates to the medical insurance department of designated hospitals for filing and registration. After filing, the hospital's maternity medical expenses are directly settled;

2. Giving birth in different places: the applicant shall go through the reimbursement procedures at the medical insurance centers in various districts or the medical insurance department for urban and rural residents of the Municipal Medical Insurance Bureau.

To sum up, maternity insurance system is a social insurance system that the state or society provides necessary economic compensation and medical care for maternity workers. It is an important part of social security system and plays an important role in improving fertility quality. Maternity insurance is one of the five social insurances. The insured can enjoy the corresponding medical insurance, maternity allowance and other benefits when paying maternity insurance. Of course, you need to pay maternity insurance benefits continuously. The residents' medical insurance fund subsidizes the prenatal examination fees and maternity medical expenses of the insured residents.

Legal basis:

Article 54 of the Social Insurance Law of People's Republic of China (PRC)

The employer has paid maternity insurance, and its 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.

Eleventh "Hunan province urban workers maternity insurance measures"

The following medical expenses incurred during the maternity and birth control period of the employees of the employer shall be paid by the maternity insurance fund:

(1) Expenses for examination, delivery, operation, hospitalization and medicine necessary for delivery or termination of pregnancy;

(two) the cost of placing or taking out the intrauterine device;

(three) the cost of taking contraceptive measures other than contraceptives;

(four) the cost of sterilization and vasectomy;

(five) the cost of treating complications within the scope of the second paragraph of this article.

The medical expenses caused by the complications caused by childbirth and termination of pregnancy, sterilization, vasectomy and fallopian tube recanalization of the employees of the employer during maternity leave shall be paid by the maternity insurance fund; The expenses for continuing treatment after the expiration of maternity leave and the medical expenses for treating other diseases during maternity leave shall be handled in accordance with the basic medical insurance measures. However, according to the provisions of relevant laws and regulations, the medical expenses of complications shall be borne by the unit performing the operation.

The specific scope and standards of the expenses in the first paragraph of this article shall be formulated by the provincial labor and social security administrative department in conjunction with the provincial finance, price, health, population and family planning administrative departments.