How much can I reimburse for natural childbirth?

The proportion of medical insurance reimbursement for ordinary employees in secondary hospitals is about 85%. If you choose a tertiary hospital, the proportion of medical insurance reimbursement for employees will be around 75%.

But it depends on your own consumption level. Different regions charge different fees. Municipal hospitals and county hospitals charge different fees, and so do public hospitals and private hospitals. Medical insurance for employees generally has designated hospitals. If you are hospitalized in a designated hospital, the reimbursement rate will be higher. You can consult the local medical insurance department. If dystocia occurs during natural delivery, drugs or materials may be used at their own expense, which will affect the reimbursement ratio. The reimbursement of employees' medical insurance and residents' medical insurance is different, and the reimbursement amount is different due to different production methods. In addition, different levels of hospitals have different reimbursement quotas.

If you use employee medical insurance to reimburse, you can basically reimburse about 60% to 80% of the expenses. However, maternity insurance is included in the social security handled by employees, so it is basically reimbursed by maternity insurance. If female employees give birth, maternity insurance can generally be reimbursed by more than 75%.

If residents' medical insurance is used, 300 yuan will be given a fixed subsidy in the designated hospitals at the township level; In the designated hospitals at or above the county level, 450 yuan will be given a fixed subsidy. However, if it is a caesarean section, the general medical expenses can only be reimbursed if it exceeds 2,000, and between 2,000 and 7,000, it can be reimbursed by 45%; The part exceeding 7000 can be reimbursed by 65%.

What is the principle of reimbursement for natural childbirth?

According to the relevant laws and regulations, employees can enjoy maternity allowance, maternity medical expenses, one-time maternity nutrition subsidy and one-time subsidy as long as they have participated in maternity insurance for one year. Among them, the maternity allowance must be handled within five months after birth, otherwise it will be invalid.

Employees who have participated in maternity insurance for a total of 1 year are still insured when they give birth (abortion) and enjoy maternity insurance benefits according to relevant regulations.

Maternity allowance: (per capita salary of the unit in the current month /30 days * holiday days)

Holidays:

1, normal maternity leave is 90 days (including prenatal examination 15 days);

2. The one-child leave is increased by 35 days;

3. Late maternity leave increased by 15 days;

4. Difficult maternity leave. Caesarean section and third degree rupture of perineum increased by 30 days; Suction delivery, forceps delivery and breech delivery increased 15 days;

5. Multiple birth leave, every additional baby 15 days;

6. Abortion leave: less than 2 months of pregnancy 15 days; Less than 4 months and 30 days pregnant; 4 months or more (including 4 months) to 7 months is 42 days; In case of stillbirth, stillbirth or premature delivery for more than 7 months, it takes 75 days.

legal ground

Article 53 of the Social Insurance Law of People's Republic of China (PRC)

Employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with state regulations, and employees shall not pay maternity insurance premiums.

Article 53 of the Social Insurance Law, employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with state regulations, while employees shall not pay maternity insurance premiums. 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-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.