Dalian maternity insurance reimbursement standard 2023

Dalian maternity insurance reimbursement standard 2023:

1, medical treatment:

(1) prenatal examination fees: fixed reimbursement of 800 yuan. You can apply for it through the online service hall or at the window of the health insurance office in each district of the city from the next month after the delivery;

(2) medical expenses for hospitalized delivery: local hospitalized deliveries or deliveries in hospitals that can be networked and directly billed with a card for the record will be reimbursed according to the corresponding hospitalization reimbursement ratio; for cash advances for hospitalized deliveries in a foreign country, the flat rate will be reimbursed at 3,000 yuan;

(3) medical expenses for family planning surgeries : Male and female employees who undergo family planning surgery are entitled to a fixed amount of reimbursement, and are discharged from the hospital with a card for settlement directly, without the need for individual reimbursement procedures.

2. Allowance treatment:

(1) Conditions for receiving the allowance: If an active employee (or his/her spouse) in the employing unit pays maternity insurance premiums in full and on time during pregnancy, the employee shall be entitled to maternity allowance treatment;

(2) Calculation method: the average monthly maternity insurance contribution base for the previous year of the employing unit during the period of pregnancy is taken as the base of the treatment, and the allowance is equal to the base of the treatment/30 days*maternity leave (Nursing leave) days;

(3) Payment time: from the month following the birth of a child, you can submit declarations through the online service hall or to the district health insurance offices, the treatment review through the beginning of the following month, the payment will be made to the bank account provided by the participant, which can be queried in the corresponding bank's financial function.

Employees enjoying maternity insurance benefits should have the following conditions at the same time:

1, the employer has been paying social security for the employee for a certain period of time;

2, has been filed for the record of enrollment, and give birth to a child in the local area;

3, the local Human Resources and Social Security Bureau required by other conditions.

In summary, maternity insurance is a social insurance system in which the state adopts legislation to provide medical services, maternity allowances and maternity leave by the state and society in the event of temporary interruption of labor for women workers who are pregnant and give birth, and in which the state or society provides the necessary financial compensation and medical care for workers who give birth. Maternity insurance benefits consist of two main items. The first is the maternity allowance and the second is the maternity medical treatment. Its purpose is to help working women recover their labor capacity and return to work by providing them with maternity benefits, medical care and maternity leave.

Legal basis:

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

Where an employer has paid maternity insurance premiums, its employees are entitled to maternity insurance benefits; the employee's unemployed spouse is entitled to maternity medical treatment 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.