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Medical insurance reimbursement process for delivery
Reimbursement process:

Insured employees who meet the following conditions can enjoy maternity insurance benefits according to regulations:

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

2. When giving birth or carrying out family planning operation, the employer has participated in maternity insurance and paid the maternity insurance premium in full 12 months.

3, prenatal examination fees and production costs, the parties bring a marriage certificate, social security card (citizen card) and family planning certificate issued by the street to the maternity insurance designated hospital direct credit card settlement.

4. To declare maternity allowance and one-time nutrition allowance, you need to fill in the maternity insurance benefits declaration form and affix the official seal of the unit, provide marriage certificate, one-child certificate (for children), discharge summary and other materials, and go through the declaration formalities at the obstetrics department of the municipal medical insurance center on the working day between 1- 10 every month. (Go through relevant formalities within one year after delivery)

Declare payment

1, application materials

(1) social insurance registration form;

(2) to participate in the basic pension, work injury, maternity insurance personnel increase or decrease table;

(3) Summary of basic pension, work injury and maternity insurance declaration for enterprise employees.

2. Procedure:

(1) The employer shall report to the business hall of the social labor insurance department with the application materials;

(2) The staff accepts the application materials, seals them after approval, and returns the summary table 1 copy and the increase and decrease table 1 copy;

(3) The employer shall pay the fee to the local tax department in the following month.

Extended data:

Insurance benefits

1, reporting conditions

(1) The employees of enterprises whose units have participated in childbirth or family planning operations and fulfilled their payment obligations according to regulations have paid maternity insurance premiums for them for a total of 3 months.

(2) Employees who have given birth or performed family planning operations in line with the national family planning policy.

2. Application materials

(1) Family planning certificate issued by the family planning department (original and photocopy)

(2) certificate of birth (death) of the baby issued by the medical department (original and photocopy)

(3) Female employees and family planning operation workers' ID cards (original and photocopy).

(4) Approval Form for Maternity Medical Certificate of Enterprise Employees

(5) Application form for family planning operation diagnosis of enterprise employees

(6) Application form for reimbursement of maternity medical expenses for enterprise employees

(7) the maternity insurance benefits of enterprise employees approved statement

(8) The Application Form for Maternity Insurance of Enterprise Employees for Medical Treatment in Different Places.

(9) original materials such as maternity medical bills, expense lists, outpatient medical records and discharge summaries.

(10) Receipt

operation sequence/order

(1) After a female worker is pregnant, before abortion or family planning operation, the employing unit or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance agency for handling;

(2) After the staff accepts the examination and approval, they will issue medical certificates;

(3) Within 30 days of maternity leave, the employing unit or the staff of the street or town labor security service station shall bring the application materials to the maternity insurance window of the district social labor insurance agency for treatment settlement;

(4) After the staff accepts the examination and approval, they will pay maternity medical expenses and maternity allowance.

Workers 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 surgery leave;

(3) Other circumstances stipulated by laws and regulations.

(Average monthly salary of employees in the last year of the employer where employees work /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) The maternity leave for late childbirth is increased by 15 days;

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

⑤ The maternity leave of multiple births is increased by 15 days for each additional baby;

⑥ Abortion leave: less than 2 months pregnant 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, the survival time is less than 75 days.

Baidu encyclopedia-maternity insurance