What is the scope and standard of Nanjing maternity insurance reimbursement in 2021?

Nanjing Maternity Allowance Receipt Conditions and Process 2021 Reimbursement Conditions 1. Comply with relevant family planning laws and regulations; 2. When giving birth or performing family planning surgery, the employer has participated in maternity insurance and paid maternity insurance premiums in full and without interruption for 10 consecutive months.

month; 3. Prenatal check-up, prenatal or hospitalization due to birth complications within 4 months after delivery must be in normal payment status.

If the employee's employer pays the maternity insurance premium in full and on time, the employee shall enjoy maternity insurance benefits in accordance with laws and regulations; the employee's unemployed spouse shall enjoy maternity medical expense benefits in accordance with laws and regulations.

The required funds are paid from the maternity insurance fund.

When an employee or the employee's unemployed spouse gives birth, has a miscarriage, induces labor, or undergoes family planning surgery, and the employer pays for the employee's continuous payment for less than 10 months, the employee's maternity medical expenses or the employee's unemployed spouse's medical expenses for childbirth shall be paid by the maternity insurance fund;

The employee's maternity allowance and one-time nutritional subsidy will be paid by the maternity insurance fund after the employer has paid continuously for 10 months.

Reimbursement materials 1. Maternity insurance reimbursement materials for female employees 1. Nanjing maternity insurance benefit declaration form; 2. Original marriage certificate; 3. Only child certificate; 4. Discharge record; 5. Discharge summary; 6. Hospitalization note; 2. Male

Employee maternity insurance reimbursement materials 1. Nanjing Maternity Insurance sporadic reimbursement application form 2. Marriage certificate; 3. Only child certificate; 4. Discharge summary or outpatient medical records; 5. Hospitalization notes and outpatient notes; 6. Spouse's "Employment Registration Certificate"

; 7. Unemployment certificate issued by the street (township).

Reimbursement process 1. Prepare the above information.

2. Calculation of benefits payment for the Fertility Department of the Social Security Center.

3. Review by the Finance Department of the Social Security Center.

4. The leader in charge of the Social Security Center shall review and distribute the funds.

Reimbursement standards: The reimbursement scope of Nanjing maternity insurance includes prenatal examination fees, childbirth medical expenses, birth complications, family planning surgery fees, one-time nutrition subsidies, etc.

The specific amounts are as follows: (1) The maximum reimbursement for medical expenses incurred during childbirth is 2,000 yuan, the maximum reimbursement for assisted delivery is 2,200 yuan, and the maximum reimbursement for caesarean section is 3,500 yuan.

(2) Fertility complications: Medical expenses incurred by 27 types of fertility complications, and all of them meet the payment scope and standards of maternity insurance, can be reimbursed on a proportional basis.

(3) One-time nutritional expenses: paid by the maternity insurance fund, and the payment standard is 2% of the average salary of Nanjing employees in the previous year.

(4) Family planning surgery costs: Different surgeries have different reimbursement rates.

(5) Prenatal examination fees: For examinations at registered designated hospitals, you must first pay the examination fees yourself, and then bring the relevant vouchers to the social security agency for reimbursement.